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Biomedical subjects

N Clumeck

Publications and source records attributed to N Clumeck.

At least 127 records · Page 7Linked to original sources

Seroepidemiological studies of HTLV-III antibody prevalence among selected groups of heterosexual Africans.

T-lymphocyte subsets and human T-cell lymphotropic virus type III antibody prevalence were studied in African patients with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC), and in female prostitutes. African blood donors and healthy Zairian and Rwandese persons matched for age, sex, and annual income served as controls. Seropositivity was noted in 46 (87%) of 53 patients with AIDS, 29 (88%) of 33 patients with ARC, 67 (80%) of 84 prostitutes, and five (12.5%) of 40 and eight (15.5%) of 51 healthy controls and blood donors, respectively. Patients with AIDS and ARC had a significantly lower OKT4/OKT8 ratio than healthy African controls. These studies suggest that human T-cell lymphotropic virus type III infection has already spread extensively into the general African population and that female prostitutes could be an important human reservoir of AIDS virus in the heterosexual population.

Acquired Immunodeficiency Syndrome↗

Female prostitutes: a risk group for infection with human T-cell lymphotropic virus type III.

In July, 1984 33 female prostitutes in Rwanda and 25 male customers of prostitutes were assessed clinically and for their T-lymphocyte subsets and frequency of antibodies to human T-cell lymphotropic virus type III (HTLV-III). 27 healthy males who denied contact with prostitutes, 33 healthy women who were not prostitutes, and 51 Rwandese prostitutes seen in 1983 served as controls. Only 6 prostitutes were symptom-free (group I), 13 had unexplained generalised lymphadenopathy (LAP) (group II), and 14 had LAP and constitutional symptoms (group III). Mean OKT4/OKT8 ratio in groups II and III was significantly lower than that in group I or in female controls. HTLV-III antibodies were detected in 29 of 33 prostitutes, 4 female controls, 7 male customers, and 2 male controls. In male customers, HTLV-III seropositivity increased according to the number of different sexual partners per year. This study suggests that in Central Africa prostitutes are a high-risk group for HTLV-III infection.

Acquired Immunodeficiency Syndrome↗

A prospective study of the ophthalmologic findings in the acquired immune deficiency syndrome in Africa.

A prospective study of ophthalmologic findings in 20 African patients with the acquired immunodeficiency syndrome (Group 1) and nine patients with acquired immune deficiency syndrome related complex (Group 2) disclosed that 11 patients in Group 1 and two patients in Group 2 had ocular involvement. Cotton-wool spots, Roth spots, and hemorrhages were frequent features in Group 1. In this series, unlike most others, perivasculitis occurred in five patients whereas cytomegalovirus retinitis and ocular involvement of Kaposi's sarcoma were not observed. These African patients also differed from those previously described in the high proportion of women (11 of 29) and the lack of the usual risk factors (homosexuality, intravenous drug abuse, and hemophilia).

Acquired Immunodeficiency Syndrome↗

Bovine leukemia virus-related antigens in lymphocyte cultures infected with AIDS-associated viruses.

An earlier finding that lymphocytes from African patients with the acquired immune deficiency syndrome (AIDS) react with rabbit antiserum to purified antigens of bovine leukemia virus (BLV) prompted a study of the possible cross-reactions between a BLV-infected ovine cell line and human lymphocytes inoculated with a strain of lymphadenopathy syndrome-associated virus (LAV). A solid-phase radioimmunoassay was used to detect antigenic markers of the retroviruses. Crude extracts from short-term cultures of lymphocytes infected with LAV bound rabbit antisera to the LAV glycoprotein gp13 (molecular weight 13,000) and the BLV proteins p24 and gp51, but did not bind antibodies to the p24 of human T-cell leukemia virus type I (HTLV-I). Antiserum to LAV gp13 reacted with an ovine cell line producing BLV but also weakly with virus-free ovine cells. Lymphocyte cultures from four African patients with AIDS expressed BLV-related antigens within 6 to 10 days of culture, at the moment when particle-bound reverse transcriptase was produced. BLV-related antigens were induced in lymphocyte cultures from healthy individuals by addition of filtered supernatant or irradiated cells of the original culture. The antisera to BLV used in this study may prove useful for the detection of AIDS-associated viruses in short-term cultures of lymphocytes from AIDS patients or their contacts.

