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 prospectively evaluated CSF concentrations of beta 2 microglobulin (beta 2M) in 65 human immunodeficiency virus type 1 seropositive patients. The highest concentrations occurred in those with lymphoma, neurologic opportunistic infections, and acquired immune deficiency syndrome dementia complex (ADC). There was a high correlation between the CSF beta 2M concentration and ADC severity, suggesting that CSF beta 2M may be useful as a marker for the development, progression, and perhaps response to treatment of ADC. Elevated CSF beta 2M was not due to CSF pleocytosis and was usually independent of blood-brain barrier dysfunction.
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PMID:Cerebrospinal fluid beta 2 microglobulin in patients infected with human immunodeficiency virus. 265 85

Zidovudine (Retrovir) is the only drug found to be useful for managing human immunodeficiency virus (HIV) infection in patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex. The drug is virostatic, ie, it prevents replication of HIV by inhibiting the enzyme reverse transcriptase. Zidovudine is well tolerated and provides short-term benefits by improving the quality of life and extending survival time. It is expensive and can be toxic, however, so its use requires close supervision. Zidovudine at present is approved only for patients with documented Pneumocystis carinii pneumonia or with a CD4 count below 200/mm3. Other probable indications include HIV wasting syndrome, HIV dementia complex, oral candidiasis, Kaposi's sarcoma, the presence of early markers of HIV infection, and HIV-related symptomatic thrombocytopenia. A stepwise approach to initiating zidovudine therapy should include detailed counseling and close surveillance.
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PMID:Zidovudine for treating AIDS. What physicians need to know. 266 55

Acquired immunodeficiency syndrome (AIDS), first described in 1981, is produced by infection with a retrovirus of the lentivirus family, now called human immunodeficiency virus (HIV). While, initially, the disease was almost exclusively seen in homosexual men, it has become apparent that numerous other categories of people are at risk, i.e., drug addicts who share dirty needles, hemophiliacs and haitians. In addition, epidemiological data from the industrialized nations clearly indicate that heterosexual contact is becoming an important source of viral transmission, as it has been known to occur in several african nations for many years. Initially, studies on patients with AIDS mainly focused on the immunosuppressive effects of the virus and on the various opportunistic infections and neoplastic complications that followed. Not much attention was given to a possible direct HIV infection of the nervous system. Consequently, patients who presented with neurological findings were simply considered to harbor in the CNS the same complications that occurred in other organs. While this was true in many cases, it has become also apparent that important changes in the central and peripheral nervous systems are due to direct viral involvement of these tissues. The first important step in the understanding of nervous system involvement in AIDS was the demonstration, in 1985, of HIV in the CSF and cerebral tissues of patients with neurological symptoms (47). Further studies have shown that, while opportunistic infections and neoplastic complications certainly contribute to the neurological morbidity of AIDS, the most important neuropathological changes, particularly in the brain, are due to direct HIV infection. The aim of this paper is to review the pathology of HIV-induced encephalitis and to discuss pathogenetic hypotheses regarding mechanisms of HIV-mediated tissue injury and the clinical manifestations that follow, particularly the syndrome now known as AIDS-Dementia-Complex (ADC). First, however, it may be appropriate to quickly review some basic notions on the biology of the virus.
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PMID:AIDS-dementia-complex: pathology, pathogenesis and future directions. 267 Aug 16

Vacuolar myelopathy (VM) is a frequent neurological complication of the acquired immune deficiency syndrome (AIDS). A suspected connection between VM and human immunodeficiency virus (HIV) has been based only on HIV isolation from affected spinal cord tissue. We report here an AIDS patient dying after 14 months of progressive dementia, including 3 months of spinal signs and symptoms. At autopsy, the brain revealed moderate diffuse damage of the white matter compatible with HIV-induced progressive diffuse leukoencephalopathy. The spinal cord showed VM mainly in the lateral and the posterior columns. Mono- and multinucleated macrophages were localized within intramyelinic and periaxonal vacuoles. Light and electron microscopic immunocytochemistry revealed the presence of HIV antigens restricted to mono- and multinucleated macrophages within the spongy lesions. Productive HIV infection is documented for the first time within VM lesions of this case. Therefore, VM should be included among HIV-induced lesions of the central nervous system. The intimate relation of infected macrophages to vacuolar myelinopathy could suggest secretion of a myelinotoxic factor by macrophages productively infected by HIV. Immune electron microscopy appears as promising tool to detect HIV in tissue even when the density of virus may be low.
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PMID:Vacuolar myelopathy with multinucleated giant cells in the acquired immune deficiency syndrome (AIDS). Light and electron microscopic distribution of human immunodeficiency virus (HIV) antigens. 268 61

