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Biomedical subjects

H Taelman

Publications and source records attributed to H Taelman.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Retinitis in an infant infected with HIV].

A 7 month-old HIV-infected infant of African origin was admitted to the hospital. A routinely performed fundoscopy showed the presence of an unilateral left retinitis. Urine culture was positive for cytomegalovirus (CMV). Treatment with AZT (3.5 mg/kg/6 hr) was started concomitantly with monthly 350 mg/kg gammaglobulin intravenous administration. The retinitis resolved after 3 weeks and no recurrence was observed after 4 months of follow-up. The difficulties in establishing a diagnosis and in evaluating a response to treatment are briefly discussed.

Cytomegalovirus Infections↗
PubMed1989

[Sleeping sickness in German travelers to the tropics].

A brother and sister (the latter having been resident in Ruanda for three years) fell ill with African trypanosomiasis (sleeping sickness) after a two-day safari in the Akagera National Park. Cardinal symptoms were fever, lymphadenopathy and the typical primary lesion (trypanosomal chancre). The diagnosis was confirmed by demonstrating trypanosomes in the peripheral blood. There was no CNS involvement in either case. Administration of suramin, 1 g weekly intravenously for six weeks, quickly brought about regression of the symptoms and the parasitaemia. According to the number of cases reported since 1970, the risk for German travellers to certain African areas of contracting trypanosomiasis is about 0.3 per 100,000. Since in Africa the incidence of the disease is increasing, in some parts considerably, one must reckon with an increasing risk for tourists.

Adult↗
PubMed1989

Nervous system manifestations and neuroradiologic findings in acquired immunodeficiency syndrome (AIDS).

We report a series of thirteen patients with nervous system complications out of a total of thirty AIDS patients admitted to our hospital over the last two years for which CT and/or MRI have been performed. Five were homosexual men and eight patients (5 men, 3 women) were of African origin (Zaïre and Rwanda) (n = 5) or had had sexual intercourse with the local African population (n = 3). The nervous system complications encountered included: toxoplasma gondii brain abscess (2 patients); cryptococcus neoformans meningitis + toxoplasmosis (1 patient); toxoplasmosis + lymphoma (2 patients); progressive multifocal leucoencephalopathy (1 patient); lymphocytic meningitis or encephalitis (3 patients); lymphoma (1 patient); polyradiculoneuritis (3 patients). Three of thirteen patients had multiple intracranial abnormalities: one had concomitant intraparenchymal toxoplasma abscess and cryptococcal meningitis; in one patient a lymphoma developed after the successful medical treatment of a toxoplasma abscess; conversely, one patient developed a toxoplasma abscess two years after mediastinal radiotherapy for a systemic non-Hodgkin lymphoma. In conclusion, in our experience, nervous system toxoplasmosis is the most frequent AIDS related CNS complication. Our series demonstrates the high frequency of a second neurological disease occurring either concomitantly or separately. In these cases, while CT may readily identify the intracranial abnormalities, it contributes little towards an etiological diagnosis. Finally, our series illustrates the importance of a central African endemic focus for AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Advanced immunodeficiency as a risk factor for heterosexual transmission of HIV.

To define the rate of HIV infection and associated risk factors among heterosexual partners of HIV-infected individuals, 80 partners and 77 index cases were examined for clinical, behavioural and virological variables. The study population included 61 male and 16 female index cases, of whom 40 were European and 37 African. Multiple sexual partners in central Africa was the risk factor for HIV infection in 83%. The overall infection rate among the contact cases was 45%, 53% among female partners and 13% among male partners (P less than 0.001). Variables significantly associated with HIV infection in the partners included advanced clinical stage (AIDS-related complex or AIDS), a low concentration of T4 lymphocytes and African nationality of the index case, young age of the partner, and more than 50 instances of sexual contact with the index cases. In a logistic regression analysis, a low concentration of T4 lymphocytes, clinical stage ARC/AIDS and African nationality of the index case but not number of sexual contacts, remained as independent risk factors for HIV transmission. Our data indicate that there is a significant biological heterogeneity in sexual transmission of HIV and that advanced clinical stage and severe T cell depletion of the index case are major determinants of infectivity.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Risk factors for infection with human immmunodeficiency virus among European expatriates in Africa.

The pattern of cases of AIDS in Belgium suggests that Europeans infected with human immunodeficiency virus (HIV) acquired the infection in Africa. The prevalence of infection was assessed in Belgian advisers and European expatriates and risk factors for infection defined in a case-control study of expatriate men. Fifteen (1.1%) of 1401 Belgian advisers working in Africa and 41 (0.9%) of 4564 European expatriates living in Africa, were positive for antibody to HIV in a voluntary screening programme in Belgium. Among subjects with antibody to HIV the ratio of men to women was 3:1. These subjects did not have a history of intravenous drug abuse or blood transfusion and only one was homosexual. In a case-control study of 33 expatriate men who had antibody to HIV and 119 controls the men with antibody reported significantly more female sexual partners, who were more commonly local; and significantly more sexual contact with prostitutes in Africa. They had a significantly higher prevalence of history of sexually transmitted disease and had received significantly more injections by unqualified staff in Africa during the previous five years. No specific sexual practices were associated with having antibody to HIV. After multivariate analysis sexual contact with local women (adjusted odds ratio 14.7; 95% confidence interval 2.81 to 76.9), sexual contact with prostitutes (adjusted odds ratio 10.8 (1.6 to 71.9), and injections by unqualified staff (adjusted odds ratio 13.5 (3.7 to 49.8) remained independent risk factors for infection. European expatriates in Africa were at increased risk from infection with HIV and were a means of introducing HIV into the heterosexual population in Europe. Transmission from women to men by vaginal intercourse seemed to be the most probable route of infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Inflammatory demyelinating polyradiculoneuropathy associated with human immunodeficiency virus infection.