Acquired Immunodeficiency Syndrome↗

Analysis of the interferon system in African patients with acquired immunodeficiency syndrome.

Serum interferon and in vitro production of alpha and gamma interferon by peripheral blood leucocytes were examined in 21 African patients with acquired immunodeficiency syndrome (AIDS) and in 15 African patients with AIDS-related complex. Interferon was detected in the serum of 44% of the patients with AIDS-related complex and in 70% of the patients with full-blown AIDS, and was characterized as an acid-labile alpha interferon. When compared to healthy blood donors, the interferon response of peripheral blood leucocytes to Newcastle Disease virus was impaired in 7 of 12 patients with AIDS-related complex and in 16 of 20 AIDS patients (p less than 0.005). Also, production of gamma interferon following stimulation with phytohaemagglutinin was diminished in 5 of 11 patients with AIDS-related complex and in 13 of 17 patients with AIDS (p less than 0.005). A high correlation was observed between the presence of circulating interferon and decreased in vitro production of gamma interferon, but not of alpha interferon. These results suggest that the impairment of in vitro production of gamma interferon can be used as a preclinical marker of AIDS.

Acquired Immunodeficiency Syndrome↗

Thymopentin treatment in AIDS and pre-AIDS patients.

Three pilot studies testing thymopentin in AIDS patients are presented. One study included 5 patients with the full-blown syndrome, all treated with 50 mg thymopentin 3 times a week by intravenous slow infusion; no immunologically nor clinically positive results were observed, indicating that the T cell pool in such patients is severely depleted. Six other patients with the prodromal stage of AIDS were treated 1 month with 50 mg thymopentin administered as an intravenous bolus injection 3 times weekly and thereafter for another month with same dose regimen as intravenous slow infusions. The patients on infusion therapy experienced statistically significant immunological improvements; these positive findings were paralleled with an improvement of the patients' clinical condition. These positive responses persisted for an average of 8 months. In another group of 5 pre-AIDS patients thymopentin was administered via the subcutaneous route using 15 mg 3 times weekly; only 1 patient revealed immunological and clinical improvement. In summary, only patients with the pre-AIDS syndrome are likely to benefit from immunomodulation therapy with thymopentin, and the mode of administration seems to be crucial.

Acquired Immunodeficiency Syndrome↗

Acquired immunodeficiency syndrome in Rwanda.

To evaluate acquired immunodeficiency syndrome (AIDS) in central Africa a prospective study was done in Kigali, Rwanda, where Kaposi's sarcoma (KS) is endemic. During a 4 week period, 26 patients (17 males and 9 females) were diagnosed. 16 patients had opportunistic infections, associated with KS in only 2; 1 had multifocal KS alone; and 9 had clinical conditions consistent with prodromes of AIDS. All patients had severe T-cell defects characterised by cutaneous anergy, a striking decrease in the number of helper T cells, and a decreased OKT4:OKT8 ratio (mean 0.27). 21 of the 22 adult patients were living in urban centres and many of them were in the middle to upper income bracket. Most of the men were promiscuous heterosexuals and 43% of the females were prostitutes. No patient had a history of homosexuality, intravenous drug abuse, or transfusion in the previous 5 years. This study suggests that AIDS is present in central Africa as an entity probably unrelated to the well-known endemic African KS. An association of an urban environment, a relatively high income, and heterosexual promiscuity could be a risk factor for AIDS in Africa.

Acquired Immunodeficiency Syndrome↗

Acquired immunodeficiency syndrome in African patients.

Between May 1979 and April 1983, 18 previously healthy African patients were hospitalized in Belgium with opportunistic infections (cryptococcosis, Pneumocystis carinii pneumonia, central-nervous-system toxoplasmosis, progressive cutaneous herpes simplex virus infection, disseminated cytomegalovirus infection, candidiasis, or cryptosporidiosis) or Kaposi's sarcoma, or with both. Ten of them died. During the same period five other patients were hospitalized with an illness consistent with a prodrome of the acquired immunodeficiency syndrome (chronic lymphadenopathy, fever, weight loss, and diarrhea). All patients tested had a marked decrease in helper T cells; an inversion of the normal ratio of helper to suppressor T cells, and a decreased or absent blastogenic response of lymphocytes to mitogens. Twenty patients had anergy. There was no evidence of an underlying immunosuppressive disease and no history of blood-product transfusion, homosexuality, or intravenous-drug abuse. This syndrome in patients originating in Central Africa is similar to the acquired immunodeficiency syndrome reported in American patients.

Acquired Immunodeficiency Syndrome↗

Treatment of severe staphylococcal infections with a rifampicin-minocycline association.

During an outbreak, 25 severely impaired patients (mean age 62) presented with severe infections due to Staphylococcus aureus resistant to oxacillin and aminoglycosides. All strains were isolated in pure culture and diagnostic procedures included transtracheal puncture and bone biopsy. Median MICs were: oxacillin 50 mg/l, gentamicin 12.5 mg/l, tetracycline 25 gm/l, vancomycin 0.195 mg/l, rifampicin 0.097 mg/l and minocycline 0.195 mg/l. All patients were treated with rifampicin (600 mg/day) and minocycline (200 mg or 400 mg/day) administered together intravenously or orally bid. Mean duration of treatment was 22 days (range 5 to 119). Overall results were 19/25 infections cured and one improved. Five were failures due mostly to emergence of Staph. aureus resistant to rifampicin. No side effects were noted. These preliminary results suggest that rifampicin plus minocycline may be useful in the treatment of severe infections due to multi-resistant Staph. aureus.

Adolescent↗

Acquired immune deficiency syndrome in Belgium and its relation to Central Africa.

During the years from 1979 until 1983, 40 cases of CDC-defined AIDS were seen in Belgium. Only two patients were Belgian male homosexuals. The other patients were Central Africans who lived in Belgium or who had travelled to Belgium for medical care. There was no evidence of an underlying immunosuppressive disease, and no history of homosexuality or intravenous drug abuse. The male:female ratio was 1.5. All patients had opportunistic infections. Five of them also had Kaposi's sarcoma. All patients tested had immunologic features of severe T-cell depression. The overall mortality was 42.5 percent. It is likely that AIDS is endemic now in Central Africa, and that the cases seen in Belgium represent only the tip of the iceberg.

Acquired Immunodeficiency Syndrome↗

[Acquired immunodeficiency syndrome (AIDS) manifested as severe genital herpes. Apropos of 2 cases].

The authors present 2 cases of AIDS revealed by severe recurrent genital herpes simplex. The patients are 2 young, previously healthy, African women without histories of homosexuality or drug abuse. The first patient died after 5 months of follow-up (post mortem findings: viral bronchopneumonia with positive cultures for herpes and cytomegalovirus (CMV), viral colitis due to CMV). The second patient survived. She has been treated, during the last 11 months, for filariasis, buccal and vaginal candidiasis and cerebral toxoplasmosis.

Acquired Immunodeficiency Syndrome↗

Preliminary results on clinical and immunological effects of thymopentin in AIDS.

In an open study, 10 African patients with AIDS were treated with thymopentin 50 mg i.v. 3 times a week for 2 consecutive months: 1 month by i.v. direct injections and 1 month by 30-min i.v. infusions. In group A there were 6 patients with AIDS-lymphadenopathy characterized by weight loss, chronic fever, generalized lymphadenopathy and OKT-4 to OKT-8 ratio below 0.2. Group B consisted of 4 patients with AIDS and opportunistic infections. Immunological studies performed before, during and after therapy included lymphocyte count, T-cell subsets assessment, study of blastogenic response of lymphocytes to PHA and delayed hypersensitivity skin testing to 5 antigens. In group A, results after thymopentin i.v. direct injections showed a significant increase in OKT-3 and OKT-8 cells. After thymopentin i.v. infusion, blastogenic response to PHA increased significantly as compared with pretherapy values and to the values after i.v. direct injections. At the end of infusion therapy, skin tests became positive for 3 antigens (range 2-4). Furthermore, all 6 patients noted subjective improvement associated with significant weight gain and disappearance of fever. In contrast, in group B the clinical and immunological status worsened during therapy and two patients died from opportunistic infections. This preliminary study suggests that i.v. infusion with thymopentin may be useful in the early phase of the acquired immune deficiency syndrome as it produces symptomatic and immunological improvement.

Acquired Immunodeficiency Syndrome↗