摘要:

Previous studies have suggested that salivary secretions may act as inhibitors of HIV-1 replication in vitro. This inhibitory activity was determined to be associated mainly with secretions obtained from the human submandibular-sublingual glands, and subsequent electron micrographs revealed the association of viral particles with the salivary sediment. Fractionation of human submandibular-sublingual (HSMSL) saliva by size-exclusion chromatography was initiated, and resulting fractions were tested for their ability to modulate the replication of HIV-1 using a plaque assay on HeLa CD4+cell monolayers. Results indicated that the filtration-sensitive inhibitory activity was primarily associated with the mucin-rich fractions, and the inhibitory activity was found to reduce the number of infectious units by 75%. To determine the identity of the salivary components involved, adsorption experiments involving the interaction of HIV particles with immobilized salivary components were performed. Immunological counter staining revealed an interaction of HIV particles as well as recombinant gp120 with the lower-molecular-weight mucin. Electron microscopic examination of the mucin-rich fractions-HIV incubates revealed the aggregation of virus particles by salivary components. These results suggest that human salivary mucins may have a role in modulating the infectivity of HIV-1.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Specific pathogen-free cats were experimentally infected with feline immunodeficiency virus (FIV) and subsequently exposed to common infectious pathogens and immune stimuli over a 3-year period. Cats with preexisting FIV infection showed signs of disease after exposure toHaemobartonella felis, Toxoplasma gondii, feline herpesvirus-1, and feline calicivirus similar to signs in non-FIV-infected cats, although they were more severe. No adverse effects of immunization with inactivated rabies virus vaccine and a synthetic polypro-line immunogen were observed in either FIV-infected or non-FIV-infected cats, whereas the application of a diphtheria-tetanus-pertussis vaccine caused transient fever and lymphadenopathy in both groups of animals. Primary immune responses to pathogens or immunogens were usually delayed or diminished in FIV-infected compared with non-FIV-infected cats. Repeated infections and immune activation had no significant effects on the levels of FIV-specific antibodies or on the proportion of peripheral blood mononuclear cells (PBMCs) containing FIV proviral DNA. However, FIV-infected cats that were not exposed to immune stimuli had lower CD4+T-lymphocyte numbers and lower CD4+/CD8+T lymphocyte ratios at the end of the 3-year study than FIV-infected cats exposed to cofactors. The latter also had normal levels of interleukin-2 receptor (IL-2R) and major histocompatibility class II (MHC-II) antigen expression on PBMCs, while FIV-infected cats not exposed to cofactors had up-regulated IL-2R and down-regulated MHC-II antigen expression. It was concluded that repeated immune stimulation did not have a deleterious effect on the course of FIV-induced immunodeficiency.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

HIV-1 infection results in progressive failure of the immune system with decline in the number and/or function of B-cell clones originally recruited in specific humoral responses. Spectrotypic analysis, done by isoelectric focusing and reverse blotting (IEF-RB), is one technique for evaluating the activity and the number of specific B-cell clones and is adaptable to the direct measurement of antibodies to conformationally intact epitopes. The anti-HIV-1 (IIIB) rgp120 spectrotype was measured in 30 early-stage HIV-infected volunteers undergoing vaccine therapy with recombinant gp160 (rgp160). Twenty-five of the patients displayed a clear oligoclonal banding pattern; seven (28%) showed the same pattern in all samples, while 18 (72%) showed changes. Ten of the latter had an increase in band intensity over the course of immunization, and eight had an increase in both band intensity and number of bands. In contrast, serum samples from eight patients receiving placebo (alum) showed no changes over a comparable period. These findings suggest that vaccine therapy with rgp160 may be able to expand the anti-HIV-1 (LAI) gp120 B-cell clone pool in some HIV-infected patients as well as increase antibody synthesis by established B-cell clones recruited during natural infection. These data provide further evidence that postinfection vaccination may provide an alternative strategy in the-treatment of chronic viral diseases.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The purpose of this cross-sectional investigation was to address for the first time at what stage(s) the human immunodeficiency virus (HIV) has an influence on resting energy expenditure (REE). The subjects were 53 gay male volunteers who were grouped according to HIV status and symptoms. REE was measured by indirect calorimetry. REE was significantly different between WR 0 (1.11 kcal/min) and WR 3/4 (1.45 kcal/min) (p < 0.05). The indication of a change in REE in the midstages of HIV infection lends support for early intervention of nutritional support.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Surrogate markers generally used for observation of patients infected with human immunodeficiency virus (HIV) and their plasma and cellular viral load were assayed in a series of 40 patients before initiation of zidovudine therapy. Plasma viremia was positive in 62.5% of patients and was statistically correlated with clinical stage, CD4+T cell count, CD8+T cell count, β2-microglobulin level, neopterin level, and immunoglobulin A level. Cellular viremia was positive in 95% of patients and was correlated with clinical stage, CD4+T cell count, β2-microglobulin, neopterin levels, and disease progression during the following months. A discordance was found between p24 antigenemia, even after acid dissociation of immune complexes, and plasma viremia. In fact, p24 antigenemia was correlated with only biological markers of immune activation as β2-microglobulin and neopterin levels. The measurement of anti-p24 antibodies did not appear discriminative in our staging. Plasma viremia, like CD4+T cell count, reflects the patient's status at the time of assessment. Cellular viremia could be more informative for the prediction of future clinical progression.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

