Cases reported "HIV Infections"

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1/114. CD4 depletion in HIV-infected haemophilia patients is associated with rapid clearance of immune complex-coated CD4 lymphocytes.

    The predominant immunological finding in HIV haemophilia patients is a decrease of CD4 lymphocytes during progression of the disease. Depletion of CD4 lymphocytes is paralleled by an increase in the proportion of immune complex-coated CD4 cells. We examined the hypothesis that the formation of immune complexes on CD4 lymphocytes is followed by rapid clearance of immune complex-coated CD4 lymphocytes from the circulation. In this study, the relationship of relative to absolute numbers of immune complex-loaded CD4 blood lymphocytes and their association with viral load were studied. Two measurements of relative and absolute numbers of gp120-, IgG- and/or IgM-loaded CD4 lymphocytes were analysed in HIV and HIV- haemophilia patients, with a median interval of approx. 3 years. Immune complexes on CD4 lymphocytes were determined using double-fluorescence flow cytometry and whole blood samples. viral load was assessed using NASBA and Nuclisens kits. Whereas the proportion of immune complex-coated CD4 lymphocytes increased with progression of the disease, absolute numbers of immune complex-coated CD4 lymphocytes in the blood were consistently low. Relative increases of immune complex-coated CD4 blood lymphocytes were significantly associated with decreases of absolute numbers of circulating CD4 lymphocytes. The gp120 load on CD4 blood lymphocytes increased in parallel with the viral load in the blood. These results indicate that immune complex-coated CD4 lymphocytes are rapidly cleared from the circulation, suggesting that CD4 reactive autoantibodies and immune complexes are relevant factors in the pathogenesis of AIDS. Relative increases of immune complex-positive cells seem to be a consequence of both an increasing retroviral activity as well as a stronger loading with immune complexes of the reduced number of CD4 cells remaining during the process of CD4 depletion. The two mechanisms seem to enhance each other and contribute to the progressive CD4 decrease during the course of the disease.
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keywords = complex
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2/114. The role of precise conceptualization in the treatment of a complicated hiv-1-infected neuropsychiatric patient.

    patients infected with human immunodeficiency virus, type 1, may present with neuropsychiatric manifestations across all stages of disease. Frequently, these patients may present with more than one neuropsychiatric disorder concomitantly. The case presented highlights the utility of detailed clinical observation, careful use of medical terminology, and a neuropsychiatric organizing paradigm in the diagnosis and treatment of a patient presenting over time with delirium, aphasia, mania, and a complex partial seizure disorder.
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keywords = complex
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3/114. Beyond the biomedical and behavioural: towards an integrated approach to HIV prevention in the southern African mining industry.

    While migrant labour is believed to play an important role in the dynamics of HIV-transmission in many of the countries of southern africa, little has been written about the way in which HIV/AIDS has been dealt with in the industrial settings in which many migrant workers are employed. This paper takes the gold mining industry in the countries of the Southern African Development Community (SADC) as a case study. While many mines made substantial efforts to establish HIV-prevention programmes relatively early on in the epidemic, these appear to have had little impact. The paper analyses the response of key players in the mining industry, in the interests of highlighting the limitations of the way in which both managements and trade unions have responded to HIV. It will be argued that the energy that has been devoted either to biomedical or behavioural prevention programmes or to human rights issues has served to obscure the social and developmental dimensions of HIV-transmission. This argument is supported by means of a case study which seeks to highlight the complexity of the dynamics of disease transmission in this context, a complexity which is not reflected in individualistic responses. An account is given of a new intervention which seeks to develop a more integrated approach to HIV management in an industrial setting.
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ranking = 0.125
keywords = complex
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4/114. sarcoidosis-related anterior uveitis in a patient with human immunodeficiency virus.

