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Biomedical subjects

R Colebunders

Publications and source records attributed to R Colebunders.

At least 19 recordsLinked to original sources
PubMed1992

An African patient with AIDS and linitis plastica.

This is a case report about an African patient with AIDS who was diagnosed with a linitis plastica of the stomach. The evolution of this linitis plastica does not differ in any aspect from that in HIV-negative patients. The question remains unanswered whether there is a link between the HIV infection and the development of linitis plastica in this patient.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Subset markers of CD8(+) cells and their relation to enhanced cytotoxic T-cell activity during human immunodeficiency virus infection.

Using fresh whole blood or isolated lymphocytes, the activity of in vivo generated cytotoxic T-lymphocytes (CTL) was measured as the OKT3-specific lysis of HL-60 targets, in a cross-sectional study of 53 HIV (+) patients. CTL activity in the entire HIV(+) group was two to three times higher than in HIV(-) controls, with WHO stage 3 (=pre-AIDS) patients showing the highest cytolytic function. The whole-blood CTL assay was validated and its practical and theoretical advantages are discussed. Within the CD8(+) cells, the number and proportion of the CD45RO(+) "memory" subset were significantly increased in HIV(+) subjects. The HLA-DR(+) subset rose most spectacularly in the asymptomatic stage of the infection, while the CD38(+) subset was the only one still significantly rising between the pre-AIDS and the AIDS stage. CTL activity was most closely correlated with T8 cells expressing the CD38 marker. In the context of CTL, CD38 thus seems to reflect activation rather than immaturity. Lymphocytes from HIV(+) subjects with a high OKT3-specific lytic capacity also destroyed normal lymphoblasts to a significant extent, pointing to their possible involvement in an autodestructive process. Our data thus suggest the importance of T8 cytolytic function and/or T8 subtyping in the immunopathogenesis and the prognosis of HIV infection.

ADP-ribosyl Cyclase↗
PubMed1991

Seroconversion rate, mortality, and clinical manifestations associated with the receipt of a human immunodeficiency virus-infected blood transfusion in Kinshasa, Zaire.

To evaluate the consequences of receiving human immunodeficiency virus type 1 (HIV-1)-seropositive blood, 90 HIV-1-seronegative recipients of HIV-1-seropositive blood (case patients) and 90 HIV-1-seronegative recipients of HIV-1-seronegative blood, matched for age, sex, number of transfusions, diagnosis, and severity of illness (controls), were followed for 12 months after transfusion at Mama Yemo Hospital in Kinshasa, Zaire. Of case patients and controls, 72% were children transfused for anemia caused by malaria. Of the 46 case patients case patients alive 6 months after transfusion and for whom HIV-1 serologic results were obtained, 44 (96%) had seroconverted. Significantly more case patients (47%) than controls (16%) died within 1 year after transfusion (P less than .001). In the first 3 months after transfusion, fatigue, diarrhea, fever, cough, pruritus, pallor, oral candidiasis, polyadenopathy, hepatosplenomegaly, and rhinorrhea were observed more often among seroconverters than controls (P less than .04). Six percent of case patients and no controls had developed clinical AIDS after 12 months of follow-up. These findings underscore the urgent need for appropriate HIV screening facilities in transfusion centers worldwide.

Adolescent↗
PubMed1991

[Clinical aspects and treatment of bites by poisonous snakes].

Every year there are hundreds of snake bites in Europe, but the main problems occur in tropical areas. Symptoms such as hemorrhages, paralysis and local necrosis vary according to the snake species. Inappropriate first aid should be avoided. Antitoxin should be administered if there are signs of poisoning. It is never too late to give antitoxin. Antitoxin can have a number of potentially very dangerous side-effects.

Antivenins↗
PubMed1990

Incidence of malaria and efficacy of oral quinine in patients recently infected with human immunodeficiency virus in Kinshasa, Zaire.

There is concern that the impaired cell mediated immunity caused by the human immunodeficiency virus may increase the risk of severity of Plasmodium falciparum infection and could lead eventually to a decreased response to standard antimalarial treatment. In 1986, at Mama Yemo Hospital, Kinshasa, Zaire, the incidence of malaria was determined in a cohort of 59 patients who had recently acquired HIV-I infection through blood transfusion and in a cohort of 83 HIV-I seronegative controls who were recipients of HIV-I seronegative blood. All cohort patients were asked to visit the study physician whenever they developed fever. On each of these occasions thick film was examined for the presence of malarial parasites. HIV-I seropositive patients presented more often with episodes of fever per person month observation than HIV-I seronegative patients (P = 0.003). The total number of positive thick films per person months observation was significantly higher among HIV-I seropositive patients than among the HIV-I seronegative ones, but percentages of positive thick films per episode of fever were the same in both groups (46%). During a 5 month period, cohort patients presenting with a moderate attack of malaria were treated with oral quinine 20 mg/kg daily in two doses for 5 days. Twenty-three (92%) of 25 HIV-I seropositive patients and 28 (82%) of 34 HIV-I seronegative patients had a negative film 7 days after starting treatment. This study suggests that there seems to be no direct interaction of major clinical importance between HIV infection and malaria.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Opportunistic parasitic diseases in Africa. Clinical aspects and diagnosis].

