1/31. Distinguishing immunosilent AIDS from the acute retroviral syndrome in a frequent blood donor.BACKGROUND: There are seven reports of "immunosilent AIDS" in which there was a lack of development of anti-hiv for more than 6 months. Thus, when a frequent blood donor presented with clinical findings highly suggestive of overt AIDS, there was concern that he may have had a prolonged immunosilent infection. CASE REPORT: A 24-year-old man who had donated blood six times in the previous year was diagnosed as having AIDS; he presented with fever, nausea, vomiting, diarrhea, weight loss, and oral candidiasis. The anti-hiv enzyme immunoassay was positive, the Western blot was indeterminate (gp160 only), the CD4 count was 174 per mL, the hiv polymerase chain reaction was positive (2.8 x 10(6) copies/mL), and the hiv p24 antigen assay was positive. Twelve components from previous donations had been transfused, and 2 units of fresh-frozen plasma were still in inventory. Repeat donor testing 57 days after donation indicated seroconversion with a positive anti-hiv enzyme immunoassay, a positive Western blot, a negative hiv p24 antigen assay, and a positive test for hiv by polymerase chain reaction (89,000 copies/mL). Both units of fresh-frozen plasma tested negative for hiv by polymerase chain reaction. Four transfusion recipients had died, and the remaining eight are anti-hiv negative with >6 months' follow-up. CONCLUSION: The donor had an unusually severe acute retroviral syndrome and presented with findings that were difficult to distinguish from overt AIDS.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/31. Large granular lymphocytosis terminating in a polymorphous B-lymphocytic proliferation after low-dose cyclophosphamide therapy: a case report with necropsy findings.A 70-year-old man presented with clonal large granular lymphocytosis of T-suppressor/cytotoxic immunophenotype, neutropenia, paraproteinemia, and proneness to infection. The patient became severely leukopenic during 14 days of chemotherapy with low-dose cyclophosphamide, and remained so after discontinuation of the drug. Clinically, he was thought to have prolonged chemotherapy-induced marrow hypoplasia. At death, 16 days after the last dose of chemotherapy, autopsy confirmed bone marrow hypoplasia and revealed that well-differentiated, polymorphous, and (immunophenotypically and genotypically) polyclonal b-lymphocytes predominated in normal hematopoietic and lymphoid organs. A similar lymphoid infiltrate was intimately associated with multiple ulcers and smooth muscle necrosis in the stomach. These terminal findings resemble B-lymphoproliferative conditions described in certain forms of immune deficiency.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
3/31. erythema elevatum diutinum and pre-AIDS.erythema elevatum diutinum (EED) is a chronic disease with symmetrical persistent erythematous nodules and plaques primarily in an acral distribution. EED is often associated with infections, especially of streptococcals. An immunological reaction has been proposed as pathogenetic mechanism. We describe a patient, who developed EED secondary to a LAV/HTLV III positive lymphadenopathy syndrome. Immunological investigation of a skin lesion and a lymph node biopsy is described.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
4/31. Pulmonary infection in human immunodeficiency disease: viral pulmonary infections.Viral pneumonitides are among the known pulmonary complications of human immunodeficiency virus (hiv) infection. cytomegalovirus (CMV) pneumonitis is the most frequently recognized viral infection involving the lung. Although CMV may occasionally be the sole pathogen found to be responsible for severe pneumonitis in patients with the acquired immunodeficiency syndrome (AIDS), in most cases, its role in causing pulmonary disease is less clear, primarily because of the propensity to infect with a variety of other copathogens. CMV pneumonitis has been difficult to diagnose during life, although techniques utilizing in situ dna hybridization or monoclonal antibodies for detection of the virus may improve the diagnostic yield of less invasive procedures such as bronchoalveolar lavage. Pneumonitis due to herpes simplex virus, varicella-zoster, and respiratory syncytial virus have occasionally been reported in AIDS patients, and are of practical importance because of the availability of effective treatment. The role of influenza and adenoviruses in causing hiv-related pulmonary complications is unknown, but could be of importance during outbreaks of these infections. Finally, data from several studies now suggest that Epstein-Barr virus or hiv itself or both have a role in the pneumonitis. Further study in this area could provide information leading to more effective management of this common complication of childhood AIDS.- - - - - - - - - - ranking = 11keywords = infection (Clic here for more details about this article) |
5/31. Retroviruses and their play-pals.A 28-year-old man with a previous history of Neissena infection presented with diminished vision, disc swelling, and panuveitis. serologic tests revealed positive titers for both hiv and syphilis. Current epidemiology and treatment of such cases are discussed.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
