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

The authors investigate the importance of physical symptoms as a correlate of depressive symptoms and suicidal thoughts in a large (N = 881) community-based sample of persons infected with human immunodeficiency virus. The study overcomes limitations of prior research by minimizing overlap in measures of affective and physical symptoms, studying a more diverse population, and including correlates such as measures of social support, function, employment, insurance coverage, and cognitive impairment in the analysis. The authors' data support the notion that in diagnosing depression in the medically ill, concern over isolating physical symptoms as either "affective" or "physical" may be exaggerated.
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PMID:Physical symptoms and depressive symptoms among individuals with HIV infection. 146 67

Studies of cognitive function in subjects with human immunodeficiency virus type 1 (HIV-1) infection who remain relatively asymptomatic (ie, Centers for Disease Control stages II and III) have provided widely variable estimates of cognitive impairment. In view of the finding that approximately 25% of asymptomatic HIV-1-infected subjects demonstrate either marginal or overt vitamin B12 deficiency, we have investigated plasma vitamin B12 status as a potential cofactor in studies of HIV-1-related cognitive impairment. When cognition was assessed in asymptomatic (Centers for Disease Control stages II and III) HIV-1-infected participants taking into consideration vitamin B12 status, those subjects with low plasma vitamin B12 levels (less than 180 pmol/L) performed more poorly than did those with normal (greater than or equal to 180 pmol/L) vitamin B12 status on specific measures of information processing speed and visuospatial problem-solving skills. These findings suggest that concurrent vitamin B12 deficiency may be a cofactor in subtle cognitive changes observed in the asymptomatic stages of HIV-1 infection. These differences in prevalence of low plasma vitamin B12 levels may help to explain differences among studies in the proportion of HIV-1-infected subjects showing cognitive impairment.
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PMID:Plasma vitamin B12 level as a potential cofactor in studies of human immunodeficiency virus type 1-related cognitive changes. 850 91

The presence of mental disorder and cognitive functioning were examined in groups of 20 multiple sclerosis (MS) and homosexual acquired immunodeficiency syndrome (AIDS) ambulatory male outpatients matched for disability and demographic features. Patients who were somatically ill, had past central nervous system infection or tumours or abused intravenous drugs or alcohol were excluded. The groups significantly differed in mental symptoms and mental disorders (DSM-III classification) seen currently and after the diagnosis of MS or human immunodeficiency virus-1 infection. AIDS patients had pre-existing anxiety disorders that affected their current mental symptoms. MS patients showed more evidence of cognitive impairment than equally disabled AIDS patients. The differing neural and mental features are discussed in relation to the current concepts of subcortical and cortical disorders.
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PMID:AIDS and multiple sclerosis: neural and mental features. 160 52

To evaluate the long-term toxicity and activity profile of 2',3'-dideoxyinosine (ddI), a potent inhibitor of human immunodeficiency virus (HIV) replication, in vitro. 58 patients with AIDS or AIDS-related complex were studied with additional reference to the effect of previous treatment with zidovudine, and the effect of ddI on HIV-induced cognitive dysfunction. Doses above 9.6 mg/kg per day of ddI were frequently associated with toxicity (peripheral neuropathy, pancreatitis, or hepatitis). Doses of 9.6 mg/kg per day or below were well tolerated for up to 21 months. A subset of patients receiving 3.2-9.6 mg/kg per day of ddI had long-term immunological improvement and reduction of serum HIV p24 antigen. Immunological changes were especially seen in patients who had little previous zidovudine therapy. 5 patients with HIV-induced cognitive impairment improved with ddI. Thus, ddI may have anti-HIV activity at doses which are tolerated for long-term therapy, although pancreatitis could be a life-threatening complication.
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PMID:Long-term toxicity/activity profile of 2',3'-dideoxyinosine in AIDS or AIDS-related complex. 197 29

