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 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The association between AIDS and a spectrum of malignancies relates to chronic, profound defects in both cellular and humoral mechanisms of immune surveillance. Ironically, as AIDS patients live longer in response to increasingly effective antiretroviral therapies, the incidence of AIDS-related malignancies will continue to rise. The emergence of non-Hodgkin's lymphomas (NHL) as a major sequela of HIV infection bears a striking relationship to depletion of CD4 lymphocytes, particularly below 50/mm3. The ability to interfere early in the course of active HIV infection with additional mechanisms that may promulgate transformed cell hyperproliferation and clonal expansion--growth factors, HIV itself or other viruses (Epstein-Barr, in particular), aberrant oncogene or tumor suppressor genes expression, factors that induce genetic instability or DNA damage or alter host or viral genome repair--might decrease the occurrence or prolong the time to development of AIDS-related malignancies. The development of antiretroviral strategies that confer long-term suppression of HIV activity and relative preservation of immune function are essential to the ultimate prevention of malignancies that arise as a consequence of HIV-induced immunosuppression.
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PMID:The pathogenesis of AIDS lymphomas: a foundation for addressing the challenges of therapy and prevention. 136 82

Kaposi's sarcoma (KS) presents with variable severity in the context of HIV infection. Various therapeutic approaches can be taken, and these are determined by the extent and location of KS lesions and the severity of tumor-related symptoms. New insights into the pathogenesis of KS lesions may provide innovative treatment strategies and a more rational basis for the control of this neoplasm.
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PMID:Medical management of AIDS patients. Kaposi's sarcoma. 137 98

Immunosuppressed persons are at greater risk of developing malignancies. In human immunodeficiency virus (HIV) immunosuppression the most common oral cancers are Kaposi's sarcoma and non-Hodgkin's lymphoma. Squamous cell carcinoma has also been reported to be associated with HIV disease. Kaposi's sarcoma is the most frequent neoplastic disease in acquired immunodeficiency syndrome and is by far the most common in the head and neck area. This article reviews the prevalence, clinical features, and management of these diseases in HIV infection.
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PMID:Head and neck malignancies associated with HIV infection. 137 99

The majority of lymphomas in the setting of acquired, iatrogenic, or congenital immunodeficiencies are B-cell lymphoproliferations. We describe a rare T-cell lymphoma in a fulminantly ill patient infected with human immunodeficiency virus type 1 (HIV-1). The T-cell nature of the process was defined genotypically (monoclonal T-cell receptor beta-chain [CT beta] rearrangement) and phenotypically (CD45RO+, CD4+, CD5+, CD25+, CD8-, CD3- and negative for a variety of B-cell and monocyte markers). The CD4+, CD25+ (interleukin-2 receptor [IL-2R]) phenotype with production of IL-2 and IL-2R RNA is analogous to human T-lymphotropic virus type I (HTLV-I)-associated adult T-cell leukemia/lymphoma (ATLL); however, no HTLV-1 could be detected. Southern blot analysis did demonstrate monoclonally integrated HIV-1 within the tumor genome. Furthermore, the tumor cells were producing HIV p24 antigen as shown by immunohistochemistry. This is the first case of acquired immunodeficiency syndrome (AIDS)-associated non-Hodgkin's lymphoma in which HIV-1 infection may have played a central role in the lymphocyte transformation process.
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PMID:Acquired immunodeficiency syndrome-associated T-cell lymphoma: evidence for human immunodeficiency virus type 1-associated T-cell transformation. 137 87

gamma/delta+ T-cells are a recently identified subpopulation of T-lymphocytes expressing an "alternative" T-cell receptor (TCR) molecule consisting of disulfate-linked or nonlinked gamma and delta chains. Despite a limited number of V gamma and V delta genes in the germ line, there is a large and diverse gamma delta TCR repertoire due to extensive N region variability. Recently developed monoclonal antibodies against V gamma and V delta gene products are useful reagents for the identification and isolation of gamma/delta+ T-cell subpopulations. The physiological significance of gamma/delta+ T-cells is still unknown. However, accumulating evidence indicates that human gamma/delta+ T-cells frequently recognize bacterial ligands as well as certain tumor cells. Interestingly, reactivity towards microbial antigens is usually restricted to a subpopulation of gamma/delta+ T-cells expressing a V gamma 9/V delta 2 TCR. However, different bacteria-reactive V gamma 9+/V delta 2+ gamma/delta+ T-cells display extensive N region variability, suggesting the involvement of a gamma/delta-specific superantigen in these responses. Little is known about the role of gamma/delta+ T-cells under pathological conditions. Rare cases of gamma/delta+ T-cell leukemias and lymphomas have been described. In addition, discrete changes in the distribution of gamma/delta+ T-cell subpopulations have been observed during HIV infection. Current thinking favors the interpretation that gamma/delta+ T-cells play a role in the immune reaction during infection and in the regulation of physiological or pathophysiological autoimmune responses.
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PMID:Function and specificity of human gamma/delta-positive T cells. 137 36

The development of AIDS-related lymphomas (ARL) has been on the rise in recent years. During an analysis of ARL from AIDS patients, one individual developed atypical syncytial variants of high-grade Burkitt's-type B-cell lymphomas, which prompted further study. However, the search for a HIV-1 retrovirus, which we hypothesized was infecting these cells, led to the subsequent discovery of a type D retrovirus in two early-passage lymphoma cell lines derived from this patient. Nucleotide and amino acid sequence analysis, as well as immunologic reactivity, indicated that the virus was closely related to Mason-Pfizer monkey virus (MPMV) or simian retrovirus type 1 (SRV-1). MPMV and SRV-1 are immunosuppressive type D retroviruses that cause an AIDS-like syndrome in rhesus macaques. Amplification of DNA from the patient's diagnostic bone marrow biopsy specimen by the polymerase chain reaction generated MPMV-specific fragments indicative of infection by a retrovirus similar to MPMV. Additionally, the patient's serum contained antibodies that recognized type D retroviral env proteins (gp20 and gp70) and gag proteins (p27 and p14) as assayed by immunoblot and radioimmunoprecipitation techniques. Although there have been reports of human cell lines infected with type D retroviruses and of type D reactive human sera, this is the first report of a type D retrovirus infection in a human confirmed by virus isolation, serum immunoreactivity, and viral DNA identification in tumor tissue.
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PMID:Studies on a type D retrovirus isolated from an AIDS patient lymphoma. 138 Dec 7

The focus of infection with HIV is the lymphatic system, resulting in a specific HIV-related pathology in the parotid. Of the salivary glands, the parotid gland is unusual in including lymphoid tissue within its capsule. Infection by HIV is accompanied by a characteristic follicular hyperplasia of lymphoid tissue which can be recognized histologically as primary HIV lymphadenopathy and presents clinically as persistent generalized lymphadenopathy. Subsequent opportunistic infections and HIV-related neoplasia can result in secondary HIV lymphadenopathy. Parotid lymph nodes reflect these HIV-related changes. Diffuse enlargement of the parotid glands are further manifestations of HIV infection. All patients who presented to a general surgical unit of the University Teaching Hospital, Lusaka, Zambia, over the 2-year period of 1989-1991 were studied in a prospective clinicopathological study of lymphadenopathy. The diagnosis of HIV infection was made clinically and with a single serological test. Parotid lymphadenopathy was present in 69 of 261 HIV-seropositive patients with generalized lymphadenopathy who underwent lymph node biopsy during the 2-year period. In all but one patient, biopsy of a node other than the parotid provided the histological diagnosis. 9 patients presented with bilateral parotid enlargement. 8 of the patients had generalized lymphadenopathy caused by primary HIV lymphadenopathy in 5, Kaposi's disease in 2 and tuberculous lymphadenitis in 1. 4 patients presented with multiple cystic parotid lesions of between 1 month and 4 years duration. Unilateral extraparotid lymphoepithelial cysts of a diameter of 2 and 3 cm were removed from the jugulodigastric area of 2 patients with generalized lymphadenopathy. Parotid disease not related to HIV included: 1 case each of papillary carcinoma and pleomorphic adenoma; 7 patients with parotid lymph nodes, and 3 patients with diffuse bilateral parotid enlargement.
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PMID:Parotid disease and human immunodeficiency virus infection in Zambia. 836 52

