Biomedical subjects

C Perronne

Publications and source records attributed to C Perronne.

111 records · Page 7Linked to original sources

PubMedDate not supplied

[Tuberculosis in patients infected with the human immunodeficiency virus. 30 cases].

Between May, 1983 and September, 1987, 8 per cent of the patients hospitalised for an HIV infection (i.e. 30 patients, 20 with an ARC and 10 with AIDS) had tuberculosis. The percentage of patients originating from Central Africa or Haiti was important (23 per cent). Tuberculosis was thoracic (76 per cent) and/or extrathoracic (63 per cent). The main organs involved were the lungs (n = 21), the mediastinal lymph nodes (n = 9), the superficial lymph nodes (n = 9), and the liver (n = 8). The pulmonary infection was often multilobar (n = 14), but without caverns. The tuberculin PPD (purified protein derived) test was positive in 63 per cent of ARC patients and in 30 per cent of AIDS patients. The diagnosis of tuberculosis was confirmed in 27/30 patients by culture of Mycobacterium tuberculosis (n = 23) and/or histology (n = 13), and in the remaining patients by response to a specific treatment. In 3 patients with normal X-ray film of the chest, M. tuberculosis could be recovered by culture of the gastric fluid. Antituberculous treatment was effective, but its optimum duration is to be determined since relapse may occur, even after one year of treatment. The side-effects of the treatment were unusually frequent (54 per cent). The occurrence of tuberculosis seemed to aggravate the prognosis of the HIV disease, since 57 per cent of the ARC patients reached the stage of AIDS within 6 months on average. These results are in agreement with the new recommendations of the Centers for disease control which include extrapulmonary tuberculosis in the AIDS criteria. However, in our study, pulmonary tuberculosis had the same detrimental effect and should therefore be included in the AIDS criteria.

AIDS-Related Complex↗

PubMedDate not supplied

[Pneumopathies caused by Streptococcus pneumoniae in 27 HIV infected patients].

OBJECTIVES: Determine the clinical features and outcome of acute pneumonia due to Streptococcus pneumoniae in HIV infected patients compared with non-HIV infected patients. METHODS: From January 1986 to February 1992, we observed 33 episodes of pneumococcal pneumonia in 27 HIV-infected patients. Most of the patients were drug addicts (16/27), and/or originated from Central Africa or Haiti (10/27). In 9/27 (33%) patients, HIV infection was previously unknown. Eleven of the 27 patients were at the CDC stages II-III and CD4 cell count was greater than 200/mm3 and CD8 cell count was greater than 1000/mm3 in 12/23 patients and 10/20 patients respectively. RESULTS: In 10/33 episodes, respiratory symptoms were severe: bilateral pneumonia (n = 2) and/or hypoxaemia (n = 9). In 22/33 episodes, hospitalization occurred less than 24 h after the onset of symptoms and in 9/33 episodes, the initial chest X-ray was normal. Streptococcus pneumoniae was isolated in 16/33 episodes, from blood (n = 10), bronchoalveolar lavage (n = 3) or sputum (n = 3). Penicillin G or amoxicillin was used and allowed a favorable and quick response in all episodes. Recurrence occurred in 5/18 (27%) followed patients. These recurrences were not favoured by a low CD4 cell count since it was more than 200/mm3 in these five patients. However, the mean count of CD8 cells was higher in patients with recurrence than in patients without recurrence, 1990/mm3 versus 995/mm3 (p = 0.03). CONCLUSION: CD8 hyperlymphocytosis could increase the risk of recurrence and would help identify a subgroup with higher risk of pneumococcal pneumonia among HIV infected persons.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

[Primary chemoprevention of tuberculosis in HIV-infected patients in non-industrialized countries].

In randomized placebo-controlled trials in Haïti, Zambia and Uganda, prophylactic use of isoniazid (INH) for 6 to 12 months reduced the annual incidence of tuberculosis in HIV-infected patients by more than 50 per cent. For several years, WHO, IUTATLD and CDC have recommended that HIV-positive patients testing positive in a PPD test should be treated with INH as a form of anti-tuberculosis chemoprophylaxis (ATC). Whilst these recommendations are easy to follow in industrialized countries, widespread use of ATC in developing countries remains problematic because: (i) It is unknown what proportion of patients are likely to be re-infected at the end of ATC in countries where TB is endemic; (ii) It is possible that resistant bacilli may be selected due to the incomplete exclusion from the ATC program of patients with active TB at enrollment; (iii) It is difficult to identify asymptomatic carriers of M. tuberculosis at enrollment; (iv) It is doubtful that all patients will comply with a treatment regime which lasts several months; (v) The cost of a widespread ATC program, whose full benefit remains to be evaluated, may be difficult to justify. This paper attempts to review these issues and demonstrates the need for more population-based clinical trials in the field.

AIDS-Related Opportunistic Infections↗