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Biomedical subjects

A Lazzarin

Publications and source records attributed to A Lazzarin.

At least 235 records · Page 13Linked to original sources

A trial with ribavirin in patients with AIDS or AIDS-related complex.

A therapeutic trial is described which concerns 6 patients with AIDS and 6 patients with ARC who were submitted to a 6 month course of Ribavirin. Ribavirin was administered orally as the following doses: 3.000 mg daily the first week, 2.000 mg daily the second 2 weeks, and 1.000 mg daily up to completion of the 6 months period. No major side-effects were recorded; only a transient anemia was observed in almost all patients at the higher dose; none of them, however, required to be transfused. No improvement was shown by any of the 6 AIDS patients, neither clinically nor according to laboratory test, whereas all 6 patients with ARC experienced a sense of well-being, a clearing of their symptoms and an average weight gain of about 2.5 kg. No significant changes, though, were recorded as for their immune parameters. A remarkable drop of aminotransfereas was also observed in 4 of the patients, who were affected with chronic hepatitis as well. We conclude that additional, if any, Ribavirin trials should be carried out only in ARC patients.

AIDS-Related Complex↗

Morphogenesis, evolution and prognostic significance of lymphatic tissue lesions in HIV infection.

Morphological changes in lymph node biopsies of HIV-infected patients can be classified in four stages, based upon the degree of damage to follicular structures: (1) follicular hyperplasia, (2) follicular lysis, (3) follicular atrophy and (4) follicular and lymphocytic depletion. To define the relative usefulness of morphological, clinical and immunological findings for prognostic purposes, we followed the clinical evolution of 86 biopsied HIV+ patients for a period ranging from 1 to 56 months. A relatively good correlation between histological and clinical findings, at the time of biopsy, was observed. Statistical analysis confirmed the prognostic value of the histological features for clinical deterioration, progression to AIDS and survival. Moreover, histological findings gave more reliable prognostic information than clinical values. Our data suggest that lymph node biopsy can be utilized for prognostic purposes in the evaluation of the progression of the disease and effectiveness of antiviral therapeutic trials.

Acquired Immunodeficiency Syndrome↗

Impairment of in vitro natural antibacterial activity in HIV-infected patients.

Circulating PBMC of healthy subjects possess an in vitro natural antibacterial (NA) against enteropathogenic bacteria, including Salmonella species. The effector cell of NA activity is a CD: 4+, 8-, Leu-8/TQ-1+ T lymphocyte acting against bacteria via cytophylic IgA in a mechanism similar to antibody-dependent cellular activity. Because AIDS is a profound immunodeficiency caused by HIV involving primarily CD4 lymphocytes and in particular the Leu-8/TQ-1 subset, it was of interest to assess NA activity of HIV+ subjects at various stages of the disease. Results indicate that NA activity against Salmonella typhi and Salmonella paratyphi C is significantly decreased in AIDS as well as in lymphadenopathy syndrome patients. Furthermore, sera containing IgA against salmonellae were not able to arm PBMC from HIV+ patients. The humoral response against S. typhi-LPS was also greatly decreased after HIV infection, in contrast to the known hypergammaglobulinemia seen in these subjects. Defective NA activity might contribute to the increased incidence of salmonellosis observed in AIDS.

AIDS-Related Complex↗

Oligoclonal IgG bands in cerebrospinal fluid and serum during asymptomatic human immunodeficiency virus infection.

Serum and cerebrospinal fluid (CSF) samples from asymptomatic patients seropositive for human immunodeficiency virus (HIV) showed frequent evidence of intrathecal IgG synthesis and oligoclonal IgG bands, with different isoelectric focusing patterns in serum and CSF; 2 of 7 had a CSF pleocytosis. The results suggest frequent, early, chronic central nervous system infection following HIV infection.

Acquired Immunodeficiency Syndrome↗

HLA-associated susceptibility to AIDS: HLA B35 is a major risk factor for Italian HIV-infected intravenous drug addicts.

Thirty-one AIDS patients were typed for HLA A, B, C, and DR antigens. We confirmed that frequency of B35 is significantly higher in patients than in controls. No significant frequency differences in other HLA antigens were found. The analysis of HLA distribution in AIDS patients by risk categories suggests that B35 is a major risk factor, primarily mainly for patients belonging to the category of intravenous (IV) drug addicts.

Acquired Immunodeficiency Syndrome↗

Focal lymphocytic myocarditis in acquired immunodeficiency syndrome (AIDS): a correlative morphologic and clinical study in 26 consecutive fatal cases.

In 26 consecutive cases with acquired immunodeficiency syndrome (AIDS) the main cardiac findings were Kaposi's sarcoma in 2 cases, microfocal myocardial abscess in 1, subendocardial infarct necrosis in 2, contraction band necrosis in 13, lymphocytic myocarditis in 9, intramyocardial lymphocytic infiltrates without myocell necrosis in 7 and epicardial lymphocytic infiltrates in 4. No patient had congestive heart failure. However, two-dimensional echocardiography performed in eight patients demonstrated functional abnormalities in six (fractional shortening ranging from 18 to 30%, globular shape, hypokinesia, mild ventricular dilation). Four of these six patients had lymphocytic myocarditis and two had lymphocytic infiltrates in the myocardium and epicardium without myocell necrosis. No lymphocytic infiltrates were seen in the two cases with a normal echocardiogram. Quantitative analysis indicated that involvement of the heart by lymphocytic myocarditis is inadequate in itself to explain dysfunction. It remains to be established 1) whether lymphocytic myocarditis is a possible indication of a more widespread molecular disorder, and 2) what its eventual relation with dilated cardiomyopathy will be.

