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)

Anemia of chronic disease (ACD) is frequent in patients with human immunodeficiency virus (HIV) and its etiology is multifactorial. In a group of 111 patients with HIV, 19 were diagnosed with ACD. Parameters related to iron metabolism, such as serum iron (SI), serum ferritin (SF), and soluble transferrin receptor (sTfR) were correlated to levels of interferon-gamma (IFN-gamma) and results compared to a group of 42 nonanemic patients with HIV. Measurements of erythropoietin (EPO), CD4/CD8 T-cell ratio, and reticulocyte count (RTC) were determined to verify aspects related to severity of disease and bone marrow response. The results showed higher SF concentrations in ACD patients and normal or slightly increased sTfR measurements in both groups. There was no correlation between IFN-gamma and SF and between IFN-gamma and sTfR determinations. Lower CD4/CD8 values were obtained in ACD, and an inverse correlation was observed between IFN-gamma and CD4/CD8 in groups with and without anemia. RTC counts and EPO concentrations were similar in both groups: immature RTC were increased in patients with anemia, indicating an apparent attempt of marrow response to compensate the increased demand. Our data showed no correlation between IFN-gamma levels and iron disturbances in ACD, but results reinforced the observation of enhanced immunologic system deterioration in patients with HIV and ACD.
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PMID:Human immunodeficiency virus-related anemia of chronic disease: relationship to hematologic, immune, and iron metabolism parameters, and lack of association with serum interferon-gamma levels. 1222 86

An estimated 50% of pregnant women in Africa are anemic-- a condition that has been linked to intrauterine growth retardation, increased perinatal mortality, low birthweight, compromised immunity, and possible psychomotor and cognitive impairments. In tropical Africa, iron and folate deficiencies and malaria are the major causes of anemia in pregnancy. Iron deficiency anemia results from a combination of dietary insufficiency, excessive requirements associated with multiparity, and chronic blood loss from hookworm infestation. An essential component of maternal-child health services in Africa is prevention of anemia and therapeutic management once severe anemia is documented. Since 35% of nonpregnant African women are anemic, many women will enter pregnancy with inadequate iron stores. Thus, the prophylactic dose of iron should be at least 120 mg/day rather than the usual 60 mg dose. Unfortunately, increased dosages of iron increase the side effects of constipation and nausea, so careful counseling is necessary to ensure compliance. Folic acid, which has no side effects, should be administered in doses of 1.5 mg/day. To reduce the risk of malaria, a therapeutic dose of chloroquine should be administered at the 1st prenatal visit (600 mg for 2 days and 300 mg on the 3rd day) followed by proguanil (100 mg/day) until delivery. In cases where anemia persists or emerges, the iron dose should be increased to 200 mg of ferrous sulfate 3 time/day (180 m,g of elemental iron) and 5 mg of folic acid should be provided. Blood transfusion should be used sparingly and only in severe cases, given the risk of transmission of human immunodeficiency virus.
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PMID:Towards a more effective management of pregnancy related anaemias in Africa. 1231 81

Mycobacterium avium is a facultative intracellular pathogen cleared rapidly via intact host defense mechanisms. In the absence of adequate T cell function, as occurs in HIV-1-induced immunodeficiency, M. avium becomes an opportunistic infection with uncontrolled replication and reinfection of macrophage hosts. How M. avium infects, survives, and replicates in macrophages without signaling an effective microbicidal counterattack is unresolved. To address whether M. avium signals the expression of molecules, which influence mycobacterial survival or clearance, human monocyte-derived macrophage cultures were exposed to M. avium. Within minutes, M. avium, or its cell wall lipoarabinomannan, binds to the adherent macrophages and induces a spectrum of gene expression. In this innate response, the most abundant genes detected within 2 h by cDNA expression array involved proinflammatory chemokines, cytokines including TNF-alpha and IL-1, and adhesion molecules. Associated with this rapid initial up-regulation of recruitment and amplification molecules was enhanced expression of transcription factors and signaling molecules. By 24 h, this proinflammatory response subsided, and after 4 days, when some bacteria were being degraded, others escaped destruction to replicate within intracellular vacuoles. Under these conditions, inducible NO synthase was not up-regulated and increased transferrin receptors may facilitate iron-dependent mycobacterial growth. Sustained adhesion molecule and chemokine expression along with the formation of multinucleated giant cells appeared consistent with in vivo events. Thus, in the absence of T lymphocyte mediators, macrophages are insufficiently microbicidal and provide a nonhostile environment in which mycobacteria not only survive and replicate, but continue to promote recruitment of new macrophages to perpetuate the infection.
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PMID:Mycobacterium avium infection and modulation of human macrophage gene expression. 1244 35