Opportunistic parasitic infections are diagnosed more and more often in African patients with AIDS. Cryptosporidiosis is the most frequent with a prevalence between 7 and 31%. The prevalence of Isospora belli is between 5 and 19% and that of strongyloidiasis between 2 and 5%, depending on the authors. These parasitic infections are probably one of the frequent causes of chronic diarrhea in Africa. The prevalence of toxoplasmosis and pneumocystosis are not well known. (Between 5 and 17% for toxoplasmosis and 29% for pneumocystosis). The diagnostic technics used are those currently known. Toxoplasmosis and pneumocystosis seen in these patients have the same presentations as those in developed countries.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Evidence for circulating activated cytotoxic T cells in HIV-infected subjects before the onset of opportunistic infections.

The activity of both cytotoxic T lymphocyte (CTL) and natural killer (NK) cells were measured cross-sectionally in 43 subjects seropositive for HIV, in 27 HIV- blood donors and in 24 HIV- persons from the Outpatients Clinic for sexually transmitted diseases. CTL activity was evaluated using the HL-60 cells coated with OKT3 as the targets and freshly separated peripheral blood lymphocytes as the effectors. In 20 out of 43 HIV+ subjects, CTL activity was significantly enhanced in comparison to the HIV- subjects. This lytic activity correlated positively with the percentages of CD3+ HLA-DR+, of CD8+ CR3- and of CD57+ CD16- lymphocytes, and was greatly reduced after elimination of CD8+, of HLA-DR+ or of CD57+ cells. The median CTL activity seemed to increase from CDC group II to CDC group IV (Centers for Disease Control classification), but to return back to control levels in those patients with a history of opportunistic infections. NK function in HIV+ subjects was not significantly different from that in the blood donors. In seropositive patients, NK activity correlated positively with the percentages of both CD16+ CD57+ and of CD8+ CR3+ cells and was strongly diminished after elimination of CD16+ or of CD57+ cells. There was no significant change in NK function according to the clinical stage. The data show that circulating CD8+ HLA-DR+ CD57+ T cells in HIV+ subjects are activated cytotoxic T cells and point to progressive (over) activation of this T cell compartment until the onset of opportunistic infections.

Antigens, Surface↗
PubMed1990

HIV-1 infection in HIV-1 enzyme-linked immunoassay seronegative patients in Kinshasa, Zaire.

Serum samples of 62 African patients who had clinical manifestations of HIV-1 infection but were seronegative for HIV-1 by ELISA (Organon) were subsequently further tested by another HIV-1 ELISA test (Wellcozyme), HIV-1 IgG Western blot, HIV-1 antigen detection and HIV-2 ELISA. Patients' lymphocytes were cultured for HIV-1 and 2. Because of limited quantities of serum available all tests were not performed on all samples. Seven (26%) of 27 sera of patients meeting the WHO clinical case definition of AIDS were Western-blot-positive. In contrast, of 35 patients' sera with possible HIV related disease, only one (3%) was Western blot positive (P = 0.02) and none of 75 sera from HIV-1 ELISA (Organon) seronegative blood donors (P less than 0.01) were Western blot positive. Of 30 HIV-1 ELISA (Organon) seronegative patients tested with the HIV-1 ELISA Wellcozyme assay only one was seropositive (this patient's serum was also Western blot positive). Of 17 HIV-1 ELISA (Organon) seronegative patients tested, HIV-1 antigen was found in 1 case (6%) (this patient's serum was Western blot negative). None of the 34 patients tested by HIV-2 serology was HIV-2 seropositive. HIV-1 was isolated by culture in 3 (21%) of 14 HIV-1 ELISA seronegative patients (sera of the 3 patients were Western blot negative). In total, 12 (19%) of 62 HIV-1 ELISA (Organon) seronegative patients were found to be positive for HIV, either by Western blot HIV antigen testing or viral culture.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS Serodiagnosis↗
PubMed1990

Isolation of mycobacteria from stools and intestinal biopsies from HIV seropositive and HIV seronegative patients with and without diarrhea in Kinshasa, Zaïre. Preliminary results.

