摘要:

SummaryWhile anemia and a positive direct anti-globulin test are each frequently observed in the clinical syndrome of human immunodeficiency virus (HIV) infection, autoimmune hemolytic anemia has rarely been reported in this setting. A case of severe warm autoimmune hemolytic anemia (AIHA) with reticulocytopenia in a patient with AIDS-related complex is reported. Laboratory and clinical findings of severe hemolysis were present, including anhaptoglobinemia, microspherocytosis, splenomegaly, and transfusion dependence. Azidothymidine (AZT) therapy may have exacerbated this patient's anemia. Splenectomy produced a delayed but complete remission of the AIHA despite continuation of AZT therapy. Review of other reports of positive direct antiglobulin tests and autoimmune hemolytic anemia in patients with HIV infections suggests that autoantibodies may be a significant cause of anemia in this population and that the frequent lack of reticulocytosis, despite bone marrow erythroid hyperplasia, may lead to the underdiagnosis of AIHA in HIV-infected patients.

ISSN:0894-9255    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

SummaryThere are conflicting reports on the early effects of human immunodeficiency virus (HIV) infection on the nervous system. Some studies have suggested that there may be early cognitive impairment, while others have refuted this. We describe the results of extensive neuropsychological testing in a group of 40 infected subjects. These indicate that the degree of impairment is closely related to confounding factors other than the infection itself. Our conclusion is that the early stages of HIV disease are not associated with a high frequency of cognitive impairment if these confounding variables are taken into consideration.

ISSN:0894-9255    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

SummaryInterferon-gamma (IFN-γ) was used to treat rats with steroid-inducedPneumocystis cariniipneumonia (PCP). Treatment with 427,000 U/day prophylactically prevented infection in this model. Treatment with 200,000 U, three times/week for 2 weeks caused a significant reduction in the number of cysts in the lungs and prolonged survival of the rats. In addition, IFN-γ and trimethoprim/sulfamethoxazole behaved synergistically in the treatment of PCP in rats. Reduced dosages of each drug, when given together, caused an almost complete eradication of the infection. This may be a useful approach in patients with acquired immune deficency syndrome in whom anti-Pneumocystisdrugs are often toxic.

ISSN:0894-9255    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

SummaryWe performed prospective and retrospective studies of 96 consecutive patients with acquired immune deficiency syndrome (AIDS) or AIDS-related complex (ARC) to determine the incidence, pathogenesis, and clinical significance of hyponatremia, defined as serum sodium levels ≤130 mmol/L on more than one occasion. Thirty (31.3%), six with ARC and 24 with AIDS, had hyponatremia, and it developed in 20 as outpatients. Age, gender, duration of illness, and weight loss did not differ between groups. The hyponatremic patients had more opportunistic illnesses, includingPneumocystis cariniipneumonia and cytomegalovirus infections, and had a mortality of 70% as compared to 36.4% of the patients without hyponatremia. The probability of 50% survival after diagnosis of human immunodeficiency virus (HIV) infection in the hyponatremic group was 11.5 months, as compared to 39 months for those without hyponatremia, p < 0.001. The probability of 50% survival after development of hyponatremia was 4.5 months and the median length of time to development of hyponatremia was 12.5 months after diagnosis of HIV infection. Eighty-eight percent had hypovolemia and 12% normovolemia. Seventeen of 21 with hypovolemia had no evident source of fluid loss. Two had Addison's disease, and 15 had unexpectedly high urine sodium concentration without evidence of renal or adrenal insufficiency. Hyponatremia occurs commonly in ambulatory patients with ARC or AIDS, appears in patients with higher mortality and morbidity, and does not represent a terminal event. Most patients had hypovolemia and unexpectedly high urine sodium concentration, suggesting defective renal sodium conservation.

ISSN:0894-9255    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

SummaryHIV-1-specific secretory antibodies may be a desirable outcome in individuals receiving AIDS vaccines. We investigated parotid and whole saliva samples for HIV-specific antibodies collected from five volunteers who received a recombinant HIV-1 envelope glycoprotein (rgp160) vaccine. Ten healthy, adult volunteers received intramuscularly either three doses of rgp160 (40 or 80 μg), a hepatitis B vaccine, or a placebo on days 0, 30, and 180. Saliva samples were collected on days 0, 28, 60, 120, 194, and 270 from the volunteers. All volunteers were negative for serum HIV antibodies by ELISA (Abbott). By Western blotting, serum antibodies to envelope antigens were demonstrated in one of three individuals who received the low dose vaccine and two of two who received the high dose. Antibodies to gp160 were detected in whole saliva on day 194 from one of these individuals by Western blotting. Parotid saliva collected on all dates did not contain detectable HIV-specific antibodies. The finding of HIV-1-specific antibodies in whole saliva following vaccination may indicate that development of mucosal immunity is possible.

