ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectiveTo characterize the biological properties of HIV isolates obtained at the time of primary infection, and relate this to the subsequent course of the infection.MethodsSyncytium-inducing (SI) capacity, tropism for cell lines (MT4 and H9) and replication rate were determined in 49 HIV isolates obtained from 17 HIV seroconverters. Thirteen of the 17 patients had a symptomatic primary HIV infection. Correlation between biological phenotype and clinical progression was analysed.ResultsSI isolates were recovered in six patients from the first sample taken during primary infection, non-SI (NSI) isolates only were identified in 10 of the patients and isolation culture was negative in one patient. For all patients from whom SI virus was initially isolated, this phenotype persisted during the follow-up period (range, 17–219 weeks). The duration of fever during primary infection was longer for patients with SI isolates than for patients with NSI isolates (P= 0.05). Both types of isolates were associated with a significant fall in CD4 lymphocytes during follow-up (P< 0.05). Patients with SI isolates developed HIV-related immune deficiency more rapidly than patients with NSI isolates (P< 0.05).ConclusionsThe biological phenotype of HIV strains isolated during the time of seroconversion may be an important determinant of the subsequent course of the infection.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectiveAn in-frame stop codon prematurely truncating the transmembrane glycoprotein (TMP) is a common feature of many simian immunodeficiency virus, African green monkey strain (SIVagm) molecular clones. The purpose of this study was to investigate the native form of the SIVagmIMP in a naturally infected African green monkey (AGM) and to study the fate of the stop codon following the passage of SIVagmin primates.DesignPolymerase chain reaction was used to clone the entire intracellular portion of the TMP from: (1) peripheral blood mononuclear cells (PBMC) of the naturally infected AGM 155; (2) an isolate of SIVagm155in rhesus PBMC and (3) PBMC from pig-tailed macaques and AGM experimentally infected with an SIVagmmolecular clone encoding a truncated TMP.ResultsPBMC of the naturally infected AGM contained a ‘swarm‘ of related virus genotypes that encoded a full-length TMP, whereas tissue-culture passage in rhesus PBMC resulted in a prematurely truncated form of the TMP. This premature stop codon persisted in PBMC of monkeys experimentally infected with an SIVagmmolecular clone. Both macaques and AGM of same subspecies as AGM 155 (Cercopithecus pygerythrus) and other subspecies (C. aethiopsandC. sabaeus) became infected with SIVagm155. Genetic drift of this region ofenv, as assessed by calculation of the nucleotide substitution/site/year rate, was similar to that of other retroviruses.ConclusionsThe native form of the SIVagmTMP is a full-length gp40, similar to the SIV macaque (SIVmac) strain and HIV-1. However, passage of SIVagmin tissue culture can result in point mutations that introduce a premature stop codon. This stop codon persists during subsequentin vivopassage of SIVagmin primates. This contrasts with similar studies in macaques infected with SIVmac, in which reversion of the TMP stop codon was observed.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectiveTo determine the mechanism underlying the poor growthin vitroof haematopoietic progenitor cells isolated from HIV-1-infected patients.MethodApoptotic death in liquid culture of bone-marrow CD34+ cells obtained from 11 HIV-1-seropositive patients and 18 HIV-1-seronegative donors was quantitatively monitored by a flow cytometry procedure.ResultsNo significant differences in the percentage of apoptotic cells were noted between the two groups immediately after purification. When CD34 + cells were placed in liquid cultures supplemented with 2 ng/ml interleukin-3, the number of apoptotic cells progressively and significantly (P< 0.05) increased in all HIV-1-seropositive patients, while it remained constant in HIV-1-seronegative individuals. Although all HIV-1-seropositive patients showed signs of active viral replication in the bone-marrow micro-environment, progenitor CD34 + cells did not show the presence of active and/or latent HIV-1 infection.ConclusionOur data demonstrate that CD34 + cells isolated from AIDS patients with active HIV-1 replication in bone-marrow accessory cells are committed to apoptotic death without being directly affected by productive infection.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectiveTo evaluate an algorithm using two enzyme immunoassays (EIA) for anti-HIV-1 antibodies in a rural African population and to assess alternative simplified algorithms.MethodsSera obtained from 7895 individuals in a rural population survey were tested using an algorithm based on two different EIA systems: Recombigen HIV-1 EIA and Wellcozyme HIV-1 Recombinant. Alternative algorithms were assessed using negative or confirmed positive sera.ResultsNone of the 227 sera classified as unequivocably negative by the two assays were positive by Western blot. Of 192 sera unequivocably positive by both assays, four were seronegative by Western blot. The possibility of technical error cannot be ruled out in three of these. One of the alternative algorithms assessed classified all borderline or discordant assay results as negative had a specificity of 100% and a sensitivity of 98.4%. The cost of this algorithm is one-third that of the conventional algorithm.ConclusionsOur evaluation suggests that high specificity and sensitivity can be obtained without using Western blot and at a considerable reduction in cost.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectiveTo study the effect of splenectomy in HIV-infected patients.DesignA retrospective chart review of patients admitted to St Vincent's Hospital who had splenectomies and were HIV-positive.SettingAll patients were treated at St Vincent's Hospital, New York City, New York, USA.PatientsOnly patients who were HIV-positive and who had had a splenectomy at St Vincent's Hospital were included.InterventionAll patients had a splenectomy.Main outcome measuresThe effect of the splenectomy in these HIV-positive patients was studied with respect to their operative morbidity and mortality, platelet counts, overall survival and the development of new opportunistic infections.ResultsAll patients who did not have AIDS but did have thrombocytopenia responded to splenectomy in terms of their thrombocytopenia. None of them had an accelerated progression to AIDS. Most patients with AIDS and thrombocytopenia responded to splenectomy in terms of correcting their thrombocytopenia.ConclusionsSplenectomy as a treatment for thrombocytopenia is successful not only in HIV-positive patients without AIDS, but also in AIDS patients. However, in patients with disseminated Kaposi's sarcoma orMycobacterium avium intracellulare, splenectomy may not be a factor for survival.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectiveTo investigate progression of distal-symmetric sensory polyneuropathy and its correlation to immunological development.MethodsClinical, neurophysiological and immunological parameters were followed in 42 HIV-infected patients for 13±6 months. Neurophysiological investigations were performed in the sural and peroneal nerve. Initially, 14 patients showed clinical signs of polyneuropathy (paresthesia, hypesthesia, diminution of vibration and deep ankle reflexes) compared with 28 patients at the end of the follow-up, 13±6 months later.ResultsAll neurophysiological parameters deteriorated during the observation period. In 20 patients changes of plasma immunoglobulin (Ig) G, IgM, IgA levels, T- helper-, T-suppressor-, natural killer cell counts and plasma β2-microglobulin were determined. There was a significant correlation between the development of IgG, IgM, IgA and paired stimulation and conduction velocity of the sural nerve (Spearman's rank-correlation coefficient,P< 0.05).ConclusionThese results show that distal-symmetric polyneuropathy during HIV infection is rapidly progressive and related to immunological factors. It is assumed that immunological mechanisms play an important part in the pathogenesis of polyneuropathy during HIV infection.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectiveTo evaluate alterations in lung function during the course of HIV infection.DesignTotal lung capacity (TLC), the ratio of forced expiratory volume in one second to vital capacity (FEV1/VC), the carbon monoxide transfer factor (TLCO) and the alveolar-arterial oxygen gradient [Δ (A-a)O2] were determined in this retrospective study.PatientsPulmonary function tests (PFT) were performed on 331 patients at various stages of HIV infection. Patients with a history of intravenous drug use or Kaposi's sarcoma were excluded.ResultsNo significant differences were observed between the results for asymptomatic patients and those with AIDS-related complex (ARC). TLC, Δ(A-a)O2and TLCO were greatly altered in patients with acutePneumocystis cariniipneumonia (PCP). No significant differences were observed in the TLC, Δ(A-a)O2or TLCO results between AIDS patients with no history of PCP and those with a history of a single episode of PCP. TLCO was significantly lower (P< 0.001) in AIDS patients with one previous episode of PCP than in the patients with ARC. Interestingly, both TLC and TLCO were significantly lower in the AIDS patients with no history of PCP than in the patients with ARC. Follow-up of 28 patients at different stages of HIV infection confirmed the alteration of PFT results in the late stages.ConclusionsThe reasons for alterations in PFT results in PCP-free AIDS patients remain to be determined. Our findings suggest that PFT can provide valuable information throughout the course of HIV infection, particularly with regard to the indication for bronchoalveolar lavage.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectiveTo evaluate ultrasound measurement of Kaposi's sarcoma (KS) tumour volume for follow-up during therapy. Two-dimensional evaluation of size and description of gross alteration (for example, colour, nodularity, resolution) was used to assess treatment of KS. Flattening of palpable cutaneous KS lesions during anti-KS therapy has not been quantified objectively by a reliable method.MethodsIn six patients with advanced AIDS and KS, a total of 17 cutaneous lesions were evaluated prospectively by ultrasound and surface measurements. KS lesions were examined histologically before and after 12 weeks of chemotherapy with liposomal doxorubicin.ResultsIn comparison with size reduction, volume measurement showed a more pronounced reduction of tumour volume. The mean tumour volume was reduced by 94% from 451 mm3± 655 mm3to 66 mm3± 165 mm3at week 12 (P< 0.001). Histological evaluation of lesions no longer detectable by ultrasound after therapy showed abundant siderophages but no increase in spindle cells and no mitoses.ConclusionsOur findings suggest that ultrasound is a useful method with which to follow growth and remission of cutaneous KS. In contrast, pigmentation due to iron deposition is unaffected by chemotherapy because, despite histological remission, pigmentation can persist. Though ultrasound cannot replace histologic evaluation for complete response, we suggest the use of ultrasound assessment, thus introducing a more objective criterion than subjective rating of nodularity.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ObjectiveTo examine whether and at what stage mucosal immune responsiveness is impaired during HIV-1 infection.DesignIntestinal and systemic antibody-secreting cell (ASC) responses were examined in eight HIV-1-infected volunteers and 10 seronegative control subjects after oral cholera and parenteral tetanus vaccinations.MethodsASC numbers were determined before and after booster vaccinations by the enzyme-linked immunospot (ELISPOT) technique. This technique was performed on cell suspensions obtained from enzymatically dispersed duodenal biopsies and from peripheral blood.ResultsOral cholera vaccination evoked ASC responses in the intestinal mucosa of six out of eight HIV-1-infected volunteers, including patients with advanced disease and very low levels of circulating CD4+ T cells. The intestinal cholera ASC responses in HIV-infected volunteers were comparable to those in uninfected controls with regard to both magnitude and distribution of antibody classes. Most HIV-infected volunteers with only moderately reduced CD4+ T-cell counts also responded with vaccine-specific ASC in the blood, whereas none of the patients with < 200 x 106/1 CD4+ T cells per litre blood had detectable circulating ASC.ConclusionThese findings indicate that mucosal humoral immune responsiveness to a T-cell dependent antigen is maintained in HIV-infected individuals, despite concomitant systemic humoral hyporesponsiveness.

ISSN:0269-9370    

出版商:OVID    

年代:1993

数据来源: OVID