Involvement of the central nervous system with the human immunodeficiency virus is thought to underlie the clinical and pathologic features of acquired immunodeficiency syndrome (AIDS) encephalopathy. Although morphologic, immunocytochemical, and molecular data point to predominant human immunodeficiency virus infection of multinucleated and mononuclear macrophages, neuroglial and other cells are thought to be involved as well. Electron microscopic studies of biopsy tissue that might further define the neuropathologic changes have been limited. The opportunity to study well-preserved biopsy tissue from a 38-year-old man with the acute onset of dementia and AIDS encephalopathy prompted this report. Human immunodeficiency virus was seen budding from the surface of multinucleated and mononuclear cells with morphologic features of macrophages; a rare astrocyte process showed evidence of viral infection as well. Macrophages were noted within the walls of blood vessels and in intimate contact with lymphocytes within the neuropil. Notably rare were tubuloreticular inclusions, interferon-related cytoplasmic structures commonly found in systemic endothelial cells and lymphocytes in AIDS. Their relative scarcity may signify reduced interferon production in AIDS encephalopathy.
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PMID:The fine structure of acquired immunodeficiency syndrome encephalopathy. 275 85

Generalized tonic-clonic seizures in persons infected with the human immunodeficiency virus have usually occurred in the setting of space-occupying lesions in the brain. Seizures have also been known to occur in patients with acquired immunodeficiency syndrome-related dementia. Two patients, each with prior history of human immunodeficiency virus infection, had seizures early in the course of their illness. Neither patient had evidence of space-occupying lesions or dementia at the time of admission for the seizures. Patients with human immunodeficiency virus infection may present with seizures and may not have a clinically detectable focus for their seizures.
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PMID:Early seizures in patients with acquired immunodeficiency syndrome without mass lesions. 277 69

Accurate description of the prevalence of neurological impairment in healthy individuals who are infected with human immunodeficiency virus type 1 (HIV-1) has relevance for public health policy, for employment issues, and for planning future health needs. Within the Multicenter AIDS Cohort Study, we determined the cross-sectional prevalence of neurological abnormalities in 270 HIV-1 seropositive homosexual and bisexual men in Centers for Disease Control Groups II and III, using a control group of 193 HIV-1 seronegative homosexual men. Utilizing a neurological and neuropsychological screening battery, we found no differences in the prevalence of neuropsychiatric symptoms or in neuropsychological performance. One hundred nineteen subjects with abnormalities on screening tests completed additional neuropsychological testing and had neurological examinations. The majority had normal results and the frequency of neurological abnormalities and impaired neuropsychological performance was not significantly increased among HIV-1 seropositive subjects. Most of the abnormalities could be attributed to causes other than HIV-1. One subject had mild HIV-1-related dementia, yielding a prevalence of 3.7:1,000 (95% confidence interval: 0.19-23.7:1,000). Magnetic resonance imaging demonstrated sulcal prominence and focal areas of high signal intensity in white matter in 63% of HIV-1 seropositive subjects and 48% of uninfected control subjects. Abnormalities in cerebrospinal fluid were noted in 23 (85%) of 27 HIV-1-infected individuals. Our studies indicate that the prevalence of dementia and other HIV-1-related neurological disorders is very low among healthy HIV-1 seropositive homosexual men. The confounding effects of factors such as substance abuse or preexisting medical conditions must be considered in the neurological evaluation of such patients.
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PMID:Low prevalence of neurological and neuropsychological abnormalities in otherwise healthy HIV-1-infected individuals: results from the multicenter AIDS Cohort Study. 281 36

Early pathological abnormalities in human immunodeficiency virus (HIV-1)-related dementia have not been well documented. We report a homosexual man with fatigue and intermittent diarrhea in whom early HIV-1-related dementia was demonstrated during neurological screening in the Multicenter AIDS Cohort Study. Within 4 months he died of massive epistaxis, and the brain revealed astrocytosis of white matter and mild pallor of myelin staining in the absence of inflammation, multinucleated giant cells, and brain atrophy.
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PMID:Neuropathological changes in early HIV-1 dementia. 281 44

Neurological disease occurs frequently in patients infected with the human immunodeficiency virus. Disorders may affect either the central or peripheral nervous systems and may be the presenting manifestation of human immunodeficiency virus-related disease. Opportunistic infections and lymphomas are major causes of central nervous system disease. Increasingly, however, human immunodeficiency virus infection of the central nervous system is being recognized and is now associated with a syndrome of progressive dementia in adults, referred to as the acquired immunodeficiency syndrome dementia complex, and an encephalopathy in infants born to human immunodeficiency virus-infected mothers. Whether brain disease related to this virus will respond to antiretroviral drugs will be a major focus of future research. Although less frequent than central nervous system disease, disorders of the peripheral nervous system are increasingly being recognized, including cases that probably have an autoimmune basis.
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PMID:AIDS and neurological disorders: an overview. 283 2

3'-Azido-2',3'-dideoxythymidine (AZT) has been administered to 7 patients with human immunodeficiency virus-associated neurological disease: 3 with dementia, 2 with peripheral neuropathy, 1 with dementia and peripheral neuropathy, and 1 with T-10 paraplegia. Six of the patients showed improvement in their neurological dysfunction on being administered AZT, as assessed by clinical evaluation, neuropsychological testing, nerve conduction studies, and/or positron emission tomographic scans. Three of these 6 patients showed sustained improvement 5 to 18 months after the initiation of AZT therapy. These results suggest that certain human immunodeficiency virus-associated neurological abnormalities are at least partially reversible following the administration of antiretroviral therapy and provide a rationale for further studies using antiretroviral chemotherapy.
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PMID:Long-term administration of 3'-azido-2',3'-dideoxythymidine to patients with AIDS-related neurological disease. 283 6


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