ISSN:0269-9370    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Objective: The presence of HIV-1 in postmortem brain tissue from 31 patients with AIDS and 12 HIV-1-negative controls was investigated.Design: Most laboratories have access to the methods used. We readily appliedin situhybridization and immunohistochemistry to archival formalin-fixed paraffin-embedded (FFPE) brain specimens.Methods: The techniques used to detect HIV-1 were explant culture,in situhybridization with35S-labeled polymerase (pol) gene riboprobes and immunohistochemistry with monoclonal antibody to gp41.Results: HIV-1 was isolated from explant cultures in 13 out of 20 (65%) patients, whereas HIV-1-infected cells were detected in FFPE brain tissue from nine out of 26 (35%) patients examined byin situhybridization and in seven out of 26 (27%) patients examined by immunohistochemistry.Conclusions: Although the isolation technique was the most sensitive of the three techniques tested, infected cells may be identified within situhybridization in conjunction with immunohistochemistry.

ISSN:0269-9370    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Objectives(1) To determine whether detection of HIV proviral DNA sequences in the cerebral cortex correlates with the presence of pathological changes in this region, believed to contribute to the HIV-associated cognitive motor complex. (2) To compare the frequency with which HIV infects cortical and subcortical regions of the brain.DesignIn vitrostudies on HIV neurotoxicity suggest that HIV may be involved in the pathogenesis of cortical damage, recently defined as diffuse poliodystrophy (DPD) in AIDS. Previous detection of HIV antigen has localized HIV more frequently to subcortical than to cortical regions It is not known whether HIV preferentially infects subcortical tissues or if viral expression varies in these two regions.MethodsHIV antigen and proviral DNA sequences were detected in anterior frontal lobe tissues using immunohistochemistry (IHC) and the polymerase chain reaction (PCR), respectively. DPD was assessed by staining with antibodies against astrocytes (CFAP) and microglia/macrophages (HAM 56).ResultsHIV proviral DNA was detected in nine out of 15 cortical samples and in 10 out of 15 white matter samples, whilst HIV p24 antigen was localized to the cortex in three out of 15 and to the white matter in seven out of 15 cases. DPD was found in 10 cases, although in five a different aetiology may have been involved. However, DPD was present in eight out of the nine cases in which HIV proviral DNA was detected in the cortex.ConclusionsUsing a non-isotopic PCR method, HIV was detected in the brains of more cases than would be expected on the basis of IHC detection, and was present in the cortex as frequently as in the white matter. HIV, together with other factors, may contribute to the pathogenesis of DPD.

ISSN:0269-9370    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

ObjectiveTo analyse serological aspects of systemic autoimmunity in HIV-1-seropositive patients and in individuals at risk for AIDS.Design and methodsThe reactivity of antibodies in the serum of 100 HIV-1-seropositive patients was investigated by enzyme-linked immunosorbent assay (ELISA) using a series of antigens known to be recognized by antibodies from patients with multisystemic autoimmune diseases, such as systemic lupus erythematosus, mixed-connective tissue disease and Sjogren's syndrome.ResultsHigh levels of immunoglobulin G (IgC) antibodies reacting with double-stranded DNA (dsDNA), synthetic peptides of ubiquitinated histone H2A, Sm-D antigen, U1-A RNP antigen and 60 kD SSA/Ro antigen were found in 44–95% of HIV-infected patients. Among histone antibodies, the most frequent reactions were towards the carboxy-terminal region of histone H1 and to histone H2B and its amino-terminal domain 1–25. Eight HIV-1-seropositive patients at different stages of disease according to the Centers for Disease Control classification were also studied. In most cases, no obvious fluctuations were observed over several years. Antibodies were found early, and their specificity and apparent level of activity remained relatively constant. There was no evidence of such an autoimmune response in the serum of high-risk homosexual seronegative men.ConclusionsAlthough the aetiology of AIDS is known, in general the aetiology of multisystemic autoimmune diseases remains to be determined, and the sequence of events taking place remains obscure in both cases. It is possible that the large spectrum of antibodies found in HIV-infected patients reflects a specific stimulation of B-cells by nuclear antigens released by apoptosis during an early stage of disease.

ISSN:0269-9370    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

ObjectiveTo correlate severe anaemia and frequent neutropenia in HIV-2-infected patients with an inhibitory effect on bone-marrow progenitors common to several HIV-2 isolates.DesignThe effects of eight HIV-2 isolates on early (BFU-E) and late (CFU-E) erythroid progenitors and on granulomonocytic (CFU-CM) progenitors, produced in long-term bone-marrow cultures (LTBMC), were studied.MethodsAbsolute numbers of BFU-E, CFU-E and CFU-CM per culture flask were calculated weekly for each HIV-2-infected LTBMC using semi-solid clonogenic assays, and compared with those obtained in mock-infected LTBMC. Levels of significance for comparisons were determined by an analysis of variance (ANOVA).ResultsPooled data from 24 series of LTBMC (three series for each HIV-2 isolate) revealed 80 and 100% inhibition of BFU-E and CFU-E on days 6 and 12 of LTBMC, respectively, while transient stimulation of CFU-CM was observed between days 14 and 20 of LTBMC, followed by total inhibition on day 30.ConclusionsThese results confirm a direct inhibitory effect of HIV-2 onin vitrohaematopoiesis. The similar pattern of erythroid progenitor inhibition obtained from seven out of eight isolates suggests that the inhibitory effect on erythropoiesis is a feature common to a large number of HIV-2 isolates, which correlates with clinical findings.

ISSN:0269-9370    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

ObjectiveTo determine whether HIV could be identified in semen samples during the first few weeks after infection.DesignA series of three homosexual men with symptomatic primary HIV-1 infection.MethodsEach subject provided a series of semen samples that was examined for HIV-1 by virus culture, polymerase chain reaction (PCR) and transmission electron micrography.ResultsThe first samples obtained for each subject (17, 22 and 24 days following onset of primary HIV-1 infection) were all positive by PCR and negative by viral culture. Of 13 samples obtained during the first 80 days after onset of primary HIV-1 infection and analysed by PCR, 10 were positive. Only one of these samples was virus culture-positive. Four semen samples obtained from two subjects during treatment with zidovudine were PCR-positive. Eight samples were examined for presence of HIV-1 by electron microscopy and one was found to be positive.ConclusionsThese results indicate that men with HIV-1 infection are potentially infectious through sexual transmission during the first few weeks after infection. The findings emphasize that individuals in all stages of HIV-1 infection should practise safer sex to reduce transmission of HIV-1.

ISSN:0269-9370    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

ObjectiveTo evaluate the use of saliva specimens for the detection of HIV antibodies among high-risk groups in epidemiological studies.DesignTesting of saliva specimens collected by different methods from individuals with known HIV status. The most reliable method was examined for its usefulness in a field study among a high-risk group.MethodsSaliva samples were obtained either by using a cotton-wool roll ('Salivette') or as 'whole saliva'. HIV antibodies were determined using commercial enzyme-linked immunosorbent assays (ELISA). Confirmation was performed using a line immunoassay or an immunoblot assay.ResultsIn 'Salivette' samples, HIV antibodies were detected by ELISA in seven out of 22 seropositive individuals. In contrast, testing of 'whole saliva' samples from 79 HIV-seropositive and 115 HIV-seronegative individuals resulted in a 100% correlation with HIV serum status. The positive reaction of 20 'whole saliva' specimens was confirmed in a line immunoassay, whereas in an immunoblot assay only seven specimens were positive, one negative, and 12 indeterminate. In an HIV prevalence study among drug users, 395 'whole saliva' samples were tested in two different ELISA. Both assays showed complete agreement in detecting 58 positive and 337 negative samples. All positive samples were confirmed by the line immunoassay.ConclusionOur study demonstrates that 'whole saliva' specimens are a good alternative to blood samples in epidemiological studies of HIV prevalence in high-risk groups.

