Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026916 (MAC)
 5,226 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A longitudinal study with follow up to the end of 1989 was carried out on 23 patients with AIDS who had attended St. James's Hospital, Dublin, by the end of 1987. Until then only 33 cases of AIDS had been reported in Ireland. The patients, all of whom had antibodies to human immunodeficiency virus (HIV), were predominantly male, young (mean age 31.3 years) and belonged about equally to three major risk groups: homosexuals, intravenous drug abusers (IVDA) and haemophiliacs. AIDS was diagnosed because of oesophageal candidiasis (8 cases), Kaposi's sarcoma (4), mycobacterial infection (4), pneumocystis carinii pneumonia (3), toxoplasmosis (2) or encephalopathy (2). Malignant lymphoma and a variety of infections occurred in the course of illness, and neurological involvement developed in 11 patients (48%). Mortality following diagnosis of AIDS was 39% at one year and 64% after two years. Autopsy in 10 of the 16 deaths contributed much to defining the extent and nature of the disease. The demographic pattern, risk group status, survival and range of complications were broadly similar to the pattern of AIDS as seen elsewhere in developed countries. However, compared to the profile of disease reported from the United States, oesophageal candidiasis (52%) and Mycobacterium tuberculosis (22%) were more prominent, pneumocystis carinii pneumonia (39%), Kaposi's sarcoma (22%) and Mycobacterium avium intracellulare (13%) were less frequent and cryptococcal infection was not identified. These regional variations in the frequency of the various complications and particularly the prominence of tuberculosis, probably reflect the interaction of the immunocompromised patient with the local environment and may have important diagnostic and therapeutic implications.
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PMID:The emerging AIDS epidemic in Ireland--clinicopathological findings in 23 early cases. 239 Dec 9

Over a three-year period, 54 episodes of pneumonia were diagnosed in 45 adults infected with the human immunodeficiency virus (HIV). These episodes were reviewed in order to assess the distribution of pathogens and their clinical presentation. Thirty-six episodes were due to an opportunistic pathogen (Pneumocystis carinii in 31, Mycobacterium avium complex in 3, Mycobacterium tuberculosis in 2), and 18 were caused by non-opportunistic pathogens (11 Streptococcus pneumoniae, 2 Haemophilus influenzae, 5 unknown pathogens that responded to broad-spectrum antibiotics). Non-opportunistic pneumonias were characterized by an abrupt onset (18/18 had pulmonary symptoms of less than 7 days duration), high fever (13/18), and focal lung infiltrates (17/18). In contrast, opportunistic infections infrequently presented with pulmonary symptoms of less than 7 days duration (3/36) or high fever (7/36), and most of the chest radiograms (34/36) disclosed a diffuse lung infiltrate. In HIV-infected patients presenting with pneumonia, simple clinical and radiological data may point to bacterial pathogens. Such data could be used in selected cases to spare invasive procedures and to start empirical antibiotic therapy.
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PMID:Diagnosis of pulmonary infections in patients infected with the human immunodeficiency virus. 249 92

Three full-length cDNA clones were obtained from cells infected with the simian immunodeficiency virus (SIV) isolated from captive macaques (SIVMAC). Nucleotide sequence analyses suggested that these represented mRNA for the SIV MAC genes tat, rev (formerly, art/trs), and nef (formerly, 3'orf). The putative tat-specific clone was active in trans-activation of the SIV MAC long terminal repeat in COS-1 and Jurkat cells. In contrast, the human immunodeficiency virus 1 long terminal repeat was significantly trans-activated only in the COS-1 cells. This suggests that trans-activation by the SIV tat gene is modulated by cell-specific factors. The structure of all of the clones suggested an mRNA splicing pattern more complex than that described for human immunodeficiency virus 1.
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PMID:Structure of simian immunodeficiency virus regulatory genes. 254 74

Four juvenile rhesus macaques were infected with simian immunodeficiency virus (SIV)MAC-Freshly isolated peripheral blood mononuclear cells (PBMC) from these SIVMAC-infected and from uninfected control macaques were assessed for cytotoxic T-lymphocyte (CTL) activity monthly for 7 consecutive months, beginning 2 months after infection. Target cells consisted of major histocompatibility complex (MHC) haploidentical parental PBMC which were stimulated with mitogen and then pulsed with heat-killed SIVMAC. CTL activity was demonstrated on all four infected animals. The effector cells are T cells which mediate cytotoxicity against SIVMAC-pulsed target cells in an MHC-restricted manner. Furthermore, the cytotoxicity is virus specific and predominantly, if not exclusively, mediated by CD8+ T cells; it is also MHC class-I restricted. Incubation of target cells with leupeptin prior to the cytotoxic assay inhibited target cell generation, suggesting that viral antigens are processed via an endocytic pathway.
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PMID:Characterization of simian immunodeficiency virus-specific T-cell-mediated cytotoxic response of infected rhesus macaques. 256 Oct 53

Clofazimine is useful in the treatment of Hansen's disease (leprosy) and some dermatological disorders, and is currently being used in drug regimens for patients with human immunodeficiency viral infections who are also infected with Mycobacterium avium complex. After an oral dose, absorption is variable, but when given in an oil-wax suspension is approximately 70%. Administration with food appears to increase the peak plasma drug concentration and reduce the time to peak level. Data on the volume of distribution and percentage or type of protein binding are not available; however, the drug undergoes extensive tissue distribution. Clofazimine does not cross the blood-brain barrier, but does cross the placenta, and is found in human breast milk. To date 3 urinary metabolites have been identified in man, but their biological activity is unknown. A substantial portion of the unchanged drug is excreted in faeces. The elimination half-life is variable, with values as long as 70 days being quoted in the literature. Frequently reported side effects of clofazimine are hyperpigmentation of the skin and conjunctiva, and abdominal pain. These resolve upon cessation of therapy. Biochemical and haematological adverse effects have been reported, but are generally not clinically relevant. Pharmacokinetic drug interactions of potential clinical significance have been observed with dapsone, oestrogen, rifampicin and vitamin A.
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PMID:Clinical pharmacokinetics of clofazimine. A review. 265 45

Because of the abnormalities of host defenses caused by the human immunodeficiency virus (HIV), persons with HIV infection are vulnerable to tuberculosis. Inferential data from several parts of the country indicate increases in tuberculosis case rates, probably occurring in patients with HIV infection. In a person infected with both HIV and Mycobacterium tuberculosis, attack rates of tuberculosis seem to be very high. In general, the disease tends to occur earlier in the course of HIV infection than other opportunistic processes that serve to define the acquired immunodeficiency syndrome (AIDS), presumably because M tuberculosis is more pathogenic than Pneumocystis carinii or Mycobacterium avium complex, for example. The clinical features of tuberculosis in this patient population seem to vary depending on the stage of the HIV infection. Late in the process, tuberculosis usually has atypical features with chest films showing diffuse infiltration, no cavities, and intrathoracic adenopathy. Tuberculin skin tests commonly are negative. At earlier stages of HIV infection, the clinical findings are similar to those in HIV-seronegative persons. Response to treatment is generally good; however, it is recommended that the standard duration be at least 9 months, using isoniazid and rifampin usually supplemented by pyrazinamide in the first 2 months. The use of isoniazid for preventive therapy is recommended for all HIV-seropositive persons who have tuberculin skin test reactions greater than or equal to 5 minutes. Those implementing infection-control measures for HIV-infected patients who have pulmonary findings should take tuberculosis into account until the disease is excluded. Medical personnel providing care for patients with tuberculosis should use universal blood and body substance precautions because of the possibility of undetected HIV infection in patients with tuberculosis.
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PMID:Tuberculosis and human immunodeficiency virus infection. 266 35

Mycobacterial disease is an increasingly common and serious problem in patients infected with the human immunodeficiency virus. Whereas Mycobacterium avium complex organisms are noncommunicable and extremely difficult to treat, Mycobacterium tuberculosis is transmissible to patients who do not have the acquired immunodeficiency syndrome, but is preventable and treatable.
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PMID:Mycobacterial disease in patients infected with the human immunodeficiency virus. 267 52

Between January 1981 and December 1986, 4,178 patients were cultured for mycobacteria at a community teaching hospital in Hartford. The number of patients with positive cultures totaled 278 (6.65%). Mycobacterium other than tuberculosis (MOTT) was isolated from 228 (82%). MOTT isolation increased yearly from 1.5% of the patients in 1981 to 14.5% of the patients in 1986. Mycobacterium avium intracellulare (MAI) was the most common MOTT species isolated (197/228). Fifty-nine patients were under the age of 50, but 23 had predisposing factors for MOTT. Of the 36 who did not have an underlying condition, 25 had the human immunodeficiency virus (HIV). The isolation of MAI preceded the diagnosis of AIDS/ARC in nine patients, in 10 others it coincided with their diagnosis and in six it followed the diagnosis. Isolation of MAI in a patient under the age of 50 with no predisposing factors may suggest concommitant HIV disease.
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PMID:Mycobacterium avium intracellulare as a marker of human immunodeficiency virus disease. 275 31

To establish the indications for splenectomy in patients with human immunodeficiency virus (HIV) infection we retrospectively analyzed 12 patients who underwent splenectomy. Patients with HIV infection who had immune thrombocytopenic purpura (ITP) were excluded as they had no splenomegaly and a definite indication for splenectomy exists in some of these patients. All 12 patients were anemic; 6 were thrombocytopenic and 6 leukopenic. All patients had splenomegaly and all were febrile. At surgery 3 patients were found to have Mycobacterium avium intracellulare (MAI) infection; 2 had splenic abscess due to Salmonella group D; 1 each had cytomegalovirus (CMV) splenitis and localized Kaposi's sarcoma (KS) of the spleen. No definite histopathologic diagnosis could be made in five patients, all of whom had evidence of extramedullary hematopoiesis. The degree of splenic enlargement did not correlate with the outcome. Both clinical and hematologic improvements were achieved in patients with splenic abscess and in patients who had splenomegaly, anemia, and thrombocytopenia. The presence of either of these findings constitutes an indication for splenectomy. Anemia and/or leukopenia without thrombocytopenia failed to improve; the presence of MAI and active CMV infection also resulted in failure. The presence of either of these conditions may be considered a contraindication to splenectomy.
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PMID:Splenectomy in patients with AIDS. 281 11

Mycobacterial disease is common among patients with the acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection. Among all patients with AIDS, the most frequently isolated cause is Mycobacterium avium complex; but in some groups, such as Haitians and intravenous drug users, M. tuberculosis is commoner. Extrapulmonary disease and noncavitary, nonapical pulmonary tuberculosis are frequently seen. It is recommended that initial treatment of tuberculosis in these patients include at least three standard antituberculosis drugs and that therapy be continued for a minimum of 9 months. Treatment of disseminated disease due to M. avium complex with this regimen is unsatisfactory, and a four-drug regimen that includes two experimental drugs, rifabutine and clofazimine, is the recommended treatment. Patients with AIDS or HIV infection and pulmonary tuberculosis should be considered potentially infectious, and appropriate infection-control and contact-tracing procedures applied. Persons with HIV infection should be given a tuberculin skin test and, if the reaction is positive (10 mm or more in diameter), isoniazid preventive therapy.
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PMID:Diagnosis and management of mycobacterial infection and disease in persons with human immunodeficiency virus infection. Centers for Disease Control, U.S. Department of Health and Human Services. 380 Jan 86


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