Infection from human immunodeficiency virus (HIV) is well known for the particular host susceptibility to a variety of opportunistic infections and unusual malignant neoplasms. Although no tumor develops exclusively in concomitance with HIV infection, malignancies in these patients have different clinical behaviour, response to treatment and prognosis than the pattern observed in HIV negative hosts. Kaposi's sarcoma (EKS) and non-Hodgkin's lymphoma (NHL) are tumors per se diagnostic of AIDS in patients with HIV infection. From 1987 to 1991, 210 HIV positive patients underwent ENT examination without symptom-related selection: 128 were intravenous drug users, 50 homosexual males, 22 heterosexuals, 4 intravenous male homosexual drug users, 3 blood recipients and 3 subjects without known risk factors. Sixteen were allocated in group II, 37 in III, 9 in IV A, 2 in IV B, 31 in IV C1, 37 in IV C2, 48 in IV D and 30 in IV E. Fourteen had head and neck EKS localization. All were males, with a median age of 40 of which 11/14 were homosexuals. The concomitant involvement of skin and mucosa was the most common manifestation and the palate was the most frequently affected mucosal site. Twenty-four had NHL localized within the head and neck: 21 males and 4 females with a average age of 38, 10 intravenous drug users, 9 homosexual males, 3 heterosexuals, 1 blood recipient, 1 subject without known risk factors. Extranodal localization was the most frequent characteristic while the gums were the most commonly involved site. The main characteristics of head and neck manifestations of EKS and NHL are reported with references to literature. The majority of HIV infected patients with EKS or NHL have ENT localizations, perhaps because lymphatic tissue, a HIV target, is well represented in this area and contamination by infectious agents (such as Epstein-Barr virus and cytomegalovirus, probably involved in the pathogenesis of EKS and NHL) can easily occur in the head and neck. The otolaryngologist should be aware of the various, and sometimes misleading, characteristics of these diseases.
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PMID:[The cervicofacial manifestations of Kaposi's sarcoma and of non-Hodgkin's lymphomas in HIV-infected patients]. 141 19

Kaposi's sarcoma (KS) is the most common tumor among HIV-infected individuals, but its involvement in the gastrointestinal tract was reported long before the AIDS epidemic. Although most cases of gastrointestinal KS are asymptomatic, advanced lesions may occasionally result in a severe and life-threatening hemorrhage that requires immediate treatment. At the NYU Medical Center, we have seen three AIDS patients present with severe upper tract bleeding (> 8 U/48 h) from KS lesions of the antrum, fundus, and duodenum. The last patient was also bleeding from an ulcerated rectal KS lesion. Because all three patients had a coexisting thrombocytopenia (platelets < 50,000/mm3) and were poor operative risks, injection sclerotherapy was performed. All four KS lesions stopped bleeding, and three out of the four lesions decreased in size. To our knowledge, this is the first report of successfully using sclerotherapy to treat severe hemorrhage due to gastrointestinal KS.
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PMID:Severe hemorrhage caused by gastrointestinal Kaposi's syndrome in patients with the acquired immunodeficiency syndrome: treatment with endoscopic injection sclerotherapy. 141 7

Ninety-two cases of Hodgkin's disease (HD) in patients with HIV infection have been collected by the Italian Cooperative Group on AIDS and Tumors (G.I.C.A.T.). In accordance with the epidemiology of HIV infection in Italy, 82% were intravenous drug users (IVDU), 8% homosexual men, 5% IVDU+homosexuals and 5% heterosexuals. At diagnosis of HD, 16% had AIDS, 20% AIDS related complex (ARC), 33% persistent generalized lymphadenopathy (PGL) and 31% were asymptomatic. Fifty-three percent of the patients had stage IV disease and 70% mixed cellularity and lymphocytic depletion. Forty-six patients were treated with MOPP or MOPP [symbol: see text] ABVD +/- radiotherapy (zidovudine was not given) with complete remission (CR) in 54% and partial remission (PR) in 46% of the patients. Fifty-six percent of these patients developed opportunistic infections (OI) during therapy or follow-up. Sixteen patients were treated with epirubicin, bleomycin and vinblastine (EBV) and concomitant zidovudine, with CR in 44% and PR in 38%. However, only one of these patients developed OI during therapy or follow-up. The clinico-pathological features and natural history of HD in HIV setting are peculiar and quite distinct from those observed in HD in the general population. Better combined chemotherapy and antiretroviral therapy is needed in order to ameliorate the CR rate and decrease the OI in patients with HIV infection and HD.
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PMID:Hodgkin's disease in 92 patients with HIV infection: the Italian experience. GICAT (Italian Cooperative Group on AIDS & Tumors). 145 83


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