    BACKGROUND: This is the first ophthalmic report--to our knowledge--of an anterior uveitis secondary to sarcoidosis in a patient infected with human immunodeficiency virus (HIV). Other reported causes of uveitis in HIV-infected patients have included HIV, herpes zoster, tuberculosis, syphilis, toxoplasmosis, cryptococcus, rifabutin prophylaxis for mycobacterium, and protease inhibitors such as ritonavir and indinavir. uveitis secondary to sarcoidosis in the non-HIV population is classically seen in young, female, African-American patients. There are rare reports, found exclusively in the pulmonary literature, of sarcoidosis in HIV-infected patients. CASE REPORT: A 38-year-old African-American male infected with HIV was treated for chronic recurrent anterior uveitis secondary to sarcoidosis. His sarcoidosis was diagnosed 1 month earlier, along with the onset of his uveitis. During the previous 6 years he has been treated with anti-HIV antivirals as well as prophylaxis for opportunistic infections. To date, his infectious disease specialist continues to treat his HIV and systemic sarcoidosis. CONCLUSION: patients with HIV infection in whom sarcoidosis with secondary uveitis develops are very rare. Management of these patients requires careful use of topical and oral steroidal anti-inflammatories to control ocular and systemic sequelae of sarcoidosis. This case initiates some interesting questions about the immunology of sarcoidosis and its presence in immunocompromised patients. Use of steroids in an immunocompromised patient is clinically complex. Further clinical study is needed to elicit the full clinical significance of sarcoidosis and HIV infection.
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ranking = 74.166224825765
keywords = mycobacterium, complex
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5/114. central nervous system toxoplasmosis in acquired immunodeficiency syndrome: An emerging disease in india.

    With the incidence of patients infected with human immuno-deficiency virus (HIV) increasing in india, the central nervous system (CNS) manifestations of the disease will be seen more frequently. The CNS may be primarily afflicted by the virus or by opportunistic infections and neoplasms secondary to the immune suppression caused by the virus. In india, although mycobacterium tuberculosis has been reported to be the most common opportunistic infection, toxoplasmosis may become as common owing to the ubiquitous nature of the protozoan. Since an empirical trial of medical therapy without histopathological diagnosis is recommended, the true incidence of this condition may remain under estimated. The role of ancillary tests such as radiology and serology in the initial diagnosis of this condition remain crucial. This report highlights two patients who were diagnosed to have acquired immuno-deficiency syndrome (AIDS) only after the biopsy of the intracranial lesion was reported as toxoplasmosis. Presently all patients for elective neurosurgery are tested for HIV antigen. The management protocol to be followed in a known patient with AIDS presenting with CNS symptoms is discussed in detail. The value of ancillary tests is also reviewed.
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ranking = 74.103724825765
keywords = mycobacterium
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6/114. Multicystic autoimmune thyroiditis-like disease associated with HIV infection. A case report.

    BACKGROUND: Human immunodeficiency virus (HIV) infection and resulting acquired immunodeficiency syndrome (AIDS) may involve virtually every organ system, including the endocrine glands. Thyroid dysfunction most commonly reflects advanced disease and generally resembles euthyroid sick syndrome. Rarely do opportunistic infections, hemorrhage, neoplasms and drugs account for alterations in thyroid tissue. Multiple lymphoepithelial cysts of parotid gland and thymus have been identified, but similar findings in thyroid gland have not been reported. CASE: A 41-year-old, HIV-seropositive woman, asymptomatic for seven years, developed a squamous cell carcinoma of the cervix with local-regional extension. At the same time, bilateral complex thyroid cysts and high titers of antimicrosomal antibodies (1/6,400) were detected. Ultrasound-guided fine needle aspiration biopsy of the thyroid showed a heterogeneous lymphocytic population with a reactive appearance and occasional groups of epithelial cells with an immature squamous pattern, along with cytologic features of autoimmune thyroiditis. Immunocytochemistry was positive for CD20, CD3 and CD5. Immunoglobulin heavy chain gene rearrangement by polymerase chain reaction from cytologic material showed a polyclonal lymphoid population. External radiotherapy resulted in a significant reduction in the pelvic lesion. Four months after diagnosis, abdominal ultrasound displayed multiple hepatic metastasis, the patient's condition rapidly deteriorated, and she died about a month later. CONCLUSION: This case had unique features and probably represented an AIDS-related lesion and distinct entity.
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ranking = 0.0625
keywords = complex
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7/114. Stories of AIDS outreach and case management: context and activities.

