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 evaluated the histopathologic features of the esophageal mucosa in 88 patients seropositive for human immunodeficiency virus (HIV). All patients had an upper endoscopy because of esophageal symptoms. Forceps biopsies and brushings of the esophagus were examined histologically and cytologically for evidence of viral, fungal, and mycobacterial infections: in addition, biopsies and brushings were cultured for cytomegalovirus and herpes simplex. Esophageal inflammation (acute or chronic) was graded 0 through 3. Twenty-one patients (24%) had a normal endoscopy; none displayed high grade (grade 2 and 3) acute inflammation and only two (9.5%) had high grade chronic inflammation in the esophagus. Moreover, no fungi or viral inclusions were seen in samples from these patients. Eleven patients (12%) had an abnormal esophageal mucosa but no pathogen detected and were categorized as "idiopathic esophagitis." The percent with high-grade inflammation (27%) was not significantly different from the normal group. Fifty-six patients (64%) had an infectious diagnosis. Forty-six percent had Candida, 16% had viral esophagitis alone, and one patient had Kaposi's sarcoma. Infections were associated with high-grade acute and chronic inflammation in 53% and 47% of patients, respectively. The location of the infiltrate did not predict the type of infection. In conclusion, if esophagoscopy is normal in patients with HIV infection and esophageal symptoms, a biopsy is not necessary.
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PMID:Histopathology of human immunodeficiency virus-associated esophageal disease. 821 36

This retrospective study used sensitive immunohistochemical methods to detect Pneumocystis carinii infections in fixed lung tissues collected from 107 simian immunodeficiency virus (SIV)-infected and 10 noninfected rhesus macaques during a 4-year period. P. carinii were detected in 51% of 85 terminally ill SIV-infected macaques but in only 2 of 22 macaques killed at earlier stages of SIV infection. P. carinii were not detected in any SIV-infected macaques held in isolators or in uninfected controls. Infection rates varied significantly between rooms, and the percentage of clinically important P. carinii infections increased from 0 in the first 2 years to > 50% during the final year. Infections were centered on terminal airways in 59% of infected animals. These results challenge the assumption that P. carinii pneumonia (PCP) results primarily from reactivated latent infections and suggest instead that horizontal spread of infection is important in the epidemiology of PCP in immunosuppressed macaques.
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PMID:Evidence of horizontal transmission of Pneumocystis carinii pneumonia in simian immunodeficiency virus-infected rhesus macaques. 837 30

Infections caused by lentiviruses, including human immunodeficiency virus, are characterized by slowly progressive disease in the presence of a virus-specific immune response. The earliest events in the virus-host interaction are likely to be important in determining disease establishment and progression, and the kinetics of these early events following lentiviral infection are described here. Lymphatic cannulation in the sheep has been used to monitor both the virus and the immune response in efferent lymph after infection of the node with maedi-visna virus (MVV). Viral replication and dissemination could be detected and consisted of a wave of MVV-infected cells leaving the node around 9 to 18 days postinfection. No cell-free virus was recovered despite the fact that soluble MVV p25 was detected in lymph plasma. The maximum frequency of MVV-infected cells was only 11 in 10(6) but over the first 20 days of infection amounted to greater than 10(4) virus-infected cells leaving the node. There was a profound increase in the output of activated lymphoblast from the lymph nodes of infected sheep, characterized by an increased percentage of CD8+ lymphoblasts. All of the CD8+ lymphoblasts at the peak of the response expressed both major histocompatibility complex class II DR and DQ molecules but not interleukin-2 receptor (CD25). The in vitro proliferative response of efferent lymph cells existing the node after challenge with MVV to both recombinant human interleukin-2 and the mitogen concanavalin A was decreased between days 8 and 16 postinfection, and a specific proliferative response to MVV was not detected until after day 15. Despite the high level of CD8+ lymphoblasts in efferent lymph, direct MVV-specific cytotoxic activity was demonstrated in only one of the five MVV-challenged sheep. MVV-specific antibody responses, including neutralization and MVV p25 immune complexes in efferent lymph, were detectable during the major period of virus dissemination. The relationship of these findings to the evasion of the host's acute immune response by MVV is discussed.
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PMID:Early events in immune evasion by the lentivirus maedi-visna occurring within infected lymphoid tissue. 839 44

Sexually transmissible diseases (STD), caused by viruses are by far the most important ones, even though German legislation has ignored them up to now as STD. Anogenital herpes is easily diagnosed by means of monoclonal antibodies. This makes therapy available with acyclovir without delay in atypical cases or for example in persons with immunodeficiency. The therapy regimen usually is 5 x 200-400 mg/day. Recurrent herpes in high frequency and with severe pain may be successfully suppressed by 2-5 x 200 mg/day of acyclovir orally without serious side effects. This will not eliminate herpes viruses. Anogenital warts may look very different and occasionally cannot be detected before local application of 3% acetic acid. Histology is diagnostic. There are different strains causing diseases in men. Therapy of choice is destroying infected cells by CO2-laser coagulation. The incidence of hepatitis B in developed countries is decreasing slowly within the past years, this may partly be due to vaccines, that are available since the early eighties, producing immunity in about 95%. Treatment of chronic hepatitis with interferons seems to be beneficial. Infections with the human immunodeficiency virus (HIV) and their end stage disease AIDS are a growing problem all over the world. Interventions are possible with different nucleoside analogs, e. g. zidovudine (AZT), dideoxycytidine (DDC), dideoxyinosine (DDI). Up to now there is no agreement on when to start with one of the drugs and if or when to switch to combination therapy. Hopefully this may stabilize immunologic parameters and hold disease progression to some time.
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PMID:[Sexually transmitted diseases by herpes simplex, wart, hepatitis B, and human immunodeficiency virus]. 839 59

Infections due to pneumococci are frequent in patients infected with the human immunodeficiency virus (HIV), but joint infections are rare. We observed two cases of septic arthritis due to pneumococci in two non-haemophilic HIV seropositive patients. In the first case, a 31-year old drug addict who had undergone splenectomy, developed hip joint infection during an episode of meningitis due to pneumococci. The germ was moderately sensitive to ampicillin. The second case involved the knee joint in a 29-year-old woman who developed pneumococcal pneumonia after a trip to Zaire. In both cases, joint infection developed after antibiotics had been initiated, and in the first case, after the infection appear to be under control. This would be similar to "post-infectious" arthritis described in gonococcal and meningococcal infections. In HIV positive patients, joint infections are rare compared with other types of immunodepression, but can be observed in all stages of the disease. A total of 75 cases have been reported in the literature, including 8 cases due to pneumococci. These joint infections could be another argument in favour of anti-pneumococcal vaccination in HIV positive patients.
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PMID:[Pneumococcal septic arthritis in HIV infection]. 853 17

We review the epidemiology and prevention of and future research priorities for bacterial enteric infections in persons infected with the human immunodeficiency virus (HIV). HIV-infected persons are more frequently infected with Salmonella, Campylobacter, Listeria, and (possibly) Shigella species than are individuals not infected with HIV. In addition, Salmonella and (possibly) Campylobacter infections are more likely to be severe, recurrent, or persistent and associated with extraintestinal disease when they occur in HIV-infected persons. Infections caused by Shigella and Vibrio species can also result in more serious disease in HIV-infected persons than in those not infected with HIV. Risk of these infections can be reduced with proper precautions, particularly those pertaining to food hygiene, animal contact, and travel. Individuals infected with HIV should be informed of their increased risk of acquiring these diseases and should be counseled on the recommended precautions.
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PMID:Bacterial enteric infections in persons infected with human immunodeficiency virus. 854 18

