Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe two unique cases of pulmonary hypertension in association with the human immunodeficiency virus (HIV) and review the 28 previously reported cases in the world literature. Our first patient has coexistent chronic active hepatitis, which has previously been associated with the development of plexogenic pulmonary hypertension; however, our second case clearly demonstrates a closer link between HIV infection and pulmonary hypertension. Unlike previously reported cases, our latter case was devoid of all other coexistent factors including intravenous drug abuse, hepatitis B antigenemia, coexisting immunologic lung parenchymal injury, and hepatitis. Additionally, this is the first case documenting the presence of asymptomatic type II cryoglobulins in an HIV-positive patient with plexogenic pulmonary hypertension.
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PMID:HIV and pulmonary hypertension: a review. 781 37

Persistent generalized lymphadenopathy has been well described in patients with seropositivity to the human immunodeficiency virus (HIV). Moreover, isolated enlargement of the parotid gland and parotid lymphadenopathy have been noted much more frequently over the past few years. Histologically, these lesions demonstrate follicular hyperplasia, cystic dilatation of the ducts lined by pseudo-stratified squamous epithelium, and lymphocytic infiltrates. They are generally considered to be benign lymphoepithelial lesions of the parotid or hyperplastic periparotid lymph nodes. The relationship of this entity to the AIDS-related complex (ARC) and the subsequent development of AIDS is not clear. Over the past 7 years, we have seen 50 patients with parotid enlargement in whom the diagnosis of benign lymphoepithelial lesion was made. Fine-needle aspiration was performed in 32 patients. Although not conclusively diagnostic, needle aspirates ruled out primary salivary glandular pathology. Most patients gave a history of intravenous drug abuse. HIV tests have been performed on a routine basis only in the last 2 years, and these were positive in the majority of the patients. Thirty-five patients underwent surgical excision. In the initial 20 patients, we routinely performed parotid exploration, identification of the facial nerve, and superficial parotidectomy. In the last 15 patients, we changed our surgical approach to parotid exploration and excision of the mass in the tail of the parotid. The exposure of the posterior belly of the digastric muscle, with identification and removal of the deep jugular node, has become routine. In each case, we found an enlarged lymph node in the deep jugular region, which was not clinically palpable preoperatively. The rate of surgical complications was minimal, and, after resection of the mass, patients improved symptomatically. If the patient shows obvious signs of AIDS, a nonsurgical approach with repeated aspirations should be considered, and treatment with zidovudine offered.
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PMID:Benign lymphoepithelial lesions of the parotid. 821 2

Intravenous drug abusers often resort to deep cervical venous access if peripheral access is problematic. Deep cervical injection can occasionally result in needle breakage and needle foreign body. The records of 50 patients with neck needle foreign bodies related to intravenous drug abuse treated at The Johns Hopkins Hospital were reviewed retrospectively. Only half of these patients presented to this hospital with a complaint of a neck needle. Complications related to neck needles were manifested in 5 (10%) of the patients at the time of initial presentation. No delayed complications occurred. Human immunodeficiency virus seropositivity for this group of patients was 77% compared to a rate of 29% for all intravenous drug abusers at the same institution. The demographics and management of neck needle foreign bodies are discussed, and the importance of recognition of neck needle foreign bodies is emphasized.
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PMID:Neck needle foreign bodies in intravenous drug abusers. 842 20

EEGs, brainstem auditory evoked potentials (BAEPs) and auditory event-related potentials (ERPs) were recorded from 33 individuals infected with the human immunodeficiency virus, type 1 (HIV1+ patients: 13 CDC Class II or III; 20 Class IV). All were neurologically asymptomatic, non-demented, and had a past history of intravenous drug abuse. Sixteen age- and sex-matched normals and 10 HIV1- former drug addicts served as controls. Half of the HIV1+ and HIV1- subjects displayed mild EEG anomalies and, except for one HIV1+ patient, BAEPs were normal in both groups. ERPs were normal in all HIV1- subjects but anomalous (longer latencies of components P2, N2, P3; reduced amplitude of P3) in 9 HIV1+ patients (27%), the incidence of such anomalies being higher for Class IV than Class II/III patients. Auditory ERPs proved the most sensitive and specific of these electrophysiological procedures in detecting subclinical central nervous system involvement in HIV1 infection.
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PMID:Electrophysiological study of neurologically asymptomatic HIV1 seropositive patients. 842 11

The human T cell leukaemia virus type II (HTLV-II), whose pathogenicity is as yet unclear, was recently found to be associated with intravenous drug abuse in North America and Europe. HTLV-II was isolated from two Italian drug abusers belonging to the same cohort and coinfected with human immunodeficiency virus type 1. Two new isolates, HTLV-II Gu and Va, were established in a culture of BJAB cells, a continuous B cell line (Epstein-Barr virus-negative), and characterized by nucleotide sequence analysis of the long terminal repeat (LTR) and portions of the gag, env and X regions. These sequences were compared to those of the HTLV-II Mo isolate reported in the literature. No major variations were observed in important regulatory elements of LTR nor in the stem-bulge-loop configuration known to be essential for binding of rex protein. The results obtained from the sequence of the 1988 nucleotides examined indicated a 1.6% variability between the Gu and Va isolates and about 6% with respect to Mo. Notable differences were found in the structure of putative open reading frames of the X region when compared to those reported for the Mo isolate. Restriction analysis of proviral DNA of two isolates and comparison with the physical map of the Mo isolate confirmed the existence of genetic heterogeneity in the HTLV-II group and demonstrated that the new isolates Gu and Va belong to the HTLV-IIb subtype. The results of this study show that the new isolates have distinct features with respect to the Mo isolate though all important regulatory elements of the LTR appear to be well conserved.
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PMID:Molecular characterization of two isolates of human T cell leukaemia virus type II from Italian drug abusers and comparison of genome structure with other isolates. 844 66

