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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A boy 13 year-old suffered an extremely severe and prolonged attack of hemorrhagic chickenpox with visceral involvement, the diagnosis being confirmed by isolation of varicella-zoster-virus (VZV). There was no other compromising disease. All preceding vaccinations including two against smallpox had been uneventful. The severity of the attack could not be ascribed to any persistent cellular or humoral immunodeficiency. The patient developed a good antibody response. The course of serological reactions to VZV infection was studied extensively using the different techniques of complement fixation and immunofluorescence for IgG, IgM, and IgA antibodies. Therapy was conducted cautiously using cytosine arabinoside (Ara-C) between the 10th and 17th day of disease; the temperature fell and VZV multiplication ceased, strongly suggesting a beneficial influence on the patient, who recovered completely.
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PMID:Severe hemorrhagic varicella with visceral involvement: virological and serological studies during treatment with cytosine arabinoside. 18 29

An attempt was made to evaluate the humoral and cellular immune status of preterm and small for dates babies born at All India Institute of Medical Sciences Hospital. The study sample included 24 term small-for-dates babies and 12 preterm babies (gestation of less than 37 weeks) and 20 term appropriate-for-dates babies who served as controls. The small-for-dates babies were subdivided into the following 2 subgroups on the basis of severity of intrauterine growth retardation (IUGR): mild IUGR -- babies weighing between 3rd and 10th percentile for their gestation; and severe IUGR -- babies weighing less than 2 S.D. or 3rd percentile for their gestation. The levels of immunoglobulin G (IgG), M (IgM), and A (IgA) were determined in the cord blood using the single radical diffusion technique. The B-lymphocytes were identified and counted by the surface membrane immunoglobulin (SmIg) using immunofluorescence technique. The cellular immune response was assessed by counting T-lymphocytes by E-rosette technique employing sheep red blood cells. The neonates with severe IUGR and preterm babies had significantly lower levels of IgG. The levels of IgM and IgA did not differ significantly in the 4 groups. The preterm babies had significantly higher percentage of B-lymphocytes though the absolute count was not significantly different from normal newborn babies. The absolute count B cells was significantly low in babies with severe IUGR. The babies with severe IUGR had significantly low absolute and percentage count of E-rosette forming cells as compared to normal newborn babies. The findings suggest that low birth weight babies with severe IUGR are at a greater risk to develop bacterial infection due to deficiency of both humoral and cellular immune host defenses. In contrast, preterm babies are immunologically competent though passively transferred maternal IgG levels are low. It is desirable to study the duration of immunodeficiency caused by severe IUGR and its reversibility on nutritional rehabilitation. In view of the wide prevalence of IUGR in India it is possible that inadequacy of cell mediated immune response in these infants may be associated with poor "takes" following at birth BCG and small pox vaccinations. The vaccination schedule may have to be modified depending upon the duration of immunodeficiency in babies with IUGR.
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PMID:Immune status of low birth weight babies. 56 31

Short-time (< or = 7 days) cultures of trophoblast mononuclear cells isolated from term placentae were challenged with vaccinia virus. Cytopathic effects were induced in crude placental cell preparations as well as in cultures established after negative immunosorting of major histocompatibility complex class I epitope-expressing cells, i.e. cultures exclusively derived from villous cytotrophoblast according to our present state of knowledge. The trophoblast in vitro supported a full replicative cycle of both wild-type viruses and a recombinant clone serving as a vector for the human immunodeficiency virus type 1 envelope gene. Results may shed light on mechanisms involved in the rarely observed foetal damage caused by smallpox vaccination during pregnancy.
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PMID:In vitro infection of human placental trophoblast by wild-type vaccinia virus and recombinant virus expressing HIV envelope glycoprotein. 148 Aug 24