ISSN:0894-9255    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

SummaryAdministration of zidovudine (ZDV) to pregnant women with human immunodeficiency virus infection may be of benefit to both the mother and the unborn child. Before testing this hypothesis, however, it is necessary to determine the transplacental transfer, fetal toxicity, and fetal accumulation of ZDV (if any) in a representative animal model. Therefore, the transplacental transfer and the fetal accumulation of ZDV were determined at steady state in near-term pregnant macaques (Macaca nemestrina). ZDV was administered to five dams at a rate predicted to produce a steady-state plasma concentration of about 1 μg/ml. When steady state was predicted to have been achieved, a cesarean section was performed on each dam. At this time, blood samples from the dam (peripheral vein) and the fetus (umbilical vein) were obtained simultaneously. The plasma concentration of ZDV and its major metabolite, zidovudine glucuronide (ZDVG), were determined by a specific high-performance liquid chromatography (HPLC) method. The ratio of steady-state plasma concentration (Crss) of ZDV in the fetus (Cssf) to that in the dam (Cssd) (Crss=Cssf/Cssd) was found to be close to unity (0.826 ± 0.067). Similar results were obtained for the ratio of steady-state unbound ZDV plasma concentration (0.852 ± 0.083). We conclude that ZDV readily crosses the placenta, probably by passive diffusion, and that ZDV does not accumulate in the fetus when administered to near-term pregnant macaques.

ISSN:0894-9255    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

SummaryTwo entry mechanisms of HIV occur in both lymphocytes and macrophages incubated with purified virus suspensions: (a) direct fusion of the viral envelope with the cell membrane and (b) receptor-mediated endocytosis via clathrin-coated pits and vesicles. Both mechanisms are shown in detail in a time-interval series of electron micrographs. The two lipid bilayers of the viral envelope and of the cellular membrane usually fuse seamlessly within 1–3 min at 37°, but occasionally membrane ruptures occur, leading to rapid cytopathic effects, i.e., vacuolization and cytolysis only a few minutes later. In the course of virus-cell fusion, gp 120 is integrated into the cell membrane; subsequent syncytia formation was observed after 1 h of incubation. The core disintegrates and releases the viral ribonucleoprotein through the opening at the fusion site into the cytoplasm.

ISSN:0894-9255    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

SummaryThe polymerase chain reaction (PCR), using primer pairs in thegag, pol, andenvregions, was used in a comparative study of HIV-I DNA in peripheral mononuclear blood cells from HIV-1-seropositive individuals in Ethiopia and Sweden. Although all Swedish samples were positive by PCR, the reactivity was more pronounced in samples from late stages than in those from early stages of infection. Six of nine Ethiopian samples from HIV-1-seropositive patients were positive by PCR, but the reactions were much weaker than those observed for Swedish samples, and in most cases seen with one primer pair only. These results suggest that the burden of HIV-1 DNA in peripheral mononuclear blood cells increases with advancing disease. PCR using primer pairs designed to detect HIV-1 infection in Europe and North America is not always suitable for the detection of HIV-1 infection in Ethiopia. The differences in PCR reactivity could possibly be a consequence of differences regarding host responses to the virus in the two countries, but more likely due to genomic differences between HIV-1 strains prevalent in Ethiopia and Sweden.

ISSN:0894-9255    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

SummaryA multicenter study was undertaken to determine the sensitivity and reproducibility of markers for human immunodeficiency virus type 1 (HIV −1) viral growth and the effect of various preparations of lymphocytes on the sensitivity of standard and routinely used procedures for HIV-1 isolation. In phase 1, cocultivated culture supernatants obtained from 10 HIV-1 cultures were transported to three Multicenter AIDS Cohort Study (MACS) Virology Laboratories. Three commercial HIV-p24 antigen capture (AC) tests and two reverse transcriptase (RT) assays were used to ascertain the replication of HIV-1. The Du Pont and Abbott AC assays were found to be most sensitive (85–100%), and the RT assay with 24-h incubation period had comparable sensitivity (75–100%). In phase II, the sensitivity of standard cocultivation procedure for HIV-1 isolation was compared using freshly phytohemagglutinin-P (PHA-P)-stimulated, stimulated-frozen, and frozen-thawed and then stimulated normal human peripheral blood mononuclear cells (PBMCs) as cocultivating cells. Blood samples from 13 HIV-1 infected individuals with various CD4+cell counts were cocultivated in each of the three MACS laboratories using one of the aforementioned normal PBMCs. The PHA-P-stimulated fresh normal PBMC showed a maximum isolation rate of 100% (13 of 13) with an average of 8 days to positivity. This rate of isolation was significantly greater than other rates using any one of the other PBMC preparations. These findings demonstrated that the use of freshly PHA-P stimulated PBMCs maximized HIV-1 isolation from blood when a sensitive HIV-1 p24 AC assay or RT assay with overnight incubation is employed for the detection of HIV in culture supernatant.

ISSN:0894-9255    

出版商:OVID    

年代:1990

数据来源: OVID