Atrophy and white matter changes seen on magnetic resonance imaging scans have been observed in association with the acquired immunodeficiency syndrome dementia complex, but these appear to be late findings relative to clinical expression. We report a new magnetic resonance imaging observation in patients with early cognitive impairment due to human immunodeficiency virus infection. Fifty-two patients had a total of 86 magnetic resonance imaging scans during the study period. All scans were obtained with a 1.5-T system. The proton density spin echo (repetition time of 2000 milliseconds and echo delay time of 30 milliseconds) study demonstrated high-signal lesions in the region of the splenium of the corpus callosum and in the crura of the fornices. The lesions demonstrated no contrast enhancement with gadopentate dimeglumine. Pathological examination was performed in five patients. The fornix-subcallosal abnormality may be related to the memory dysfunction in patients with human immunodeficiency virus-related cognitive impairment.
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PMID:Magnetic resonance imaging findings in HIV cognitive impairment. 234 91

There are conflicting reports on the early effects of human immunodeficiency virus (HIV) infection on the nervous system. Some studies have suggested that there may be early cognitive impairment, while others have refuted this. We describe the results of extensive neuropsychological testing in a group of 40 infected subjects. These indicate that the degree of impairment is closely related to confounding factors other than the infection itself. Our conclusion is that the early stages of HIV disease are not associated with a high frequency of cognitive impairment if these confounding variables are taken into consideration.
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PMID:The importance of confounding factors in the evaluation of neuropsychological changes in patients infected with human immunodeficiency virus. 239 57

Although individuals with acquired immunodeficiency syndrome (AIDS) are often impaired on a variety of neuropsychological tasks, questions remain as to when neuropsychological decline can be reliably detected during the course of human immunodeficiency virus (HIV) infection. Detailed neuropsychological testing was accomplished on a cohort of 83 immunologically and neurologically intact asymptomatic HIV-infected individuals drawn from a larger pool of 649 US Air Force personnel with HIV antibodies. These asymptomatic subjects were compared with a group of HIV-negative subjects, and no significant differences in neuropsychological functioning were found. No significant neuropsychological differences were found as a function of cerebrospinal fluid abnormalities in these asymptomatic subjects. When data from 13 subjects with immune compromise were included in the analyses, those with abnormal cerebrospinal fluid values performed significantly poorer on a task of verbal memory, suggesting that cognitive dysfunction is antedated by immunological decline. Methodological problems that inhibit specification of the incidence, prevalence, and natural history of HIV-related cognitive impairment are discussed, as are data suggesting that previously published high estimates of the frequency of HIV-related dementia may not be representative of all HIV-infected populations.
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PMID:Neuropsychological and neurological function of human immunodeficiency virus seropositive asymptomatic individuals. 291 51

Psychiatric symptoms among patients with acquired immune deficiency syndrome (AIDS) may be functional reactions to contracting a fatal and stigmatizing disease or may be secondary to malignancies and opportunistic infections in the central nervous system (CNS). More recent evidence indicates that HTLV-III, the virus that causes AIDS, directly infects the CNS and may cause psychiatric symptoms before signs of immunodeficiency, cognitive impairment, or neurological abnormalities emerge. AIDS-related organic mental syndromes may mimic functional disorders such as chronic mild depression and acute psychosis. Both of these common presentations are illustrated with detailed case reports, and diagnostic and management guidelines are provided.
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PMID:Neuropsychiatric manifestations of AIDS-spectrum disorders. 300 46

Patients with acquired immunodeficiency syndrome (AIDS), who present with or develop psychotic symptoms, almost invariably have evidence of cognitive impairment. Three psychotic patients, one with AIDS, and two with AIDS-related complex (ARC), who showed no evidence of cognitive impairment, are reported. It is suggested that the human immunodeficiency virus (HIV) may produce symptoms indistinguishable from those seen in the functional psychoses.
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PMID:HIV infection associated with symptoms indistinguishable from functional psychosis. 316 39

Combined medical, neurological, and serological investigations were carried out in 59 patients infected with human immunodeficiency virus (HIV). In stage I clinical and neuropsychiatric testing did not reveal evidence for HIV encephalitis as diagnosed by local antibody production in CSF. Neuropsychiatric abnormalities, brain atrophy, memory and cognitive impairment reliably indicated HIV encephalitis in later stages. The commonest symptoms were cerebellar and brainstem signs, followed by dementia. Epileptic fits and hemiparesis always were associated with cerebral toxoplasmosis. A polyneuropathy was frequently found but other causes have to be considered.
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PMID:Chronic HIV encephalitis--II. Clinical aspects. 334 5


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