After years of decreasing prevalence and increasing hope that tuberculosis, like smallpox, could be eliminated, the disease has resurfaced as a major public health problem in the United States. Particularly ominous are the appearance of multiple-drug-resistant strains and their impact on patients and health care workers who are infected with the human immunodeficiency virus, among whom mortality rates reach 80% 2-3 months postdiagnosis. To respond effectively to this new threat, it is critical that we reorient our thinking about tuberculosis and redirect health care resources to programs for tuberculosis control. We need to reinstitute screening of high-risk populations and ensure proper isolation of patients with the disease. Diagnosing tuberculosis at the earliest possible stage is obviously of the utmost importance. High priority must be given to the development of rapid diagnostic tests and techniques that screen for drug resistance. We must implement and adequately fund drug-discovery programs to develop new therapeutic agents that are effective against multiple-drug-resistant strains of Mycobacterium tuberculosis. Effective programs for monitoring the treatment of patients with tuberculosis must also be implemented. Failure to adequately support such programs has probably led to the recent upswing in multiple-drug-resistant tuberculosis, especially in large cities along the eastern seaboard. Leadership for and funding of these programs must come from the federal government, specifically the U.S. Department of Health & Human Services and the Centers for Disease Control (Atlanta). The Infectious Diseases Society of America is actively supporting a variety of tuberculosis control-related initiatives and will keep its members updated on progress in this area.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Impact of human immunodeficiency virus infection on the epidemiology, clinical features, management, and control of tuberculosis. 152 Aug 6

In a randomised phase I trial of a recombinant vaccina virus vaccine expressing the gp160 envelope gene of the human immunodeficiency virus (HIVAC-1e) 35 healthy, HIV-seronegative males, 31 of whom had a history of smallpox immunisation and 4 of whom were vaccinia naive, were vaccinated and then boosted 8 weeks later with HIVAC-1e or standard NY strain vaccinia virus. The frequency, duration, and titre of virus isolation from the vaccination site and occurrence of local side-effects were similar between the two groups of vaccinees. Vaccinia-naive (vac-n) subjects shed virus from the vaccination site for longer and at a higher titre than did vaccinia-primed (vac-p) individuals (19 vs 7 days and 10(7) vs 10(5) pfu/ml, respectively). In-vitro T-cell proliferative responses to one or more HIV antigen preparations developed in 13 of 16 vaccinia-primed subjects inoculated with HIVAC-1e. T-cell responses were, however, transient and in no subject did antibodies to HIV become detectable. The 2 vaccinia-naive subjects vaccinated with HIVAC-1e showed strong T-cell responses to homologous and heterologous strains of whole virus and to recombinant gp160 protein that remained detectable for over a year; antibodies to HIV envelope also developed in both. Recombinant vaccinia virus vaccines induce T-cell priming to the foreign gene products in most individuals. If used as the sole immunising agent they will be most efficacious in vaccinia-naive individuals.
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PMID:Safety of and immunological response to a recombinant vaccinia virus vaccine expressing HIV envelope glycoprotein. 167 28

The Centers for Disease Control reported that 109,167 cases of AIDS had been diagnosed since 1981 and that approximately 40,000 persons were living with AIDS at the time of this writing. These numbers, however, are the tip of an iceberg that consists of approximately 1.5 million Americans who are infected by the human immunodeficiency virus (HIV). As we described in earlier articles of this series, the HIV infection/AIDS epidemic has invaded the domain of the American family through heterosexual transmission, vertical transmission, drug abuse, and sexual abuse of children. Therefore, physicians for children are now facing the prospects of having to deal with this disease in their practices. If there is something unique about pediatrics and other specialties of the medical profession dealing with infants and children, it is that "prevention" of disease can be and has been used effectively. One only needs to remember the 1950s, when the poliomyelitis epidemic was causing the same, if not greater, concerns in the lives of the American families. The development and application of the "polio" vaccines has virtually eliminated the threat of poliomyelitis in our society. Similarly, the incidence of diphtheria, tetanus, and smallpox has decreased to the point that these diseases present practically no threat to the US population. Armed with these positive experiences, we need to examine what we can do today to curb the spread of the HIV infection/AIDS among infants and children, and by extension, among the general population of our country.
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PMID:Pediatric AIDS: prevention of HIV infection in infants and children. 240 77

