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

Oral lesions of opportunistic infections and neoplasms are associated with immunosuppression caused by the human immunodeficiency virus (HIV). These include oral candidiasis, viral lesions such as warts, herpes simplex, herpes zoster and hairy leukoplakia, as well as Kaposi's sarcoma and an aggressive form of periodontal disease. Many of these can occur as the first clinical signs of HIV infection. Thus, careful oral examination is an important part of the clinical evaluation.
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PMID:Oral mucosal manifestations of AIDS? 331 52

Oral manifestations in AIDS, in AIDS-related complex, and in patients with antibodies to the AIDS-causing virus, human immunodeficiency virus (HIV), have been described previously. One of these manifestations, oral hairy leukoplakia, is apparently specifically associated with HIV infection and has until recently been reported in homosexual men only. This article demonstrates, among European patients, the occurrence of hairy leukoplakia in three patients belonging to another risk group for AIDS, namely HIV-infected hemophiliacs.
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PMID:Oral hairy leukoplakia in three hemophiliacs with human immunodeficiency virus infection. 347 44

Oral hairy leukoplakia (HL) is a frequent, apparently specific, and early clinical sign of exposure to human immunodeficiency virus. We studied 50 consecutive patients, or whom two had acquired immune deficiency syndrome (AIDS) at the time of diagnosis of HL. AIDS developed in another eight patients during the observation period. All patients had HL on the lateral portion of the tongue, most often evident as bilateral white lesions with a corrugated surface. The size, severity, and surface characteristics of the lesions showed wide variation. Clinically flat lesions, most often located on the ventral surface of the tongue, also occurred in one third of the cases. The dominant histologic features were epithelial hyperparakeratosis with hairlike projections, hyperplasia/acanthosis, vacuolated cells resembling koilocytes, and an absence of inflammation in the connective tissue. In addition, candidal hyphae and bacteria were often seen in or on the surface epithelium. Lesions that were flat clinically often lacked "hairs" histologically. There was no correlation between clinical size, severity, or surface characteristics and the development of AIDS. Similarly, no histologic parameters identified subgroups of patients as being at a higher risk for the development of AIDS. Thus, even the most subtle white lesion of the tongue may indicate a considerable risk for the later development of AIDS. It can be concluded that HL represents a new lesion, predominantly of the tongue, in patients with HIV infection that shows considerable clinical and histologic variation. Typical HL is easily diagnosed, but atypical HL may be diagnosed mostly on the basis of absence of response to antifungal treatment and histologic exclusion of other lesions.
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PMID:Clinical and histologic spectrum of oral hairy leukoplakia. 348 Apr 88

We investigated the relation of oral hairy leukoplakia (HL) to human immunodeficiency virus (HIV) infection and to the presence or development of AIDS. All 155 patients with HL seen in our clinic were immunosuppressed homosexual men. Of 101 serum samples obtained from patients in this group who did not have AIDS, 100 showed antibodies to HIV. HIV was recovered from peripheral blood mononuclear cells of 22 of 28 patients tested. Most serum samples examined by immunoblot assay reacted with the viral envelope and gag gene precursors gp160 and p55. Of the 155 patients, 12 had AIDS at the time of diagnosis, and the syndrome developed in an additional 43 patients in one to 31 months. Survival analysis showed that the probability of AIDS developing in patients with HL was 48% by 16 months and 83% by 31 months. We conclude that oral HL is highly predictive of the development of AIDS.
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PMID:Relation of oral hairy leukoplakia to infection with the human immunodeficiency virus and the risk of developing AIDS. 349 74

Both human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are associated with an increased prevalence of several dermatologic diseases. We studied healthy homosexual men with negative reactivity to HIV antibody, homosexual men without AIDS but with positive reactivity to HIV antibody, and homosexual men with AIDS to compare the prevalence of dermatologic disease in these groups. We found that five cutaneous disorders were increased in persons with HIV infection. Oral hairy leukoplakia was increased both in seropositive subjects without AIDS and in subjects with AIDS. Condylomata acuminata and seborrheic dermatitis were slightly increased in seropositive non-AIDS subjects and significantly increased in the AIDS group. Molluscum contagiosum and oral candidiasis were increased only in the AIDS group.
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PMID:Dermatologic findings associated with human immunodeficiency virus infection. 368 Jun 53

Despite differences in the modes of transmission of human immunodeficiency virus (HIV) in Africa as compared to US and Europe, the immunologic abnormalities and clinical profile in acquired immunodeficiency syndrome (AIDS) appear to be similar. Further evidence for this observation is provided by the case of a 34-year-old African male from Burundi who developed a form of oral leukoplakia previously unseen in African AIDS patients, but resembling the so-called hairy leukoplakia found in homosexuals in California. In this African patient, the diagnosis of AIDS was established on the basis of severe opportunistic infection (meningeal cryptococcosis) together with hepatic and pulmonary tuberculosis, a severely decreased T-helper to suppressor cell ratio, and the presence of antibodies to HIV. Dermatological examination revealed several mucocutaneous lesions, including 1) candidiasis with patchy depapillation of the dorsum of the tongue and 2) discrete, chronic lesions on the lateral sides of the tongue appearing as dense, white mucosal patches about 1 cm in size. A sample of a persistent white lesion on the lateral border of this patient's tongue was submitted to light and electron microscopic examination and immunoassay. The epithelium of the lingual mucosa presented parakeratotic cells, acanthosis, and surface projections typical of "hairy" leukoplakia. The prickle cells contained pyknotic nuclei and perinuclear halos. Herpes-like virus particles were observed within the nuclei of this prickle cells and in intercellular spaces. There was no evidence of papillomavirus particles. In immunoassay, the virus particles did not react to antibodies against human herpes virus. The role of herpes virus and papillomavirus in the pathogenesis of "hairy" leukoplakia has yet to be established.
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PMID:Oral "hairy" leucoplakia in an African AIDS patient. 373 24

Infection with the human immunodeficiency virus (HIV) leads to selective depletion of the helper/inducer lymphocyte subset and a subsequent state of acquired cellular immunodeficiency. Simultaneously, evidence of B-cell hyper-activity may exist. A subset of patients infected with HIV demonstrates a syndrome of persistent generalized lymphadenopathy (PGL). Lymph node biopsies reveal benign reactive changes with a pattern of florid follicular hyperplasia. A polyclonal hypergammaglobulinemia reflects humoral immune dysfunction. Patients with PGL are similar to those with full-blown AIDS with regards to demographics, immune and virologic studies. Our prospective natural history study of PGL patients initiated in November 1981 reveals a 15% rate of evolution to AIDS in the 200 patient cohort. Factors associated with increased risk of transformation to AIDS include severity of constitutional symptoms, shrinking adenopathy, oral candidiasis or viral hairy leukoplakia, peripheral cytopenias, elevated erythrocyte sedimentation rate or an antecedent episode of herpes zoster. Therapeutic interventions to prevent evolution to AIDS in high risk subsets of lymphadenopathy patients have been investigated. In addition to benign B-cell proliferation associated with HIV infection, malignant lymphomas have also been diagnosed in 29 patients in AIDS risk groups in our clinic population. All patients were male; 26 homosexuals, 2 IV drug abusers and 1 multiply transfused sickle cell anemia patient. Seven patients had antecedent PGL. Non-Hodgkin's lymphoma was diagnosed in 19 patients. Histologies were predominantly diffuse undifferentiated or large cell. Eleven patients were Stage IV at diagnosis. Of 10 patients with mixed cellularity Hodgkin's disease, 7 were Stage IV-B at presentation. Extranodal disease was frequent in patients with lymphomas. Fourteen patients lacked peripheral lymphadenopathy. Response to chemotherapy was good, but complicated by prolonged marrow suppression and development of AIDS-related opportunistic infections. Median survival was 7 months. Laboratory studies investigating the possible role of lymphotropic retroviruses in the development of AIDS-related lymphomas revealed that serum from all patients with high grade non-Hodgkin's lymphoma contained antibodies to HIV and that the majority also expressed antibodies to HTLV-I. This degree of seroreactivity to HTLV-I and HIV was characteristic only of lymphoma patients as sera from only 10 - 15% of AIDS and ARC patients in San Francisco had similar findings.
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PMID:AIDS-related benign lymphadenopathy and malignant lymphoma: clinical aspects and virologic interactions. 382 9

