1/14. HIV counselling--a luxury or necessity?WHO and UNAIDS have consistently promoted HIV counselling as a routine part of HIV testing in developing countries. Nevertheless, in many countries counselling is not considered a crucial accompaniment of testing services, and patients are tested without access to counselling during and after testing. Thus, information on the need for and results of counselling is needed to convince policy-makers and service managers to give greater priority to the development of counselling services. This qualitative study describes informational, social and emotional needs and problems of newly diagnosed seropositive patients attending public health services in zimbabwe. Their basic factual information on HIV/AIDS was reasonable, but many patients equalled HIV to AIDS and conceptualized their infection as 'social and physical death'. This seriously impeded their capacity to use knowledge of their test results in a constructive way, and stimulated coping by denial and/or secrecy about their HIV status. These avoidant coping strategies discouraged clients from using condoms, seeking social support and taking measures to protect their vulnerable health. The complex and changing nature of clients' needs indicates that common short-cuts in counselling (e.g. giving brief information before and after the HIV test) are seriously flawed as a strategy to prepare clients for effective coping. Comprehensive pre- and post-test counselling are an essential preparation for coping effectively during and immediately after testing. Availability of supportive counselling beyond this first phase is essential to assist clients with needs and problems which will appear over time. Development of counselling interventions should be guided by research into their effectiveness and by national policy guidelines. Replacing fear-inducing HIV campaigns with interactive, constructive information about HIV prevention and care will increase the preparedness of the community as a whole for effective living with HIV.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/14. Isolation and characterization of a full-length molecular dna clone of Ghanaian HIV type 1 intersubtype A/G recombinant CRF02_AG, which is replication competent in a restricted host range.We have isolated a replication-competent, full-length molecular clone of hiv-1 CRF02_AG, designated p97GH-AG1, by reconstituting two separately amplified genomic regions of an hiv-1 provirus of a 1997 Ghanaian isolate. The phylogenetic and recombination breakpoint analyses revealed that 97GH-AG1 had an A/G recombinant structure similar to that of prototype Nigerian isolate IbNG. The 17-nucleotide insertion downstream of the primer-binding site appeared to be a common sequence signature specific to most CRF02_AG strains, including 97GH-AG1. 97GH-AG1 showed an R5 phenotype and exerted productive infection in both HOS and NP2 cell infectivity assays, whereas it failed to show a detectable level of progeny production in peripheral blood mononuclear cells (PBMCs). The data may suggest the presence of unknown determinant(s) that dictate efficient replication in PBMCs, but that are not required for replication in immortalized cell lines.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/14. spinal cord syphilis associated with human immunodeficiency virus infection: a treatable myelopathy.A 33-year-old woman, seropositive for human immunodeficiency virus type 1 (hiv-1), presented with progressive weakness and numbness of the lower extremities, gait difficulties, and urinary frequency. physical examination revealed bilateral lower extremity weakness, a left-sided Babinski reflex, and a thoracic sensory level to pinprick at T8. serum rapid plasma reagin was 1:64, and fluorescent treponemal antibody-absorption (FTA-ABS) was 4 . Examination of the cerebrospinal fluid showed a mononuclear pleocytosis and reactive FTA-ABS. The myelopathy responded promptly to high-dose intravenous aqueous penicillin. syphilis needs to be considered in the differential diagnosis of any patient who develops a myelopathy in association with hiv-1 infection. Because of the diverse nature in which syphilis may affect the spinal cord, treatment with intravenous aqueous penicillin, 12 to 24 million units daily, for a minimum of 10 days, should be considered in any hiv-1-seropositive patient with a progressive, unexplained myelopathy and positive serologic studies for syphilis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/14. Syphilitic meningitis causing paraparesis in an HIV-negative woman.Syphilitic meningitis, which can occur near the time of secondary syphilis, is frequently asymptomatic. There has been one recent report of an HIV-positive patient who developed syphilitic polyradiculopathy following a recent history of secondary syphilis. We describe an HIV-negative woman in whom paraparesis occurred secondary to syphilitic meningitis. Complete recovery followed a course of high-dose intravenous penicillin therapy, emphasizing the treatable nature of this cause of paraparesis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/14. Ultrastructural, immunohistochemical, and cytogenetic study of a malignant peripheral neuroectodermal tumor in a patient seropositive for human immunodeficiency virus.A case of malignant peripheral neuroectodermal tumor occurring during the course of a human immunodeficiency virus (HIV) infection is reported. The patient was a male homosexual who presented with a rapidly enlarging tumor of the posterior lower thoracic wall. By light microscopic examination the tumor was a small cell tumor showing occasional structures suggestive of Homer-Wright rosettes. The strong positivity for neuron-specific enolase and the neurosecretory granules indicated the neural differentiation of the tumor. Its precise nature was shown cytogenetically by the presence of the t(11;22) translocation, which distinguished it from the classical neuroblastoma.