Current experience with the safety and efficacy of vaccines in infected children and adults is reviewed to examine the basis for decisions about routine immunisations of children infected with the human immunodeficiency virus (HIV). No adverse reactions to inactivated vaccines have been noted, but complications with live vaccines have been recorded with both BCG and smallpox. Limited experience with live poliomyelitis and measles vaccines in HIV-infected children has not yet shown any severe complications from these vaccines. Theoretical concerns that immunisation might accelerate the course of HIV infection are not supported by available data. Serological response to most inactivated and live vaccines is reduced in HIV-infected persons, and is related to the degree of immunosuppression present. Preliminary evidence suggests that the severity of some vaccine-preventable diseases is increased in HIV-infected children. This review finds general support for recommendations on immunisation of HIV-infected children that have been developed by the World Health Organisation.
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PMID:Human immunodeficiency virus infection and routine childhood immunisation. 288 50

Progressive vaccinia developed in a previously healthy woman following smallpox vaccination and was successfully treated with vaccinia immune human globulin and methisazone. Immunologic evaluation over the next 4 1/2 years revealed evidence for combined variable immunodeficiency with increased numbers of circulating OKT 8 positive (suppressor-cytotoxic T) cells and the virtual absence of OKT 4 positive (helper-inducer T) cells.
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PMID:Progressive vaccinia associated with combined variable immunodeficiency. 684 20

This survey of the clinical and epidemiological features of human cowpox, a rare but relatively severe zoonotic infection, is based on 54 cases, many unpublished, which we have studied since 1969. Patients present with painful, haemorrhagic pustules or black eschars, usually on the hand or face, accompanied by oedema, erythema, lymphadenopathy, and systemic involvement. Severe, occasionally fatal, cases occur in eczematous and immunosuppressed individuals, although cowpox has not yet been reported in anyone infected with the human immunodeficiency virus. Variations in the clinical features are described, and the differential clinical diagnosis of cowpox, parapox, herpes virus, and anthrax infections is discussed. The role of the laboratory in diagnosis is described, and the value of electron microscopy in providing rapid confirmation is emphasized. Care in taking a detailed history will assist in the initial clinical diagnosis, and a history of contact with domestic cats, particularly during July-October, is important. The possible influence of smallpox vaccination on the incidence and severity is discussed and discounted.
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PMID:Human cowpox 1969-93: a review based on 54 cases. 799 88

Peripheral T lymphocytes can be classified into two groups: naive and memory T cells. The focus of this study was to examine the duration of T-cell memory in humans. Vaccinia virus replicates in the cytoplasm of infected cells and is not thought to persist or become latent after the acute phase of infection. We identified long-lived vaccinia virus-specific memory cytotoxic T cells in adults who had been immunized against smallpox as children. Initially, we detected vaccinia virus-specific T cells in peripheral blood mononuclear cells while screening for human immunodeficiency virus type 1 (HIV-1)-specific T-cell responses in HIV-1-seropositive subjects. These individuals had not had contact with vaccinia virus since their primary immunization in early childhood. Several vaccinia virus-specific CD4+ T-cell clones were derived from these donors and characterized. Healthy, HIV-1-seronegative donors who had been immunized against smallpox many (35 to 50) years earlier were also screened for vaccinia virus-specific T-cell immunity. We found significant CD8+ and CD4+ cytotoxic T-cell responses to vaccinia virus after in vitro stimulation, indicating that these memory cells are maintained in vivo for many years. The peripheral blood mononuclear cells of young adults with no history of immunization against smallpox did not develop vaccinia virus-specific T-cell responses after in vitro stimulation. Precursor frequency analysis of the vaccinia virus-specific memory CD4+ T cells from a donor immunized with vaccinia virus 35 years earlier revealed a frequency of 1 in 65,920 CD4+ T cells. We concluded that specific vaccinia virus T-cell immunity can persist for up to 50 years after immunization against smallpox in childhood in the presumed absence of exposure to vaccinia virus.
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PMID:Human cytotoxic T-cell memory: long-lived responses to vaccinia virus. 864 97


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