Biomedical subjects
D J Jeffries
Publications and source records attributed to D J Jeffries.
AIDS, cotton wool spots, and cytomegalovirus retinitis.
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Three-year prospective study of HTLV-III/LAV infection in homosexual men.
170 symptom-free homosexual men were recruited in London in 1982-83 and 133 were evaluable in 1983-85. Of the 33 who were seropositive to HTLV-III/LAV at entry, 4 (12%) progressed to AIDS, 16 (48%) progressed to persistent generalised lymphadenopathy (PGL), and 13 (40%) remained symptom-free. A further 15 men seroconverted during the study (7% per annum), of whom 8 progressed to PGL. Serial estimations of T lymphocyte subsets showed progressive reduction in T4 numbers in the seropositive groups, but these indices also varied widely in the seronegative group. Counts of T4 and T8 cells or T4/T8 ratio at entry were not of prognostic value. Seronegative subjects were as likely as seropositives to have abnormal immunological tests. Serial measurement of T lymphocyte subsets seems to be of little prognostic or clinical value in the monitoring of populations infected with the HTLV-III/LAV virus. The strongest association with prognosis was an episode of sexually transmitted disease in the six months before entry to the study. This supports the hypothesis that intercurrent infection may be an important co-factor in the acquisition of HTLV-III/LAV infection, and in subsequent disease progression.
Correlation between fulminant form of viral hepatitis and retrovirus infection associated with AIDS.
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HTLV-III: should testing ever be routine?
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Crosslinks between stereocilia in hair cells of the human and guinea pig vestibular labyrinth.
The saccules and ampullae of the semicircular canals from human and guinea pig temporal bones were fixed in glutaraldehyde without osmium. Crosslinks were seen between stereocilia of the vestibular hair cells, similar to those previously demonstrated in the guinea pig, although an additional set of crosslinks was displayed: first, horizontal crosslinks were seen between adjacent stereocilia, occupying most of the length of the hair bundle; secondly, a single upward-pointing link ran from the apex of each shorter stereocilium into the shaft of the adjacent taller stereocilium; thirdly, an extensive array of horizontal links were demonstrated between stereocilia close to their insertion into the cuticular plate. We suggest that these basal crosslinks support the long vestibular stereocilia rendering them more rigid, and that the upwind pointing crosslinks are responsible for the initiation of sensory transduction.
Early morphological and chemical changes induced by cisplatin in the guinea pig organ of Corti.
Guinea pigs were treated with a single dose of Cisplatin (5 mg IP). After 2-4 days the cochleas were prepared for morphological analysis by scanning electron microscopy and chemical analysis by X-ray dispersive microanalysis. Following Cisplatin, the bundles of stereocilia on the hair cells were found to be rough, disarrayed, fused, and finally absorbed. Significant increases were found in the levels of calcium, sulphur, and phosphorus in the abnormal hair cells. It is suggested that the high calcium levels might be due to the inhibition of enzymes which normally keep cytoplasmic calcium low, and that some of the changes in the stereocilia might be secondary to this.
Factors affecting seropositivity to human T cell lymphotropic virus type III (HTLV-III) or lymphadenopathy associated virus (LAV) and progression of disease in sexual partners of patients with AIDS.
Fifty four sexual partners of homosexual men with the acquired immune deficiency syndrome (AIDS) were studied, of whom 32 were seropositive and 22 seronegative for human T cell lymphotropic virus type III or lymphadenopathy virus (HTLV-III/LAV) antibody, which showed that repeated exposure by anal intercourse does not necessarily lead to seroconversion. Seropositivity to HTLV-III/LAV was not associated with the absolute number of sexual partners, receptive anal intercourse, or the use of recreational drugs, but was associated with a history of other sexually transmitted diseases (STDs), particularly in the year preceding the patient's initial examination. Acquisition of an STD after the date of last sexual contact with a person with AIDS was strongly associated (p less than 0.001) with the development of persistent generalised lymphadenopathy (PGL). Concurrent or recent STDs would seem to be an important cofactor in developing antibody to HTLV-III/LAV and in the progression of infection from a person being asymptomatic to having PGL.
Longitudinal immunological studies on a cohort of initially symptom-free homosexual men in London with respect to HTLV-III serology.
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Cross-links between stereocilia in the human organ of Corti.
Human cochleae were fixed in glutaraldehyde, without the use of osmium. Cross-links were seen between the stereocilia, similar to those we have previously reported for the guinea pig: first, stereocilia of the same row on each hair cell were joined by horizontally-running links; secondly, the shorter stereocilia had pointed tips, each giving rise to a single, vertically-pointing link, which ran upwards to join the adjacent taller stereocilium of the next row. We suggest that distortion of this link is involved in sensory transduction. The links were sparser than had been seen in the guinea pig which may be a reflection of the vulnerability of the links to non-optimal fixation, and the greater difficulty in producing good fixation in human specimens.
Molecular biology in viral diagnosis: restriction enzyme analysis of viruses from recurrent genital herpes infections.
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Recurrent genital herpes suppressed by oral acyclovir: a multicentre double blind trial.
Eighty-eight of 111 patients with frequently recurring genital herpes attending five centres completed a randomized, double-blind, cross over trial with 200 mg oral acyclovir four times daily for 84 days before or after a similar course of placebo tablets. During the course of placebo 77 (88%) patients reported the development of lesions, four (5%) the development of symptoms and/or erythema but no further signs of a recurrence and seven (8%) remained entirely free of symptoms and signs. In contrast during acyclovir therapy only 11 (13%) patients reported lesions, a further 37 (42%) the development of symptoms and/or erythema only, while 40 (45%) patients remained entirely free of symptoms and signs. For each parameter the difference between active and placebo treatments was highly significant (P less than 0.001). Median times to recurrence after the end of both courses were similar. The drug was well tolerated and the findings indicate that continuous oral acyclovir therapy has a place in the management of frequent recurrences of genital herpes though the indications are not entirely clear. One possibility is the suppression of recurrence at times when it would be especially unwelcome such as during examinations or holidays.
AIDS and HTLV-III/LAV infection: consequences for obstetrics and perinatal medicine.
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Cutaneous adverse reactions to acyclovir: case reports.
Intravenous, oral, and topical formulations of acyclovir have been successful in treating genital herpes. We report on two patients who developed skin reactions while taking acyclovir, which resolved when treatment was stopped.
Acquired immune deficiency syndrome (AIDS).
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BWB759U, an analogue of acyclovir, inhibits human cytomegalovirus in vitro.
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Prevalence of antibody to human T-lymphotropic virus type III in AIDS and AIDS-risk patients in Britain.
2000 persons in the UK were examined serologically for antibodies to human T-lymphotropic virus type III (HTLV-III). Sera reacting in a membrane immunofluorescence assay (IFA) to HTLV-III were also positive when tested against cells infected with lymphadenopathy virus (LAV-1), and cross-adsorption tests indicated that these retroviruses are probably identical. A competitive radioimmunoassay (RIA), which was wholly concordant with IFA, was used to screen the sera. 30/31 patients with the acquired immunodeficiency syndrome (AIDS) were seropositive, as were 89% patients with persistent generalised lymphadenopathy (PGL), 17% symptomless homosexual men, 34% haemophiliacs receiving pooled clotting factors, and 1.5% intravenous drug abusers. None of more than 1000 unselected blood donors was seropositive. These data confirm the close association between HTLV-III and AIDS and PGL and show that infection with HTLV-III is also prevalent in the populations in whom these syndromes are most likely to develop. However, it would be unwise to presume that AIDS will necessarily develop in seropositive subjects.