As more women of childbearing age are being identified as HIV infected, vertical transmission to the fetus and/or neonate is an increasingly significant therapeutic problem. Currently the use of zidovudine is one of the few specific measures available, and as a potentially teratogenic and fetotoxic agent, any decision for its use requires evaluation of the potential for fetal damage. In a series of 104 cases of intentional or inadvertent use of zidovudine at differing gestations in pregnancy, there were eight spontaneous first trimester abortions, eight therapeutic terminations, and eight cases of fetal abnormality occurring among a total of 88 cases where the pregnancy progressed. Analysis and correlation of antenatal data and drug therapy with individual cases failed to show any specific abnormality that could reasonably be attributed to zidovudine therapy. While not proving safety, these data add to previous smaller series with similar findings, thus lending tenuous support to the use of this agent. Continuing studies are required, particularly to clarify the possibility of long-term developmental defects.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

This study explores the relationship of immune dysfunction to the neuropsychological performance of i.v. drug users (IVDUs) infected with HIV-1. Ninety-seven HIV-positive and 45 HIV-negative former IVDUs on methadone maintenance were evaluated using neuropsychological measures, physical examinations, and measures of immune function, including absolute CD4 counts and β2microglobulin (β2-M). There were no significant differences between the HIV-positive and HIV-negative subjects on any single neuropsychological domain. There was, however, a significant group difference on a composite indicator of neuropsychological impairment, with 32% of HIV-positive subjects demonstrating some degree of overall impairment compared with only 13% of HIV-negative subjects. HIV-positive subjects were then stratified according to the Centers for Disease Control (CDC) symptom groupings: group II, asymptomatic, n = 29; group III, lymphanenopathy, n = 30; and group IV A or C-2, symptomatic, non-AIDS, n = 38. There were no significant neuropsychological differences among the three CDC groups. The HIV-positive subjects were also stratified on absolute CD4 counts (<200, 201–400, and >400) and β2-M (>5, 3–5, and 3). Individuals with greater immune compromise (CD4, <200, β2-M, >5) were more impaired on measures of motor functioning. β2-M was found to be a better predictor than CD4 count of impaired neuropsychological performance. Furthermore, individuals with β2-M values >5 have more than a threefold increase in the incidence of neuropsychological impairment than those with β2-M values 3.0. These results suggest that β2-M may serve as a useful clinical marker for the development of neuropsychological impairment and that the risk of such impairment increases as the immune system weakens.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The objective of this project was to study the functional status of HIV-infected persons seen in an ambulatory care setting. We reviewed baseline clinical and demographic data on patients with HIV infection presenting for care between December 1988 and May 1991 at the HIV Clinic of the Johns Hopkins Hospital, an urban, primary Care institution. Functional status was assessed at baseline in a comprehensive psychosocial assessment. Patients were asked to report on their ability to perform six activities of daily living (ADL) and nine instrumental activities of daily living (IADL). The main put-come measures were dependency in one or more ADL and death as ascertained by review of clinic death records and Maryland State Death Registries. All 728 patients had assessments of functional status. Of these, 18% reported dependencies in one or more activity, with most of these (14%) reporting dependencies in IADLs only. Dependencies were more common in persons with an AIDS diagnosis (32% vs. 15%, p < 0.001). The majority of the dependencies reported by AIDS patients were also in IADLs. Mean CD4 counts were lower for persons reporting dependencies than for those who reported no dependencies (p = 0.02). No independent associations were found between functional limitation and demographic variables. The risk of death was greater in patients with dependencies than in patients with no dependencies, even when adjusting for CD4 count and AIDS diagnosis (O.R. = 2.32, p = 0.001). Proportional hazards modeling showed that mortality was independently associated with an AIDS diagnosis (hazard ratio 1.82, p = 0.05), CD4 count <200/mm3(hazard ratio 2.37, p = 0.01), and CD4 <200/mm3and functional dependency (hazard ratio 3.45, p = 0.056). The majority of patients is this population had no functional dependencies at their initial visit, including patients with AIDS. Those patients who did have dependencies were more likely to need assistance with activities necessary for independent living, such as cooking or shopping, rather than for self care. For patients with advanced HIV disease, functional dependencies are associated with a greater risk of death.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Data on the prevalence and patterns of use of concomitant medications among participants in three large phase III clinical trials of zidovudine (ZDV) in human immunodeficiency virus type 1 (HIV-1) infection were analyzed. Overall, 2,801 patients reported 43,331 uses of concomitant medications. Over 85% of clinical trial participants used one or more concomitant medications at some point during the study. Patients with acquired immune deficiency syndrome (AIDS) used an average of 7.1 drugs per month. Patients with AIDS-related complex (ARC) or who were asymptomatic used relatively fewer drugs: 3.1 and 2.7 per month, respectively. Fourteen percent of patients with AIDS used more than 10 concomitant medications per month. The three most commonly utilized classes of drugs were antiinfectives (57%), analgesics or antipyretics (55%), and vitamins (47%). A total of 17% of patients overall and 30% of AIDS patients used acyclovir while on trial. Consumption of prescription drugs was greater, and “over-the-counter” drugs less, among AIDS patients. Reported use of agents not approved by the Food and Drug-Administration or approved drugs used for off-label indications was infrequent. Overall use of concomitant medications did not differ across demographic subgroups when corrected for disease stage at the time of enrollment. White, non-Hispanic, homosexual and bisexual men consumed significantly more antivirals and vitamins than other trial participants. Women in all three protocols took more analgesics or antipyretics than did men. Characterization of concomitant medication use in clinical trials may allow the design of studies that better reflect current clinical treatment standards and patient preferences, contribute to a more accurate evaluation of drugs being investigated, and provide preliminary indication of effects, toxicities, and costs of commonly used medications specifically in HIV-infected patients. As the number of agents demonstrated to be efficacious in the treatment of HIV infection and the potential for significant drug interaction increase, the assessment of concomitant medication use by HIV-infected patients will be vitally important.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID