摘要:

SummaryThree cases of congestive cardiomyopathy complicating the acquired immune deficiency syndrome (AIDS) are reported. In one case, acute cardiac decompensation resulted in prolonged but ultimately reversible cardiogenic shock. In the second case, clinical signs of cardiac disease were precipitated by acute renal failure and fluid overload. In the third, congestive heart failure developed spontaneously and responded promptly to administration of diuretics but the patient died suddenly, apparently due to an arrhythmia. The etiology of cardiomyopathy in AIDS is unclear and the manifestations of cardiomyopathy in this setting range from subclinical to life threatening.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

SummaryWe performed a randomized, double-blind, placebo-controlled trial to assess the tolerance and efficacy of recombinant human interferon alpha 2a (Roferon A) in patients with acquired immunodeficiency syndrome (AIDS) without Kaposi's sarcoma. A total of 67 patients were enrolled in five medical centers from October 1983 through April 1986, and received either placebo, 3 million units, or 36 million units of interferon alpha three times a week for 12 weeks. There were no significant differences in median survival, frequency of development of opportunistic infections, median T4-cell counts, or serum p24 antigen levels during therapy among the three groups. There was a significant increase in weight in the 3-million-unit group compared with 36-million-unit and placebo groups. Adverse reactions were common in the two interferon groups, but did not differ significantly from the placebo group. Neither significant therapeutic benefit nor adverse reaction was demonstrated in this study to be associated with interferon-alpha administration. This study underlines the value of randomized, double-blind, placebo-controlled studies to address specific issues of drug efficacy and toxicity.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

SummaryTen homosexual men received oral lithium carbonate at doses that maintained their serum lithium concentrations between 0.5 and 1.5 mEq/L. Prior to treatment all patients had HIV isolated from PHA-activated peripheral blood lymphocytes (PBLs) using a quantitative antigen-capture enzyme-linked immunosorbent assay (ELISA) assay for detection, and had an absolute number of CD4 (helper) lymphocytes of <300/mm3. Eight of 10 patients developed symptoms of drug toxicity requiring discontinuation of the drug in 7 patients. Two patients completed only 4–5 weeks of lithium therapy, and 5 patients received 7–8 weeks. All patients remained culture positive for HIV during the trial, and viral titers as measured by the antigen capture assay were unchanged or increased. There were no significant changes in the absolute number of CD4 lymphocytes, CD4/CD8 ratio, or phytohemagglutinin (PHA) or tetanus toxoid induced proliferative responses. There was a significant decrease in mixed lymphocyte reaction (MLR). Lithium carbonate demonstrated no immunorestora-tive or antiviral activity when given in therapeutic doses. Drug toxicity limited therapy in the majority of patients.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

SummaryTwo independent measures of human immunodeficiency virus type 1 (HIV-1) infection, virus isolation, and serum levels of p24 antigen were evaluated in a double-blind randomized clinical trial of the safety and efficacy of a nucleoside analogue, 3'-azido-3'-deoxythymidine (AZT) versus placebo in a single center. Pretreatment studies from 38 AIDS and AIDS-related complex (ARC) patients were comparably positive for virus isolation from their lymphocytes; all patients were qualitatively virus positive. Before AZT treatment, there was significantly decreased virus recovery in patients with higher numbers of CD4-positive lymphocytes. Within 1 month of AZT therapy, the time in culture required to register virus positivity was increased markedly in the AZT-treated group, and over the following several months progressive diminution in virus recovery was noted. Similar changes were not seen in patients concurrently receiving placebo treatment. Before treatment, 16 of 20 and 12 of 16 patients in the AZT and placebo groups, respectively, were p24 antigen positive. Marked reduction in serum p24 levels were noted in 11 of 16 (69%) of the p24 antigen-positive AZT-treated patients compared to 3 of 12 (25%) of the p24 antigen-positive placebo-treated patients (p = 0.02). There was a marked virologic response in 14 of 20 (70%) of the AZT-treated patients compared to 4 of 18 (22%) placebo-treated patients (p = 0.004). A higher frequency of positive clinical and immunological effects also were noted in the AZT-treated patients relative to placebo-treated patients (p = 0.02 and p = 0.06, respectively). These data from a concurrently randomized study support the hypothesis that the observed clinical efficacy of AZT relative to placebo is associated with an antiviral effect and suggest that virologic endpoints may serve as early surrogates of clinical outcome in AIDS antiviral chemotherapy trials.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

SummaryIn order to improve understanding of how HIV-1 infection down-modulates cell surface membrane expression of CD4, we have measured several parameters of CD4 expression in the human tumor T-cell lines CEM and MOLT-4 at different times after infection. Three independent HIV-1 isolates were used including one that encodes a truncatednefprotein and another that appeared to be noncytolytic against CEM. The level of CD4 mRNA, the rate of biosynthesis of CD4 protein, and the percentage of CD4-positive cells were measured. With each viral isolate it was found that infection led to a specific and almost complete inhibition of CD4 protein biosynthesis. This substantially exceeded, at every time point after infection, a concomitant reduction in CD4 mRNA. Hence an inhibition of translation probably accounts for much of the decline in the rate of CD4 biosynthesis. This implicates a novel selective translational inhibition of host gene expression by HIV-1 as a factor in the disappearance of surface membrane CD4 from infected cultures.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

SummaryTwo hundred fifty individuals from high risk categories were enrolled in a seroprevalence survey for human immunodeficiency virus (HIV) infections in Winnipeg. The overall seroprevalence in the Manitoba AIDS Virus Epidemiology Study (MAVES) was 5.2%. Of 2651 diagnostic and screening specimens in the province of Manitoba submitted over a similar period, 103 were positive (3.9%). HIV seropositivity in Manitoba was noted mainly in homosexual/bisexual males (especially those who were also intravenous drug abusers), hemophiliacs, and individuals from endemic regions of the world. Individuals whose only risk factor was intravenous drug abuse, those with sexually transmitted diseases, or those with high risk sex contacts have not demonstrated HIV seropositivity in Manitoba to date. Manitoba is currently a low seroprevalence region for HIV infection. Our study demonstrated that the awareness level of people at risk for HIV infections was low. In our study population, one-on-one counseling was demonstrated to be an effective way to improve short-term knowledge about HIV infections. Appropriate education approaches must be considered for Native/ Metis peoples (26.4% of our MAVES study population), who were younger and had a lower educational and employment level compared to Caucasian/other racial groups.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

SummaryFrom August 1985 through January 1986, 125 homosexual or bisexual men from the Kingston area were enrolled in a study to evaluate risk factors for infection with human immunodeficiency virus (HIV) and human T-lymphotropic virus type I (HTLV-I). Twelve men (10%) were seropositive for HIV and 6 (5%) for HTLV-I; 1 man had possible coinfection with HIV and HTLV-I. One third of the men reported having had homosexual encounters with foreign visitors or while travelling outside Jamaica, and sexual contact with men in the U.S. was weakly associated with HIV infection (p = 0.11). The median number of partners was 12 per year (range 0.135) and a greater number of homosexual partners per year was associated with HIV seropositivity (p = 0.01). HIV seropositives also were more likely to have a history of lymphadenopathy (p = 0.07). For HTLV-I, there were no obvious risk factors identified, and age-adjusted seroprevalence was not significantly higher than that of heterosexual men. Compared to studies of homosexual men in the U.S. prior to the advent of extensive AIDS education, the Jamaican homosexual population was more sexually conservative. Despite this circumstance, HIV appears to have entered this population via sexual contact with foreign men and spread efficiently among men with a greater number of sexual partners. The frequency of bisexuality (65/125 men) and the 11% HIV prevalence in bisexual men suggest that secondary infection of female sexual partners may occur.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

SummaryIn order to evaluate the frequency of sexual transmission of human immunodeficiency virus (HIV) among promiscuous heterosexuals, we studied the prevalence of HIV infection among a group of predominantly Caucasian call girls and women working for escort services and massage parlors in New York City. In the 78 subjects studied, the mean age was 31.6 years and the mean duration of prostitution was 5.1 years. Study participants each had a median of 200 different sexual partners in the preceding year. Six women had a history of intravenous drug abuse and none had a history of any other recognized risk factor for HIV infection. Ninety percent of the women studied used condoms during intercourse with at least some of their partners. One of the six women with a history of drug abuse and none of the 72 non-drug-abusers were seropositive for HIV. This study indicates that despite their promiscuity, HIV infection is still uncommon in call girls in New York City.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

SummaryPatients with acquired immune deficiency syndrome (AIDS) or AIDS-related complex (ARC) are developing beliefs, behaviors, and a knowledge bases that may affect their health status, sense of well-being, and health care needs. However, little documentation of these changes exists. Consequently, the purpose of this study was to describe AIDS beliefs, behaviors, and informational needs of homosexual/bisexual human immunodeficiency virus (HIV) seropositive patients 7 years into the epidemic. Data were collected once from 178 patients using a modified version of the AIDS Beliefs and Behaviors Questionnaire (ABBQ). Study results showed that in 1987, most outpatients (73%) in an AIDS epicenter wanted more information about building their immune systems. Few patients (12%) wanted more explicit information about safe sexual behaviors, although 3 years into the epidemic this information was a central concern. Results suggest that health professionals need to take an active role in monitoring and addressing patients' changing informational needs.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID