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

Some clinical trials involving subjects with the human immunodeficiency virus (HIV) allow a subject to change treatment when a marker of disease progression, for example, the CD4 cell count, falls below a defined threshold. Although the change does not involve a randomized control, there is considerable interest in assessing whether it might have beneficial effects on the marker levels. However, the effects of regression to the mean will confound a simple analysis of the repeated measurements obtained before and after the cross-over. In this paper, we present a likelihood-based methodology for this problem and apply it to assess a cross-over from placebo to treatment with a drug, zidovudine, in a cohort of HIV infected individuals. This cross-over occurred when a subject first had two successive CD4 cell counts below 500/mm3. As well as providing important information about the effects of introducing zidovudine among subjects with early asymptomatic HIV infection, this paper illustrates methods for verifying model assumptions, an important component of such analyses which are necessarily model dependent.
 ...
PMID:Analysis of uncontrolled treatment changes in HIV clinical trails. 889 39

Although anabolic effects of GH supplementation have been reported in acquired immune deficiency syndrome (AIDS) patients, the effects of human immunodeficiency virus (HIV) infection per se on GH secretion are unknown. Therefore, we evaluated the characteristics of GH secretion in eight asymptomatic HIV-infected men, eight clinically stable male AIDS patients, and eight healthy controls. Wasting AIDS patients were not included to circumvent the confounding effects of opportunistic disease on GH secretion. Samples for GH analysis were taken at 10-min intervals over 24 h. GH was measured by immunoradiometric assay (detection limit, 0.08 mU/L). Insulin-like growth factor I (IGF-I) and IGF-binding protein-3 were measured every 6 h. The pulsatile secretion of GH was evaluated by Cluster and DESADE analyses. No differences in number of peaks, peak amplitude, peak length, peak interval, or GH secretion per 24 h were found among the studied groups. IGF-I and IGF-binding protein-3 concentrations were not different among groups. Circadian GH secretion in asymptomatic HIV infection and AIDS without wasting is not different from that in healthy subjects. Therefore, anabolic effects documented in clinical trials with recombinant human GH in AIDS patients are not merely explained by alterations in the GH/IGF-I axis induced by HIV infection per se.
 ...
PMID:Circadian growth hormone secretion in asymptomatic human immune deficiency virus infection and acquired immunodeficiency syndrome. 892 55

Anti-Aspergillus fumigatus antibodies (IgG and IgE class) and serum levels of cytokines (gamma Interferon, Interleukin-2 and tumour necrosis factor-alpha) were studied in multitransfused (MT) children in relation to human immunodeficiency virus (HIV) infection. The specific antibodies to Aspergillus fumigatus were present in 25 per cent of MT children seropositive for HIV as compared to only 2 per cent among HIV-negative MT children (X2 = 14, P < 0.001). Estimation of serum cytokines level in MT children showed that the asymptomatic HIV-infected children had elevated levels of gamma interferon (Y-IFN) and tumor necrosis factor-alpha (TNF-alpha) without any alteration of Interleukin-2 (IL-2) level, compared to HIV-negative group. However, clinically diagnosed cases of AIDS in the HIV-infected group showed elevation of all the three cytokines levels as compared to HIV negative group, as well as asymptomatic HIV infected group. Presence or absence of concomitant A. fumigatus infection did not lead to alteration of Y-IFN and IL-2 level in the HIV infected group, while TNF-alpha levels were markedly raised in the cases with evidences of presence of A. fumigatus specific antibodies irrespective of whether the group belonged to asymptomatic HIV infection or clinically proven cases of AIDS. The significance of these altered cytokines profile with respect to occurence of A. fumigatus infection in HIV-positive MT children has been discussed.
 ...
PMID:Aspergillus fumigatus specific antibodies in multitransfused children with human immunodeficiency virus (HIV) infection in relation to serum levels of Interleukin-2, gamma Interferon and tumour necrosis factor. 898 20