Acquired Immunodeficiency Syndrome↗

Thymostimulin treatment in AIDS-related complex.

Thirty-four patients with AIDS-related complex (ARC) were treated for 6 months with thymostimulin, a thymic hormone. Clinical and immunological findings after a 1-year follow-up were compared with those in 24 age- and sex-matched controls receiving no immunotherapy. Statistical evaluation after 6 and 12 months showed significant differences in the two groups. The thymostimulin-treated group had higher leukocyte and lymphocyte counts, more positivity in intradermal tests with multiple recall antigens, and less lymphadenopathy and weight loss. The number of OKT3+ and OKT4+ lymphocytes decreased significantly in the control group, but did not change in the thymostimulin-treated patients. Finally, after 18 months of follow-up, no progression to AIDS was seen among the treated subjects, whereas 3 of the controls developed the disease. We conclude that thymostimulin, alone or in combination with antiviral drugs, may be helpful in the management of ARC patients.

AIDS-Related Complex↗

Echocardiography detects myocardial damage in AIDS: prospective study in 102 patients.

Few data are available about cardiac involvement in AIDS. We examined 102 consecutive patients with AIDS diagnosed clinically and serologically (Walter Reed Stage 5 and 6), by means of TM and cross-sectional echocardiography with the aim of detecting cardiac abnormalities. None of the patients had overt clinical signs of heart failure. Fifty-five (54%) patients showed persistent tachycardia, diminished left ventricular (LV) wall thickness (mean 7.6 +/- 0.2 mm) and decreased percentage LV fractional shortening (27 +/- 5). In 42 (41%) there was a globular and poorly contracting LV. Thirty-nine (38%) patients had pericardial effusion which was moderate in 30 and small in nine. In four patients, valvular endocarditic vegetation was shown--on the tricuspid valve in three, on the aortic valve in one: all of them were drug addicts; in three (2.9%) patients a cardiac mass was found which proved to be a localization of Kaposi's sarcoma in two. Twenty-five (24.5%) patients died; necropsy showed cardiac chamber dilation, and thin LV walls in 18. On microscopic examination, myocardial fibrosis and lymphocyte infiltration with cell necrosis were observed. We conclude that cardiac abnormalities are common in AIDS. Impairment in LV contractility as assessed from fractional shortening appears to be the most common echocardiographic finding, followed by LV wall thinning, pericardial effusion and eventually by LV cavity dilation. This evolution is suggestive of myocardial damage and supports the hypothesis that dilated cardiomyopathy may be a cardiac complication of AIDS.

Acquired Immunodeficiency Syndrome↗

T-lymphocyte subsets and delayed type hypersensitivity as classification parameters for HIV infection among drug-addicts.

HIV selectively infects T helper lymphocytes, which play an essential role in cell-mediated immunity mechanisms. Impairment of these mechanisms can be evaluated, other than by clinical parameters, by testing lymphocytic subsets and cutaneous delayed type hypersensitivity. All these indices are used in the Walter Reed Foundation (WR) staging system, which includes the different stages of HIV infection. In our study we investigated the above mentioned parameters in a series of 180 HIV positive PDAs. A classification of the same patients according to WR's criteria was also designed. Of our patients, 46.1% resulted normoergic, 27.2% hypoergic and 26.7% anergic. Of all normoergic subjects, 83.7% (with more than 400 OKT4+ cells/mmc) could be assigned to the WR2 and 16.3% (with less than 400 OKT4+ cells/mmc) to the WR3 staging group. Among the hypoergic patients, only 34.7% were assignable to the WR4 group, whereas the majority (65.3%) had more than 400 OKT4+ cell/mmc. Even among the anergic group, 62.5% did not fit the WR5 stage, exhibiting an OKT4+ level higher than 400/mmc. In the latter 2 groups (referred to as D and E), T helper lymphocyte counts were performed at regular intervals; however, only the ones followed-up for at least 6 months were evaluated. OKT4+ cells were shown to decrease more frequently and more rapidly in the anergic than in the hypoergic patients, which points to cutaneous anergy as representing an early sign of impairment of cell-mediated immunity.

Acquired Immunodeficiency Syndrome↗

Raised serum beta 2 microglobulin levels in different stages of human immunodeficiency virus infection.

Serum beta 2 microglobulin (beta 2-M) levels were determined in patients with Acquired Immunodeficiency Syndrome (AIDS), AIDS Related Complex (ARC), Persistent Generalized Lymphadenopathy (PGL), healthy intravenous drug addicts (IVDA) and heterosexual controls. Seventy-eight out of 79 AIDS patients (98.7%) exhibited elevated beta 2-M levels. High levels of beta 2-M were also found in 83 of 100 (83%) of PGL/ARC patients and in 24 of 56 (42.8%) healthy IVDA. Patients with AIDS had significantly higher mean beta 2-M levels when compared with all other groups. The mean levels of PGL/ARC patients were significantly higher than those of healthy IVDA and the mean levels for healthy IVDA significantly differ from those of the heterosexual controls. After 2-24 months of follow up three out of four PGL/ARC patients whose serum beta 2-M was greater than 8.0 mg/l developed AIDS.

AIDS-Related Complex↗

Parallel Western blot analysis for HIV-1 and HIV-2 antibodies: absence of HIV-2 infection in Italian subjects at risk for AIDS.

Since HIV-2 infection has been identified in some European countries, we investigated whether HIV-2 infection is present in groups of Italian subjects at risk for AIDS. Our results clearly indicate that the parallel Western blot assay for HIV-1 and HIV-2 antibodies can detect HIV-2 infection, which is presently not epidemic in Italy. Careful examination of the serological data is mandatory before announcing the detection of HIV-2-infected patients.

Acquired Immunodeficiency Syndrome↗