6/31. Acute AIDS retrovirus infection. Definition of a clinical illness associated with seroconversion.In the course of a prospective immunoepidemiological study of homosexual men in Sydney, seroconversion to the AIDS-associated retrovirus (ARV) was observed in 12 subjects. review of the clinical files defined an acute infectious-mononucleosis-like illness in 11 subjects. The illness was of sudden onset, lasted from 3 to 14 days, and was associated with fevers, sweats, malaise, lethargy, anorexia, nausea, myalgia, arthralgia, headaches, sore throat, diarrhoea, generalised lymphadenopathy, a macular erythematous truncal eruption, and thrombocytopenia. In 1 subject an incubation period of 6 days after presumed exposure to ARV was determined and in 3 subjects seroconversion took place 19, 32, and 56 days after onset. Comparison of T-cell subsets before and after the acute illness showed inversion of T4:T8 ratio in 8 subjects, due to increased numbers of circulating T8 cells. These findings support the notion of an acute clinical, immunological, and serological response to infection with ARV which should be considered in the differential diagnosis of mononucleosis-like syndromes in groups at high risk for the development of AIDS.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
7/31. Apparent transmission of human T-cell leukemia virus type III to a heterosexual woman with the acquired immunodeficiency syndrome.A 24-year-old woman developed the acquired immunodeficiency syndrome with lymphadenopathy, oral candidiasis, and Kaposi's sarcoma. Her only known risk factor for the syndrome was sexual contact with an asymptomatic Haitian man. The woman had serologic evidence for infection with human T-cell lymphotropic virus type III, and this virus was recovered from the saliva of her sexual partner. Epidemiologic and virologic studies of the cases of such patients provide further evidence of a primary pathogenetic role for this retrovirus in the acquired immunodeficiency syndrome.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
8/31. The acquired immune deficiency syndrome and related complex. A report of 2 confirmed cases in Cape Town with comments on human T-cell lymphotropic virus type III infections.We report a case of acquired immune deficiency syndrome (AIDS) and one of aids-related complex presenting in Cape Town. The first patient was probably infected in the USA. In turn he infected the second patient by regular homosexual contact. Human T-cell lymphotropic virus type III (HTLV-III) was cultured, we believe for the first time in Africa, from the peripheral blood lymphocytes and a lymph node of our patient with AIDS. HTLV-III infection and high-risk groups in south africa are discussed in comparison with those in the USA. It is suggested that HTLV-III infection and AIDS will increasingly affect women. Prevention of the spread of HTLV-III infection and AIDS is discussed in relation to close medical surveillance and the protection of blood and blood products from contamination. Counselling of patients with AIDS and persons infected with HTLV-III, general health education, and the protection of health care staff are important in preventing spread but beyond the scope of this article.- - - - - - - - - - ranking = 7keywords = infection (Clic here for more details about this article) |
9/31. Antibody seronegative human T-lymphotropic virus type III (HTLV-III)-infected patients with acquired immunodeficiency syndrome or related disorders.The human T-lymphotropic virus type III (HTLV-III) is the primary cause of the acquired immunodeficiency syndrome (AIDS) and related disorders (ARC). Prior studies have reported that nearly all symptomatic patients with AIDS or ARC manifest antibody to HTLV-III. This observation has engendered efforts to screen for HTLV-III, especially prior to blood donation, with assays for antibody to HTLV-III. We report the first two cases, one with AIDS and one with ARC, that are HTLV-III virus positive but antibody negative. Accurate diagnosis of HTLV-III infection in some cases may require direct virus culture or tests for antigen. In addition, lack of HTLV-III antibody may indicate an atypical clinical course of AIDS.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
10/31. Evidence against transmission of human T-lymphotropic virus/lymphadenopathy-associated virus (HTLV-III/LAV) in families of children with the acquired immunodeficiency syndrome.Six children with the acquired immunodeficiency syndrome (AIDS) and 12 of their household contacts were investigated serologically for evidence of infection with human T-lymphotropic virus/lymphadenopathy-associated virus (HTLV-III/LAV), the presumed etiologic agent of AIDS. All six children had antibody against HTLV-III/LAV, as measured by enzyme-linked immunosorbent assay, in each specimen tested. Of the two mothers studied both were seropositive; one was diagnosed with and died from AIDS. Four of the remaining 10 household members were seropositive, including three adults in groups at high risk for the development of AIDS and one sibling who was younger than the child with AIDS. Among the seronegative household contacts were four foster mothers or grandmothers of the children with AIDS, three of whom had cared for the children since infancy. Household contact with children with AIDS may include persons in groups at high risk for AIDS who have been infected with HTLV-III/LAV. However, the negative findings in household contacts without risk factors for AIDS suggest that horizontal transmission of the virus within households by means other than sexual contact must be infrequent.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
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