    research has shown that injection drug users (IDUs) are now at greater risk for contracting HIV infection. Studies also show that seroincidence has begun to decrease among IDUs in a number of cities due to risk-reduction interventions. One important intervention is the use of indigenous outreach workers, shown to be an effective method in reducing HIV risk behavior and promoting preventive actions among IDUs in various settings. This study explores continuities and changes in the activities of outreach workers and in their changing role as case managers in the long-standing Community Outreach Intervention Project in chicago. It examines their efforts to change risk behaviors and improve the health and living conditions of IDUs. This research is based on outreach and case-worker perspectives and related background data gathered from 10 outreach workers and the four ethnographers that supervise the project. Outreach and case workers describe the diverse populations and contexts in which they operate and the growing complexity and depth of the issues they face, especially in working with HIV and AIDS-afflicted clients. These descriptions demonstrate the important role "indigenous" outreach and case workers play in engaging out-of-treatment IDUs, supporting meaningful changes in their lives, and responding to their particular and emerging needs.
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ranking = 0.0625
keywords = complex
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8/114. Partial "repair" of defective NEF genes in a long-term nonprogressor with human immunodeficiency virus type 1 infection.

    A 36-bp deletion close to the 5' end of NEF that impaired Nef function was found in a long-term nonprogressor with human immunodeficiency virus type 1 (hiv-1) infection. forms containing an adjacent duplication of 33 bp were also frequently observed. The duplication showed no homology to the deleted region but restored the overall length of the first variable loop of Nef. NEF alleles carrying the duplication were active in class I major histocompatibility complex (MHC-I) down-modulation and enhancement of virus infectivity. However, they showed little activity in CD4 down-regulation and were unable to stimulate viral replication in human peripheral blood mononuclear cells. Our study indicates that the enhancement of virion infectivity and the stimulation of hiv-1 replication in lymphocytes are distinct functions of Nef. Our findings also illustrate the capacity for repair of attenuating deletions in hiv-1 infection and suggest that a selective pressure for Nef-mediated MHC-I down-modulation and/or enhancement of virion infectivity exists.
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ranking = 0.0625
keywords = complex
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9/114. High frequency of cytomegalovirus-specific cytotoxic T-effector cells in HLA-A*0201-positive subjects during multiple viral coinfections.

    How the cellular immune response copes with diverse antigenic competition is poorly understood. Responses of virus-specific cytotoxic T lymphocytes (CTL) were examined longitudinally in an individual coinfected with human immunodeficiency virus type 1 (hiv-1), Epstein-Barr virus (EBV), and cytomegalovirus (CMV). CTL responses to all 3 viruses were quantified by limiting dilution analysis and staining with HLA-A*0201 tetrameric complexes folded with hiv-1, EBV, and CMV peptides. A predominance of CMV-pp65-specific CTL was found, with a much lower frequency of CTL to hiv-1 Gag and Pol and to EBV-BMLF1 and LMP2. The high frequency of CMV-specific CTL, compared with hiv-1- and EBV-specific CTL, was confirmed in an additional 16 HLA-A*0201-positive virus-coinfected subjects. Therefore, the human immune system can mount CTL responses to multiple viral antigens simultaneously, albeit with different strengths.
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ranking = 0.0625
keywords = complex
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10/114. Atypical mycobacterium infection with sporotrichoid spread in a patient with human immunodeficiency virus.

    A case of mycobacterium marinum infection presenting with a sporotrichoid spread in a HIV positive Chinese male is presented. The patient responded to oral cotrimoxazole treatment. A brief review of the literature concerning atypical mycobacterial infection presenting in such a fashion is discussed.
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ranking = 296.41489930306
keywords = mycobacterium
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