To evaluate bronchial reactivity to methacholine in human immunodeficiency virus (HIV) infection, we submitted 25 HIV-seropositive subjects without full-blown AIDS and 25 HIV-seronegative subjects, all inmates in a drug rehabilitation center for previous intravenous drug abuse, to interview and to bronchial challenge with methacholine. Four (16 percent) HIV-seropositve and three (12 percent) HIV-seronegative subjects noted bronchospastic symptoms. Baseline FEV1 and MEF50 percent were within the normal range in every patient. Bronchial hyperreactivity to methacholine (PD20FEV1 < 1,400 micrograms) was found in two (8 percent) HIV-seropositive and in four (16 percent) HIV-seronegative subjects, with no significant difference in the frequency between the two groups. We conclude that HIV infection without AIDS in intravenous drug users does not appear to be associated with an increased frequency of bronchospastic disorders and to bronchial hyperreactivity to methacholine.
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PMID:Bronchial reactivity to methacholine in HIV-infected individuals without AIDS. 844 71

A 29-year-old female intravenous drug abuser infected with the human immunodeficiency virus suffered recurrent, bilateral corneal infections over an 11-month period. Multiple infectious organisms were responsible, including capnocytophaga species, Candida albicans, Staphylococcus aureus, coagulase-negative staphylococcus, and a-streptococcus. One eye was eviscerated because of corneal perforation and loss of vision; the second eye has maintained good vision. Predisposing factors usually associated with corneal infections were absent. Treatment was complicated by extremely poor patient compliance, ongoing intravenous drug abuse, and concurrent multiple extraocular medical problems.
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PMID:Recurrent corneal infections in a patient with the acquired immunodeficiency syndrome. 850 Mar 41

Acquired immunodeficiency syndrome (AIDS) was first detected in Costa Rica in 1983. For four years most known cases were in hemophiliac men. Thereafter, AIDS in homosexual and bisexual men predominated. By December 31 of 1993, 563 persons had been diagnosed with the syndrome, 71% of them homosexual and bisexual men, 10% heterosexual men and women, 6% hemophiliacs, 2% intravenous drug abusers (IVDA's), 2% women and men who had blood transfusions, 1.4% infants born to HIV-infected mothers and 7% unknown. The epidemics in homosexual/bisexual men and in heterosexual women and men are rising; cases in infants and in persons who received blood or coagulation factors, are stagnant. The steady increase in AIDS among women is linked to exposure to bisexual partners. The moderate nature of the national epidemic reflects, in part, the low incidence of IVDA, the universal screening of blood donors for antibodies to the human immunodeficiency virus (HIV) since 1985, and the prompt banning of unsafe coagulation factors. The projection of AIDS for the year 2000 is 2,304 cases (606 accumulated incidence per million inhabitants). A national educational campaign, radio and television programs and other preventive actions, apparently did not influence the rate of receptive anal intercourse without condom (about 80%) during 9 years of the epidemic. Persons with HIV/AIDS often are deprived of social and medical benefits or are subjected to harassment and exploitation by the health sector. More efficient prevention must target children, adolescents and adults in reproductive age, to promote safer lifestyles, through education and counseling effected through primary health care.
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PMID:HIV/AIDS in Costa Rica: epidemiological and sociological features, 1993. 857 48

Cohorts of patients infected with the human immunodeficiency virus (HIV), and followed-up since their infection, have identified risk factors of progression to acquired immunodeficiency syndrome (AIDS). The risk of progression increases with the subject's age at contamination by 40% for each decade. Other host factors such as certain HLA subtypes would be related to progression. Virus-related factors have also been described. Sexual or transfusional transmission from a highly immunodepressed subject increases the risk of progression in the infected subject. Progression is more rapid in male homosexuals than in heterosexuals, even after exclusion of Kaposi's syndrome. There has been little success in isolating co-infections which might explain this finding. The more rapid progression in homosexuals could be due to infection with particularly virulent strains or particular subtypes. Finally, progresion is more rapid when signs of primary infection are major or prolonged, an observation which probably results from a complex host-virus interaction. Behavioral factors occurring after contamination (pregnancy, continued intravenous drug abuse, tobacco, alcohol) have not been demonstrated until now to play a role in progression.
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PMID:[Cofactors in the course of HIV infection]. 868 85

Neuropathological studies were carried out on 180 human immunodeficiency virus-seronegative intravenous drug addicts. The findings in victims of acute heroin intoxication (n = 116) were congestion (99.1%), capillary engorgement (68.1%), and/or perivascular bleeding (68.1%) - hemodynamic processes attributable to toxic primary respiratory failure. In a high percentage of these cases (88%), cerebral edema was also present. In 18 cases of acute heroin intoxication who survived for periods of hours or days, the sole postmortem finding was ischemic nerve cell damages, resembling that typically seen in systemic hypoxia. Semiquantitative analysis revealed nerve cell loss in the hippocampal formation and/or Purkinje cell layer in 26% of the 162 chronic drug abusers. By contrast, in nearly 80% of these cases, the hippocampus showed enhanced expression of glial fibrillary acid protein by astrocytes and/or a proliferation of microglia, demonstrated by CD68 expression. Since such reactive processes are produced by primary neuronal damages, it can be assumed that chronic intravenous drug abuse results in obviously ischemic nerve cell loss. This could be demonstrated in the hippocampus, but it must also occur throughout the whole brain. The demonstration of ischemic nerve cell damage and neuronal loss or secondary reactive alterations has not been described previously.
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PMID:Neuropathology in non-human immunodeficiency virus-infected drug addicts: hypoxic brain damage after chronic intravenous drug abuse. 878 64


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