摘要:

The action of zidovudine when administered to individuals with severe HIV thrombocytopenia was investigated. Four individuals with platelets < 50 x 109/l and CD4 cells > 200 x 106/l were treated with 600 mg zidovudine per day for 6 weeks, no drug for 6 weeks, 1200 mg zidovudine per day for 6 weeks, then no drug for 6 weeks. Glycocalicin, a platelet protein which correlates inversely with platelet survival, was assayed before and after treatment. Glycocalicin indices were also measured in four additional individuals with HIV thrombocytopenia. Platelet counts rose 2.5-fold [95% confidence interval (Cl), 2.0–3.0)] for four subjects who received 600 mg zidovudine per day and 4.9-fold (95% Cl, 4.0–5.8) for three subjects receiving 1200 mg zidovudine per day. Platelet counts declined during drug-free intervals. Plasma glycocalicin indices were elevated in all with untreated HIV thrombocytopenia. Indices fell after zidovudine treatment in six of seven individuals, suggesting that zidovudine prolonged platelet survival. Analysis of 170 HIV-seropositive asymptomatic individuals [mean CD4 count 474 x x 106/l, standard deviation (s.d.) 245 x 106/l] revealed that 14 (8%) had < 125 x 109/l platelets but only 2 (1%) had < 50 x 109/l platelets. Platelet counts increased spontaneously in eight individuals with mild HIV thrombocytopenia among the 10 for whom repeat counts were available.

ISSN:0269-9370    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Various treatments for HIV-related thrombocytopenia have been reported. Since etiologies of the thrombocytopenia may differ with regard to risk group treatment outcomes may also vary. We have recently studied the long-term use of zidovudine in individuals with sexually transmitted HIV infection and severe thrombocytopenia. Twenty-five men, median age 34 years (range, 23–51 years), were treated with zidovudine (1000 mg/day) for a median duration of 12 months (range, 2.5-> 26 months). Nineteen patients (76%) had had episodes of symptomatic bleeding secondary to thrombocytopenia prior to study entry. All patients bleeding symptoms resolved with therapy. Six (24%) achieved a complete response, with normalization of platelet counts, while 11 patients (44%) achieved a partial response, giving an overall response rate of 68%. The median time to partial or complete normalization of platelet counts was 12 weeks (range, 4–62 weeks). Toxicities were minimal during the study period. Only one patient developed an AIDS-defining diagnosis while on therapy. We conclude that patients with sexually transmitted HIV infection and immune thrombocytopenia may need a prolonged period of therapy with zidovudine to achieve a platelet response. Other treatment modalities may be required for the 30% of patients who do not respond to zidovudine.

ISSN:0269-9370    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

In order to further characterize the pathogenesis ofToxoplasma gondiiinfection in patients with AIDS and AIDS-related complex (ARC), a cohort of HIV- and Toxoplasma-infected individuals were identified and prospectively followed. Four hundred and 10 HIV-infected individuals followed in the San Francisco General Hospital AIDS Clinic were screened for antibodies to Toxoplasma between November 1986 and November 1988. Of the 67 (16%) individuals seropositive for Toxoplasma antibodies, 33 (49%) were followed monthly for a mean duration of 7.5 months. One hundred and 11 follow-up blood samples were obtained in order to determine Toxoplasma serology and the incidence of parasitemia. In general, Toxoplasma immunoglobulin (lg) C antibodies remained stable over time. Detection of Toxoplasma antigenemia and parasitemia was uniformly negative, including those specimens obtained from two individuals within 45 days of their developing toxoplasmic encephalitis.

ISSN:0269-9370    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

To determine the efficacy and toxicity of two systemically active antifungal agents in the treatment of buccal and oesophageal candidiasis 111 HIV-infected patients with microscopically-confirmed candidiasis were randomized to receive either 200 mg itraconazole once a day or 200 mg ketoconazole twice a day for 28 days in a double blind study. After 1 week of treatment, 75 and 82% of the patients on itraconazole and ketoconazole, respectively, had responded clinically. After 4 weeks of treatment, this had risen to 93% in each group. One patient discontinued itraconozole because of toxicity (rash), five patients discontinued ketaconazole (two nausea, two hepatotoxicity and one rash). Despite successful clinical and mycological clearance, 80% patients had a further episode of candidosis within the next 3 months.

ISSN:0269-9370    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A descriptive retrospective study on the AIDS and HIV patients of rural eastern North Carolina was performed. Our data show what appears to be a ‘second wave’ of HIV-related disease (HRD) in this area. Although most of our AIDS and HIV patients migrated from urban areas such as New York State, our patient population is now largely being replaced by locally infected or ‘home-grown’ patients. The epidemiological characteristics of rural HRD are significantly different to those of urban HRD: rural patients are more likely to be female, heterosexual, non-white, and younger. These epidemiological differences, along with limited medical and social services in a poor economic base, will make treating HRD a more difficult problem in rural areas than in traditional urban centers.

ISSN:0269-9370    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0269-9370    

出版商:OVID    

年代:1991

数据来源: OVID