Proliferative lesions were found on the squamous epithelium of the tongue, esophagus, or penis or haired skin of the lip, hand, or thorax of 8 simian immunodeficiency virus-infected rhesus monkeys that died of simian AIDS. The lesions were focal and consisted of hyperkeratosis, parakeratosis, and acanthosis in the skin, with additional ballooning degeneration in the tongue, esophagus, and penis. The epithelial surfaces were frequently colonized by Candida species or gram-positive cocci. Intranuclear inclusion bodies were seen in cells in the middle and superficial layers. Herpesvirus virions were found in inclusion-bearing cells by transmission electron microscopy. An Epstein-Barr-like virus was identified in inclusion-bearing cells by immunohistochemistry and in situ hybridization. No virus was detectable in basal layers of the epithelium. These lesions resemble oral hairy leukoplakia in AIDS patients and may thus provide a useful primate model to study permissive epithelial infection by Epstein-Barr-like viruses.
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PMID:Squamous epithelial proliferative lesions associated with rhesus Epstein-Barr virus in simian immunodeficiency virus-infected rhesus monkeys. 762 99

Human immunodeficiency virus-associated oral hairy leukoplakia (HLP) is characterized by coinfection with multiple types and strains of Epstein-Barr virus (EBV) and recombination within the EBV genome. HIV-seronegative immunosuppressed and immunocompetent patients with HLP were examined to determine the pathogenic contribution of EBV coinfection and recombination to the development of HLP. Multiple coinfecting EBV strains were detected in both HLP specimens and peripheral blood lymphocytes (PBL) of HIV-seronegative persons with HLP. One specific EBV strain was detected in HLP specimens from 3 of 4 patients. Also, viral recombination during productive replication within HLP generated variants of the latent membrane protein-1 (LMP-1) and nuclear antigen-2 (EBNA-2) genes. Some variants were also detected within PBL. Thus, EBV coinfection and recombination are consistent findings in persons with HLP regardless of immune status. Virally mediated determinants may be important features of EBV pathogenesis.
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PMID:Epstein-Barr virus coinfection and recombination in non-human immunodeficiency virus-associated oral hairy leukoplakia. 775 10

The full range and occurrence of medical conditions in persons infected with human immunodeficiency virus (HIV) before they develop illnesses that define acquired immunodeficiency syndrome (AIDS) have not been systematically or completely described. In a retrospective and prospective cohort study, 1,073 homosexual and bisexual men in three US cities were interviewed and examined twice per year from January 1988 to September 1992. Study participants were from San Francisco, California (273 HIV-seropositive and 432 HIV-seronegative men), Denver, Colorado (107 positive and 129 negative men), and Chicago, Illinois (54 positive and 78 negative men). A total of 305 HIV-positive men had specifiable dates of HIV seroconversion (mean of 15.3 months between the last negative and the first positive HIV antibody test). Besides much increased incidences of thrush (incidence relative risk (IRR) = 23.3) and hairy leukoplakia (IRR = 551), the following conditions also occurred significantly more frequently in HIV-positive men than in HIV-negative men: anal herpes (incidence density (ID) = 10.7/100 person-years; IRR = 7.7); sinusitis requiring antibiotics (ID = 6.2/100 person-years; IRR = 2.1); anal warts (ID = 5.8/100 person-years; IRR = 2.7); seborrhea (ID = 3.8/100 person-years; IRR = 6.6); community-acquired pneumonia (ID = 1.4/100 person-years; IRR = 2.7); skin cancers (ID = 1.0/100 person-years; IRR = 2.2); and seizures, often apparently "breaking through" prior anticonvulsant therapy (ID = 0.8/100 person-years; IRR = 5.6). First episodes of hairy leukoplakia, thrush, and skin cancer occurred at low mean CD4 counts (mean counts were less than 350 cells/microliters) and late in HIV infection (mean times were more than 8 years after HIV seroconversion). Many medical problems, some not widely appreciated, occur in HIV-infected men before they develop AIDS-defining illnesses, signifying considerable morbidity from pre-AIDS HIV infection.
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PMID:The spectrum of medical conditions and symptoms before acquired immunodeficiency syndrome in homosexual and bisexual men infected with the human immunodeficiency virus. 853 42


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