We determined the representation in asymptomatic human immunodeficiency virus (HIV) infection of the CD45RO+ and CD45RO- CD45RA+ subsets of CD4+ and CD8+ T lymphocytes, CD11b+ and CD11b- subsets of CD8+ T cells, and activated populations of these subsets. Three-color flow cytometry was used to quantitate the different CD4+ and CD8+ T cell populations in 116 asymptomatic HIV+ individuals. In asymptomatic HIV+ infection there was a significant relative increase in the CD4+ CD45RO+ and CD8+ CD45RO+ T cell subsets, which express CD38 and DR antigens, that correlated strongly with the decline in total CD4+ T cells. In addition, we found a loss of CD4+ CD45RO- and CD8+ CD45RO- T cells associated with progression of HIV infection (as measured by the decline in total CD4+ T cells). Studies presented here also indicate that, with the progression of asymptomatic HIV infection, CD8+ CD11b- T lymphocytes showed a significant decrease, whereas CD8+ CD11b+ T cells were significantly increased. This study demonstrates that the progression of HIV infection in asymptomatic patients involves the increase in CD45RO+ subsets of CD4+ and CD8+ T cells, the increase in CD8+ CD11b+ T cells, the decrease in CD45RO- CD45RA+ subsets of CD4 and CD8 T cells, and the decline in CD8+ CD11b- T cells.
 ...
PMID:Quantitative alterations of the functionally distinct subsets of CD4 and CD8 T lymphocytes in asymptomatic HIV infection: changes in the expression of CD45RO, CD45RA, CD11b, CD38, HLA-DR, and CD25 antigens. 905 21

An understanding of quality of life (QOL) with human immunodeficiency virus (HIV) is important because the merits of prevention and treatment alternatives may depend substantially on how these interventions affect QOL. Physicians' views about QOL are important, because they influence the therapeutic options that physicians consider or offer, the recommendations that physicians make, and because they are important for the analysis of certain policy questions. We assessed physicians' utilities of health states associated with HIV infection, and hepatitis B virus (HBV) infection; assessment of utilities for HBV was induced to provide a comparison with HIV utilities. We surveyed 200 housestaff and staff physicians in an academic medical centre by anonymous paper-based questionnaire and used the time-tradeoff method to assess physicians' utilities of the health states. On a scale in which 0 was equivalent to death, and 1 was equivalent to good health, the median utilities for asymptomatic HIV infection, symptomatic HIV infection, and AIDS were 0.833, 0.417, and 0.167, respectively (p < 0.01 or each two-way comparison). Median utilities for asymptomatic HBV infection, mildly symptomatic HBV infection, and severely symptomatic HBV infection were 0.917, 0.667, and 0.167, respectively (p < 0.01 for each two-way comparison). Although physicians varied substantially in the ratings of health states, they assessed the utility of life with HIV disease, including asymptomatic infection, as severely reduced. Studies of the effectiveness and cost-effectiveness of preventive and therapeutic interventions for HIV should evaluate the effect of the intervention on utility-based assessments of QOL. Studies that do not assess such effects may significantly underestimate or overestimate the value of these interventions, depending on the intervention's effect on QOL.
 ...
PMID:Physicians' assessments of the utility of health states associated with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) infection. 906 45

The AIDS Litigation Project has reviewed nearly 600 reported cases involving individuals with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) in the federal and state courts in the United States between 1991 and 1997. Cases were identified through a federal and 50-state computer and library search. An important subset of litigation relates to HIV/AIDS in the public health and health care systems, since the law affects health care institutions and professionals, patients, and public health policy in America. This subset of HIV/AIDS litigation includes testing and reporting; privacy, the duty to warn, and the right to know; physician standards of care in prevention and treatment; and discrimination and access to health care. In broad terms, the review demonstrates a reliance on voluntary testing and protection of patient privacy through HIV-specific statutes and the common law. Negligence with potential civil and criminal liability has been alleged in cases of erroneous or missed diagnosis of HIV infection. In the first AIDS case to be considered by the Supreme Court, the Court will decide whether patients with asymptomatic HIV infection are protected under the Americans With Disabilities Act. Considerable progress has been made, both socially and legally, during the first 2 decades of the epidemic, but much still needs to be accomplished to protect privacy, prevent discrimination, and promote tolerance.
 ...
PMID:HIV infection and AIDS in the public health and health care systems: the role of law and litigation. 954 71