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/14. Long-term persistence of false positive antibody reactivity in HIV western blot testing of sera from a healthy blood donor.HIV-Western blot (WB) testing of sequential sera from a blood donor revealed identical bands in the p24 and p55 positions. Additional testing using indirect immunofluorescence antibody technique, radioimmunoprecipitation assay and an HIV p24 antigen immunoassay were negative. During a 5-year follow-up period the blood donor has remained apparently healthy and no signs of disease have developed. We conclude that sera from this blood donor show a false positive HIV WB reactivity. The nature of this reactivity remains obscure but has practical implications for the routine HIV screening of blood donors.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/14. Thrombotic thrombocytopenic purpura in human immunodeficiency (HIV)-seropositive males.Two male patients with thrombotic thrombocytopenic purpura (TTP) were found to have antibodies to the human immunodeficiency virus (HIV). In one patient, platelet-associated antibody levels were measured serially and were found to be initially elevated, but the levels decreased with initiation of successful therapy. The simultaneous occurrence of these two conditions in two of three patients admitted for TTP within the previous 2 years at this institution suggests an association between the two diseases. The precise nature of this association remains speculative inasmuch as the pathogenesis of TTP remains uncertain.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/14. polymerase chain reaction detection of human immunodeficiency virus dna in human periradicular lesions.Human immunodeficiency virus (HIV) has been previously reported to be present in the dental pulp of a patient with AIDS. The present report investigated the feasibility of polymerase chain reaction (PCR) amplification to detect the HIV proviral dna in cells from periradicular lesions from an HIV-positive patient. The standard PCR amplification with 30 cycles and the nested PCR consisting of two 25-cycle amplifications were used. Samples from each reaction were separated by nondenaturing polyacrylamide gel electrophoresis and stained with ethidium bromide for visualization. gels were electroblotted to nylon membranes, which were then fixed, denatured, and dried. membranes were hybridized to specific radioactive oligonucleotide probes and placed next to Kodak XAR film for visualization of the HIV-specific bands. No evidence of HIV-specific reaction was observed in cells (negative control) or in two periradicular lesions from two HIV-negative patients. The ethidium bromide strains revealed that PCR amplification of dna extracts from two lesions from the HIV-positive patient yielded PCR bands (with both primer pairs) which corresponded to HIV-specific bands of the expected size.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/14. Hypertrophic lichen planus in three HIV-positive patients: a histologic and immunological study.It is well known that several dermatoses, such as psoriasis vulgaris and seborrheic dermatitis, present with more extensive and severe disease in patients infected with the human immunodeficiency virus (hiv-1). Except for one report, however, lichen planus (LP) has not been described in patients with HIV infection. In this report we describe the clinical and morphological features of 3 HIV-positive patients who presented with extensive hypertrophic LP. To determine if alteration in the immune status in HIV-positive hosts is reflected in the nature of the infiltrate in LP, we determined the proportion of T-helper and T-suppressor cells in the infiltrate in 1 case. The majority of the infiltrating lymphocytes in the dermis were of the T-helper phenotype. Epidermal lymphocytes, however, were predominantly of the T-suppressor phenotype. We conclude that LP in HIV-positive hosts may present with more extensive disease than in immunocompetent hosts. Based on our immunohistochemical studies, we conclude that, similar to immunocompetent hosts, T-helper cells are the predominant cells in the dermal infiltrate of LP in HIV-positive patients. However, in contrast with reports in the literature on LP in immunocompetent hosts, we found that, in the case studied, the epidermal lymphocytes were predominantly of the T-suppressor phenotype.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/14. The child in the family--responding to AIDS and HIV.This study examines the psychosocial needs of children with AIDS and HIV infection based on a cohort of 18 infected children. Fifteen of the children live with their mothers, nine of whom are single mothers. For 14 children the mother is HIV ve and for a further 8 the father is also HIV ve. Many children have siblings (10), but only one of these is infected. Close family and grandparents are rarely involved in care and only one child, the oldest, is aware of parental and personal HIV status. Where children attend school or preschool centres none have been informed of the child's HIV infection. Cultural issues are prevalent, especially marked when English is not the first language (n = 10) which renders obstacles for counselling and developmental appraisal. Children in this group are hospitalized more frequently than the parents. child and parental hospitalization is problematic. Three case situations arising in this group are described in some detail to highlight the nature of the emotional challenges facing carers and service providers.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
| | Next -> |