Various viral, bacterial, parasitic and fungal agents have been found to cause infections of retina and choroidea in HIV-infected patients. Usually these infections are opportunistic infections caused by the profound immunodeficiency, which is a result of the decay of lymphocytes by HIV. Before the HIV epidemic only rare cases of cytomegalovirus (CMV) retinitis were known in the literature. Now CMV retinitis has become the most common infection of the eye in AIDS patients. Ocular toxoplasmosis in HIV-infected patients can have a severe clinical appearance without treatment. Spontaneous recovery, as it usually occurs in otherwise healthy patients, does not take place in HIV-infected patients, so that a lifelong maintenance therapy is mandatory. Pneumocystis carinii chorioiditis was unknown before the HIV epidemic. In 1987 Pneumocystis carinii were found in the choroidea and two years later the clinical appearance could be described. Infections of choroidea and retina associated with AIDS may not be seen as isolated diseases. Commonly other organs are infected by the same or another organism. In case of AIDS-associated eye infections other organs should be checked for opportunistic disease. Diagnosis can be difficult. Because most of all intraocular infections associated with AIDS are CMV retinitis, an effective therapy can be initiated in most cases and in the follow-up a diagnosis can finally be made. Serological testing may be inconclusive because of occasional false-negative findings. Treatment often only suppresses the infections and so ongoing maintenance therapy may be necessary, as in the cases of CMV retinitis and Toxoplasma retinochorioiditis. A variety of different diseases, which can be treated by a multitude of different substances with a lot of adverse effects and contraindications, can complicate the therapeutic modalities used for the management of each individual disorder. Additionally HIV-infected patients suffer from at least two or three different diseases and must be treated lifelong with plenty of substances, which often are given with higher doses than usual. Only by cooperation of HIV-experienced doctors of different specialities in hospitals and offices the complex subject of HIV infection can be managed.
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PMID:[AIDS: infections of the retina and choroid]. 865 1

Fungal diseases are increasing among patients infected with human immunodeficiency virus (HIV) type 1. Infections due to Candida and Cryptococcus are the most common. Although mucocutaneous candidiasis can be treated with oral antifungal agents, increasing evidence suggests that prolonged use of these drugs results in both clinical and microbiologic resistance. The optimal therapy for cryptococcal meningitis remains unresolved, although initial treatment with amphotericin B, followed by life-long maintenance therapy with fluconazole, appears promising. Most cases of histoplasmosis, coccidioidomycosis, and blastomycosis occur in regions where their causative organisms are endemic, and increasing data suggest that a significant proportion of disease is due to recent infection. Aspergillosis is increasing dramatically as an opportunistic infection in HIV-infected patients, in part because of the increased incidence of neutropenia and corticosteroid use in these patients. Infection due to Penicillium marneffei is a rapidly growing problem among HIV-infected patients living in Southeast Asia. Although the advent of oral azole antifungal drugs has made primary prophylaxis against fungal diseases in HIV-infected patients feasible, many questions remain to be answered before the preventive use of antifungal drugs can be advocated.
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PMID:Emerging disease issues and fungal pathogens associated with HIV infection. 890 10

Serological testing is a common method of diagnosis of felina viral infections, including feline immunodeficiency virus (FIV), feline leukemia virus (FeLV), and feline infectious peritonitis virus (FIPV). Infections with these viruses can be difficult to diagnose by clinical signs alone and are sometimes clinically inapparent for months after initial exposure. Serological testing to confirm a tentative diagnosis or as a screening tool for infection can be invaluable. However, serological tests must be used only with a thorough understanding of the mechanisms and abilities of the tests, and with recognition of their potential inadequacies and misinterpretations. This report summarizes the assays available for FIV, FeLV, and FIPV, and discusses merits and pitfalls associated with each test.
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PMID:FIV, FeLV, and FIPV: interpretation and misinterpretation of serological test results. 894 10

Among the different targets affected by immunodeficiency, skin is at the first line. Infections are the most frequent causes of cutaneous manifestations in immunocompromised subjects. They are primitive or secondary cutaneous infections occurring during disseminated disease. Skin manifestations may reveal the systemic disease. Primary or secondary bacterial, viral, fungic, and parasitic mucocutaneous diseases are often atypical, extensive and frequently follow chronical course. These peculiar presentations makes diagnosis difficult. The knowledge of the clinical pleomorphism of skin infections in immunocompromised subjects is essential. All doubtfull lesions must lead to histological and microbiological study. Diagnosis delay may increase the risk of dissemination resulting in morbidity and mortality.
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PMID:[Characteristics of mucocutaneous infections in immunocompromised patients]. 894 94


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