The relationship between asymptomatic human immunodeficiency virus (HIV) infection and blood hemoglobin (Hb) concentration was examined in anemic pregnant women from a population with high prevalence of both anemia (60%) and HIV seropositivity (30%). Sera from 155 pregnant women with Hb levels < 10.5 g/dL were tested for HIV status, C-reactive protein (CRP), vitamin B12, retinol, and folate levels. The observed prevalence of HIV seropositivity in the group of women with anemia was 47.1% (95% confidence interval=39.2-55.0%). This is significantly higher than the HIV prevalence in the whole population (30.1%; P < 0.001). Median Hb values in HIV-seropositive and -seronegative women with anemia were 8.40 g/dL and 8.95 g/dL, respectively. Serum retinol, vitamin B12, and folate levels were not significantly different in the HIV-seropositive and -seronegative groups. In women who were HIV-seropositive with normal levels of CRP, a median decrease in Hb of 0.4 g/dL was observed. For those with serum CRP levels > 25 mg/l, the median decrease in Hb was 0.7 g/dL. Results indicate that asymptomatic HIV infection is associated with increased prevalence and severity of anemia in pregnancy in this population.
 ...
PMID:The relationship between asymptomatic human immunodeficiency virus infection and the prevalence and severity of anemia in pregnant Malawian women. 988 14

The Americans With Disabilities Act (ADA) was widely hailed at the time of its enactment in 1990 as providing broad protection against disability discrimination, including discrimination against individuals infected with the human immunodeficiency virus (HIV). In the years since its enactment, however, courts frequently interpreted the ADA as providing far less protection than was initially anticipated. The Supreme Court's first case involving HIV and the acquired immunodeficiency syndrome, Bragdon v Abbott, addressed this trend by ruling that a woman with asymptomatic HIV infection is protected from discrimination in accessing dental services. In doing so, the Court endorsed an interpretation of the ADA that is broadly protective for individuals with disabilities. The Court also ruled that health care professionals may legally refuse to treat a patient because of concern that the patient poses a direct threat to safety only if there is an objective, scientific basis for concluding that the threat to safety is significant. In addition to the ADA, state laws frequently prohibit disability discrimination and apply to some employers and others not regulated by federal law. A state-by-state survey of those laws demonstrates that, consistent with Bragdon v Abbott, individuals with asymptomatic HIV have widespread protection on the state level.
 ...
PMID:Disability discrimination in America: HIV/AIDS and other health conditions. 1050 Nov 11

The microsporidia have been involved in several clinical manifestations in patients with AIDS, of whom diarrhoea is the commonest. The diagnosis of microsporidiasis depended on invasive procedures and the identification of the organisms is made by electron microscopy. The modified trichrome staining method allows that the diagnosis be made without such procedures by using light microscopy. In the present work, the modified trchrome method was applied in stools from 62 patients with diarrhoea, who had asymptomatic HIV infection or AIDS. Of the 62 samples analyzed, there was detection of microsporidial spores in one. This work confirms the existence of such protozoans in our patients, associated with manifestations of chronic diarrhoea in patients with AIDS who have severe immunodeficiency and ascertains that this staining method allows satisfactory identification of microsporidia from faeces, as well points out some directions to further studies.
 ...
PMID:[Trichome staining method applied to stools from HIV-infected patients with diarrhea, for microsporidia investigation]. 1038 May 67

We report detailed quantitative analysis of human immunodeficiency virus-1 (HIV-1) p24 and HIV-1 RNA in tonsil biopsies from 13 patients with early, asymptomatic HIV infection before and during combination antiretroviral therapy. Using fluorescent microscopy in conjunction with reverse transcriptase-polymerase chain reaction of frozen tissue sections, we show that plasma and tissue viral loads decreased by approximately 3 logs during the 1-year treatment period, with good correlation between the HIV-1 p24 and HIV-1 RNA response in tissue. The decrease of tissue viral load was delayed compared to plasma viral load, possibly explained by the observation that the amount of follicular dendritic cell-associated virus correlated best with the area under the curve of plasma HIV-1 RNA throughout the last 12 weeks. Before and during treatment, the relative proportions of HIV-1 on follicular dendritic cells and within mononuclear cells remained constant, suggesting similar decay characteristics in these two lymphoid tissue compartments. However, viral p24 or RNA remained almost always detectable in tissue despite full suppression of HIV-1 RNA in plasma, and increased even after short-term rebounds in plasma viral load. Thus, full and sustained suppression of viral replication was required to efficiently decrease viral load in lymphoid tissue, but complete abolition of residual viral replication was not achieved.
 ...
PMID:Treatment-induced decline of human immunodeficiency virus-1 p24 and HIV-1 RNA in lymphoid tissue of patients with early human immunodeficiency virus-1 infection. 1085 20


<< Previous 1 2 3 4 5 6 Next >>