Five patients infected with immunodeficiency virus who were suffering from chronic polyradiculoneuropathy were investigated during evolution of the disease. Four of them were immunodeficient. The prominent neurological feature was distal and symmetrical weakness of the legs. After 5 months only one patient had improved. All patients had an increased protein level in the cerebrospinal fluid and pleocytosis. Electrodiagnostic studies and sural nerve biopsies indicated demyelination. Sural nerve viral cultures, including human immunodeficiency virus, were negative. The presence of circulating anti-peripheral nerve antibodies and of immunoglobulin deposits in nerve biopsy specimens was investigated by immunofluorescence techniques but failed to demonstrate any immunoreactivity.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Salmonella bacteremia in African patients with human immunodeficiency virus infection.

During a two-year period, 26 Central African patients with AIDS or AIDS-related complex were seen in two Belgian hospitals and five of these patients presented with non-typhoid Salmonella bacteremia. Three additional patients were observed in a Rwandese hospital. These eight African patients were compared with 16 non-AIDS patients with non-typhoid Salmonella bacteremias. The patients with AIDS or AIDS-related complex did not have gastroenteritis, but they did have a high recurrence rate and high prevalence of Salmonella typhimurium. Long-term antibiotic prophylaxis seems warranted for such patients despite the high frequency of side effects from antibiotics.

AIDS-Related Complex↗
PubMed1988

[Treatment of human trypanosomiasis caused by Trypanosoma brucei gambiense using alpha-difluoromethylornithine. Results in 7 patients].

Alpha-difluoromethylornithine (DFMO, eflornithine) is a specific irreversible inhibitor of ornithine decarboxylase, shown to be curative in various Trypanosoma species infections of animals. In the present open study, the efficiency of DFMO was assessed in 7 patients (4 Africans, 3 Europeans) with Trypanosoma brucei gambiense (Tbg) infection, 4 in the advanced stage and 3 in the early phase of the disease. Treatment with DFMO at initial dosages ranging 300-500 mg/kg/day administered IV (except 1 case) for 10-15 days, followed by 200-300 mg/kg/day per os for 28-69 days was associated with clearing of trypanosomes from blood within 1-4 days, a trend towards normalisation or full normalisation of all altered biological values characterizing the disease and disappearance of clinical symptoms. Side effects of DFMO, including loose stools (5 cases), anemia (3 cases) and decreased hearing (1 case), were mild and transient requiring no treatment or interruption of the drug, except in one case. Pharmacokinetic studies carried out in 4 patients, demonstrate penetration of the drug into CNS. In 6 cases, no evidence of relapse was found at 24 months posttreatment follow-up indicating that DFMO can be curative in early and late-stage of Tbg sleeping sickness. In 1 case, no relapse could be detected after a follow-up of 6 months. Further studies are needed to confirm our encouraging results and to determine the optimal regimens of DFMO for the cure of the early and late-stage of sleeping sickness.

Adult↗
PubMed1987

Serologic and immunologic studies in patients with AIDS in North America and Africa. The potential role of infectious agents as cofactors in human immunodeficiency virus infection.

Serologic and immunologic studies were performed in 38 African and 60 US patients with acquired immunodeficiency syndrome (AIDS), 100 African and 100 US heterosexual men and women, and 100 US homosexual men to examine the potential role of infectious agents in human immunodeficiency virus (HIV) infection. There were no significant differences in the prevalence of antibodies to cytomegalovirus, Epstein-Barr virus, hepatitis A and B viruses, herpes simplex virus, syphilis, and toxoplasmosis among the African and US patients with AIDS, African heterosexual controls, and US homosexual men. However, these four groups all demonstrated a significantly greater prevalence of antibodies to each of these infectious agents compared with US heterosexual men. Immunologic studies demonstrated a significant elevation of activated lymphocytes (HLA-DR and T3 positive) and immune complexes in both AIDS populations and African heterosexual and US homosexual populations, compared with the US heterosexual population. These data demonstrate that the immune systems of African heterosexuals, similar to those of US homosexual men, are in a chronically activated state associated with chronic viral and parasitic antigenic exposure, which may cause them to be particularly susceptible to HIV infection or disease progression.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Difluoromethylornithine, an effective new treatment of Gambian trypanosomiasis. Results in five patients.

Recent studies have shown DL-alpha-difluoromethylornithine (eflornithine), an inhibitor of polyamine biosynthesis, to be curative in various Trypanosoma species infections of laboratory animals. Five patients are described with Gambian trypanosomiasis treated in Belgium with difluoromethylornithine, using various intravenous and oral dosage schedules. Three patients had late-stage and two had early-stage disease. Difluoromethylornithine treatment was associated with clearing of parasites from blood within one to four days, a trend towards normalization of all altered biologic values associated with the disease, and marked amelioration of clinical symptoms. Side effects of difluoromethylornithine, including loose stools in three patients and both anemia, and a decrease in auditory acuity in one patient, were mild, transient, and never required interruption of drug treatment. The presence of difluoromethylornithine in cerebrospinal fluid, determined in three patients, demonstrated that difluoromethylornithine penetrates into the central nervous system. In three patients, follow-up of at least 24 months after treatment demonstrated a continued healthy state without evidence of relapse. These promising, albeit preliminary, results of difluoromethylornithine therapy, even in patients with central nervous system involvement, indicate that extended clinical trials are warranted to determine the optimal dosage regimen in patients with early- and late-stage disease.

Adult↗