ISSN:0269-9370    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

ObjectiveThe routine screening of organ donors for HIV-1 since 1985 has markedly reduced the risk of acquiring infection in organ recipients. However, commercial HIV-1 p24-antigen assays reveal false-positive reactivity in certain recipients. This observation will be discussed here.MethodsPost-transplantation sera collected sequentially from different organ recipients were tested for HIV antigen: 79 samples were from 14 kidney recipients, 57 from seven bone-marrow allografts and 18 from two heart recipients. Neutralization assays to determine specificity were performed on reactive samples. Immunoblots prepared from sera containing high levels of antigens were tested by Western blot using polyclonal anti-HIV sera.ResultsAbbott HIV-1-EIA kits detected non-neutralizable antigens in early post-transplantation sera from 12 kidney, five bone-marrow and two heart recipients. Using in-house immunoblots prepared from positive non-neutralizing antigen sera, a 25–30 kD protein was detected and shown to be the cause of the false HIV antigen cross-reactivity.ConclusionFalse-positive HIV antigens related to the emergence of a 25–30 kD protein in early post-transplantation sera are detectable in transplant recipients.

ISSN:0269-9370    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

ObjectivesTo evaluate the use of zidovudine prophylaxis in HIV-exposed health-care workers (HCW) in Italy and to determine its short-term toxicity.DesignLongitudinal, open study with retrospective and prospective collection of data.SettingAll Italian clinical centres that care for HIV-infected patients and are licensed by the Ministry of Health to dispense zidovudine and 30 hospitals participating in the Italian Multicentre Study on Occupational Risk of HIV Infection.Study populationHCW and other individuals who accepted zidovudine prophylaxis after accidental exposure to HIV.ResultsData were collected for 224 HIV-exposed individuals until 30 )une 1991. An increase in zidovudine prophylaxis was observed. All but 10 subjects received 1000–1250 mg zidovudine per day. Anaemia (five cases), neutropenia (one case) and an increase in serum alanine aminotransferase levels (two cases) were the only haematochemical side-effects observed; none of the subjects ceased prophylaxis because of side-effects. More than 50% of subjects had constitutional reactions; as a result, prophylaxis was stopped by 29 patients. These adverse effects began within 10 days of prophylaxis; all resolved after prophylaxis was stopped. No HIV-antibody seroconversions were observed after a mean follow-up of 8 months.ConclusionsZidovudine prophylaxis has become a feature of the management of occupational exposures to HIV in health-care settings; short-term toxicity is mild, dose-related and reversible. Further studies are needed to assess the risk of long-term sequelae.

ISSN:0269-9370    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

ObjectivesTo correlate deep bacterial infections with HIV infection and evaluate the influence of HIV on clinical picture and outcome in patients with meningitis, pneumonia or pyomyositis.DesignCase-control comparison of HIV seroprevalence between patients and an age- and sex-matched control group in a prospective cross-sectional study of hospitalized patients.ParticipantsOne hundred and sixty-five patients admitted to hospital with either purulent meningitis, pneumonia or pyomyositis and 165 age- and sex-matched controls from orthopaedic/trauma wards.SettingUniversity Hospital, Dar es Salaam, Tanzania.Outcome measuresDifferences in HIV seroprevalence and mortality.ResultsOf 78 patients with purulent meningitis, 19 (24%) were HIV-seropositive, compared with 13 (17%) in the control group (P= 0.345). Of 36 patients with meningitis seen before a meningococcal epidemic affected Dar es Salaam, there was a statistically significant association with HIV infection (P= 0.013). Ten out of 19 (53%) HIV-seropositives died, compared with nine out of 59 (15%) seronegatives (P= 0.028). Of patients with pneumococcal meningitis, five out of six (83%) seropositives died, compared with two out of 12 (17%) seronegatives (P= 0.013). Fifteen out of 45 (33%) patients with pneumonia were HIV-seropositive, compared with four (9%) in the control group (P= 0.001). There was no difference in mortality between seropositive and seronegative patients with pneumonia. HIV seroprevalence was 62% among 42 patients with pyomyositis and 12% among 42 controls (P<0.0001). Eighteen out of 25 (72%) seropositive patients with pyomyositis fulfilled the World Health Organization (WHO) clinical case definition for AIDS. Response to recommended antibiotic treatment was satisfactory among patients with pneumonia and pyomyositis.ConclusionsThese results show a strong association between pyomyositis, pneumonia and HIV infection. They also indicate an increased mortality associated with HIV infection in patients with pyogenic meningitis, especially pneumococcal meningitis. Pyomyositis should be considered an indicator of stage III HIV disease in the proposed WHO clinical staging system.

ISSN:0269-9370    

出版商:OVID    

年代:1992

数据来源: OVID