Anemia has multiple etiologies: it may be caused by nutritional deficiencies or congenital abnormalities, or it may be associated with a number of conditions, such as chronic kidney disease, cancer, or human immunodeficiency virus (HIV) infection. Anemia is associated with an increase in morbidity and mortality in patients with endstage renal disease, cancer, or HIV infection. Each case of anemia is different, with different causes, clinical consequences, and treatment strategies. Identifying the most appropriate treatment requires an understanding of the etiology of the anemia and investigation of the nature of the causative medical condition. In some cases, such as anemia associated with chronic kidney disease, treatment is well defined and consists of administration of erythropoiesis-stimulating agents, accompanied by iron supplementation where appropriate. In other instances, such as megaloblastic anemia, which may be caused by vitamin or folate deficiency, vitamin supplementation alone may be a clinically appropriate treatment. This article gives an overview of the etiologies and current therapies of the most commonly encountered types of anemia, highlighting both the diverse nature of the condition, and the equally diverse pharmacologic and supportive treatment approaches.
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PMID:Pharmacologic and cytokine treatment of commonly encountered anemias. 1260 95

A number of factors, including increased iron stores and alcohol consumption, are known to be associated with the development of porphyria cutanea tarda (PCT) in susceptible individuals. Recent reports have described a significant association between inheritance of the C282Y and H63D mutations in the HFE gene, associated with genetic hemochromatosis (GH) and PCT. A strong association between hepatitis C virus infection and PCT has also been demonstrated, while case reports record a link between human immunodeficiency virus (HIV) and PCT. We have investigated the frequency of these factors in a racially-mixed population of patients with PCT in Cape Town, South Africa. 57 patients with PCT drawn from three ethnic groups were screened for the presence of the C282Y and H63D mutations linked to GH, and the prevalences were compared with corresponding healthy control populations. The seroprevalence of markers for HCV, hepatitis B (HBV) and HIV infection were examined in 28 of these. In the control populations, we found that both the C282Y and H63D mutations are highly prevalent in South Africans of European origin. In a population of mixed or Asian origin, the C282Y mutation is very rare whereas the H63D mutation is common. Neither mutation was encountered in any African subject. Both mutations are associated with PCT, but the association is dependent on the ethnic origins of the population to which the patient belongs. In contrast to other studies, HCV infection is numerically unimportant in PCT in our patients. HIV infection is increasingly encountered in our patients with PCT, but the strength of the association cannot be determined in view of the high background prevalence of HIV infection in some sectors of the South African population. The contribution of specific risk factors may be heavily dependent on the population from which patients are drawn, and care should be taken in extrapolating from observations in one racial or geographic population to any other.
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PMID:Porphyria cutanea tarda: the etiological importance of mutations in the HFE gene and viral infection is population-dependent. 1269 43

Eight hemochromatosis probands with HFE C282Y homozygosity had frequent, severe, or unusual infections and common variable immunodeficiency (CVID) or immunoglobulin (Ig) G subclass deficiency (IgGSD). Thus, we performed serum Ig isotyping and other characterization of 43 additional unselected probands, 5 human leukocyte antigen (HLA)-identical siblings, and 240 consecutive CVID or IgGSD index patients. C282Y allele frequencies were estimated in 58 CVID or IgGSD index patients without hemochromatosis phenotypes and in 341 controls. HLA-A and -B haplotypes and frequencies were determined in all 51 probands, 186 CVID or IgGSD index patients without hemochromatosis phenotypes, and 751 controls. Thirteen unselected probands (30%) had CVID or IgGSD. Among all 21 hemochromatosis probands with CVID (n = 4) or IgGSD (n = 17), Ig subclass deficiency patterns were IgG(1) (n = 5), IgG(1) and IgG(3) (n = 6), IgG(3) (n = 9), and IgG(1), IgG(3), and IgG(4) (n = 1). IgG(2) or IgA deficiency was not detected; one proband had IgM deficiency. Mean values of total IgG, IgG(1), and IgG(3) were significantly lower in probands with CVID or IgGSD. Mean values of age, transferrin saturation, and ferritin at diagnosis and phlebotomy units required to induce iron depletion were similar in probands with or without CVID or IgGSD; phlebotomy had no apparent effect on IgG levels. C282Y frequencies were similar in CVID or IgGSD index cases without hemochromatosis phenotypes and in controls. There was concordance of Ig and hemochromatosis phenotypes in probands and respective HLA-identical siblings. Eight of 240 CVID or IgGSD index patients had hemochromatosis phenotypes and C282Y homozygosity (3 vs 0.7% and 0.2% controls; P < 0.0001, respectively). The frequency of A*03-B*07 was greater in CVID and IgGSD index cases without hemochromatosis phenotypes than in controls (0.0968 vs 0.0546, respectively; P = 0.0032). HLA-A*03-B*07 was the predominant haplotype in probands grouped by presence or absence of CVID or IgGSD. Some probands in each group were A*03-B*07 homozygotes; group A*03-B*07 frequencies were similar. We conclude that serum IgG abnormalities characteristic of CVID or IgGSD are common in hemochromatosis probands, and that the prevalence of hemochromatosis is increased in CVID and IgGSD index cases. These observations could be explained by the increased frequencies of HLA-A*03-B*07 in C282Y homozygotes and in CVID and IgGSD, and by the common occurrence of putative CVID or IgGSD allele(s) on haplotypes bearing C282Y.
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PMID:Common variable immunodeficiency and IgG subclass deficiency in central Alabama hemochromatosis probands homozygous for HFE C282Y. 1285 Apr 93

The Hepatitis C virus has emerged over the last two decades as the cause of the second greatest viral infection epidemic after the human immunodeficiency virus (HIV). A significant characteristic of the infection with the Hepatitis C virus is the variable course of its natural history. About 80% of the people who acquire this agent develop a chronic infection, with varying degree of liver damage, including cirrhosis and even hepatocelular carcinoma. However, only a minority progresses towards more severe forms. Several factors associated with the host seem to influence the progression of Hepatitis C into cirrhosis. The most important are alcohol abuse, the age in which the infection is acquired, duration of the infection, overweight, male sex and coinfection with Hepatitis A or B or HIV. Evidence of the role of iron levels in the liver, tobacco or the source of infection are less clear. The factors associated with the agent do not seem to play any role in the progression of the disease. Additional studies with adequate control groups are required to confirm the participation of the above mentioned host factors and to identify others which could influence the natural history of the Hepatitis C infection. A reduction in the ingestion of alcohol, overweight and tobacco consumption could contribute to the treatment of HVC chronic infection, as well as vaccination against Hepatitis A and B.
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PMID:[Risk factors for the progression of chronic hepatitis C virus infection]. 1285 89

The prevalence of iron-deficiency anemia appears to be extremely high among female injection drug users in the inner city who have human immunodeficiency virus (HIV) and/or hepatitis C (HCV) infections. Iron deficiency and its associated anemia may contribute to reduced energetic efficiency, lower aerobic capacity, decreased endurance, and fatigue. In practical terms, the functional limitations of iron deficiency and iron-deficiency anemia may affect the ability of women to participate in work, school, social, and family activities. Iron deficiency may contribute to the cycle of poverty in the inner city by limiting the ability of women to work, earn money, and afford iron-rich sources of food. Although iron supplementation may prevent or treat iron deficiency, the use of iron supplements needs to be approached with caution in women with HIV and HCV infections.
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PMID:Iron-deficiency anemia and the cycle of poverty among human immunodeficiency virus-infected women in the inner city. 1294 83

We present a case of hemophagocytic syndrome in a human immunodeficiency virus-positive man with iron-deficiency anemia that did not respond to highly active antiretroviral therapy. Clinical resolution occurred only after a splenectomy was performed.
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PMID:Human immunodeficiency virus-associated hemophagocytosis with iron-deficiency anemia and massive splenomegaly. 1522 32

OBJECTIVE: To analyze the evolution of clinical and hematological aspects of the children infected with HIV 1. METHODS: Using the CDC criteria, 1994, 37 children with HIV infection were selected, followed up at the Immunodeficiency Clinic at UNICAMP. The study is longitudinal descriptive. Complete blood count, ferritin, serum iron, TIBC and direct Coombs were carried out. RESULTS: The clinical category that predominated wasB(45.94%) and categories A and C were equal (27.03%). All of them were having antiretroviral therapy. Hypochromic and microcytic anemia were seen in 100% of patients up to 12 months of age. There was association between anemia and the progression of the disease, both clinical (p=0.031) and immunological (p=0.0027) and with lymphopenia too (p=0.033). Thrombocytopenia occurred in 10 to 25% of the patients. Low serical ferritin was seen in 2.7% of the cases and low serum iron in 11.1%. All the 15 patients analyzed had negative Coombs test. There was weight and height reduction in 23.5 to 45% of the children and 70.3% had clinical manifestations up to 9 months of age. During the follow up 13.2% of the patients died. CONCLUSIONS: There was association between anemia and lymphopenia with the progression of the disease. In relation to the aetiology of the anemia, about 10% can be considered anemia of chronic disease. Probably the hematological abnormalities seen in peripheral blood are the consequences of loss of control of cellular death mechanism and hematopoiesis in individuals infected by HIV 1.
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PMID:[Evolution of hematological parameters in a group of children with human immunodeficiency virus infection - HIV 1] 1468 99


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