To determine the role of mycobacteria as etiologic agent in HIV related enteritis in Africa, the following study was performed in 1986, in the department of Internal Medicine in Mama Yemo Hospital in Kinshasa, Zaire. Stool and intestinal biopsies were obtained from HIV seropositive and HIV seronegative patients with and without diarrhea. Patients with known Mycobacterium tuberculosis infection were not enrolled. Acid fast bacilli were found in fecal smears of 6 (10%) of 59 HIV seropositive patients and in none of 41 HIV seronegative patients (p = 0.04). Isolation rates of mycobacteria were slightly lower in HIV seropositive patients than in HIV seronegative patients (25% vs 44%, p = 0.08) and significantly lower in patients with diarrhea than in patients without diarrhea (15% vs 44%, p = 0.02). Mycobacterium avium-intracellulare was the species most frequently isolated from stools, in 12% of the HIV seropositive and in 22% of the HIV seronegative patients. Mycobacteria were not isolated from any of the intestinal biopsies obtained in 17 HIV seropositive patients with persistent diarrhea and any of these biopsies showed histological evidence of a mycobacterial infection. This study suggests that mycobacteria do not seem to play a major role in causing diarrhea in HIV seropositive patients.

Adult↗
PubMed1988

Parotid swelling during human immunodeficiency virus infection.

In Europe and in the United States, bilateral parotid gland swelling has been observed as a sign of human immunodeficiency virus (HIV) infection in children, but it has not been associated with HIV infection in adults. We observed a chronic parotid gland swelling in nine HIV-seropositive patients during a nine-month period in Kinshasa, Zaire. Parotid gland enlargement was bilateral in seven patients (78%), slightly painful in seven patients (78%), and painless in two patients (22%). No evidence of inflammation was observed around Stensen's duct. One of the two patients in whom a parotid gland biopsy was performed had a malignant lymphoma of the large-cell, histiocytic type. In the other patient, the parotid gland showed normal morphology with minor inflammation. Among 284 adults and 40 children with symptomatic HIV infection, chronic parotid gland enlargement was observed in none of the patients. However, two (0.7%) of the adults presented with an acute pyogenic parotitis. Further studies are needed to determine whether parotid gland enlargement is associated with HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Herpes zoster in African patients: a clinical predictor of human immunodeficiency virus infection.

A recent episode or a history of herpes zoster was found in 30 (11%) of 284 patients hospitalized with human immunodeficiency virus (HIV) infection at Mama Yemo Hospital, Kinshasa, Zaire. Of 146 African patients with a history of herpes zoster who were referred to us by physicians at the Mama Yemo Hospital, 133 (91%) were HIV seropositive. The clinical characteristics of the herpes zoster episodes did not differ between HIV-seropositive and -seronegative individuals, except that 23% of the HIV-seropositive patients experienced recurrences compared with none of the HIV-seronegative patients (P = .05). No patient developed a generalized herpes zoster eruption, and only patients with ophthalmic zoster developed related complications. Patients who experienced severe pain during their herpes zoster attack lost more weight than did those who had only minor pain (P = .0003).

Acquired Immunodeficiency Syndrome↗
PubMed1988

Acute HIV illness following blood transfusion in three African children.

Three children are described in whom pre-transfusion samples were HIV-seronegative and post-transfusional samples, obtained within 1 week after transfusion, were HIV-seropositive. Two of them developed a transient fever within 1 week of receiving the blood transfusion, and a transient generalized skin eruption which lasted for about 2 weeks. All three developed persistent generalized lymphadenopathy. One child developed a lumbar herpes zoster 7 months after transfusion. IgM Western blots demonstrated the presence of antibodies to protein bands p17, p24 and p55 in all three children. These three case reports suggest that children who receive a seropositive blood transfusion are at high risk for developing acute manifestations of HIV infection.

Acute Disease↗
PubMed1988

Comparison of sensitivities and specificities of latex agglutination and an enzyme-linked immunosorbent assay for detection of antibodies to the human immunodeficiency virus in African sera.

The sensitivities, specificities, and positive and negative predictive values of the Cambridge BioScience Corp. (Worcester, Mass.) human immunodeficiency virus latex agglutination assay were compared by using three different blood preparations. By using the manufacturer's standard test method with diluted sera, the sensitivity of latex agglutination was 100%, the specificity was 99.58%, and the positive and negative predictive values were 99.26 and 100%, respectively. Use of diluted whole blood or undiluted whole blood did not significantly affect the sensitivity (mean, 99.72%), specificity (mean, 99.47%), positive predictive value (mean, 99.07%), or negative predictive value (mean, 99.89%). The latex agglutination assay is a simple, rapid assay for the detection of human immunodeficiency virus that would be useful in Third World countries or other areas where enzyme-linked immunosorbent assays are not available or cannot be used.

Acquired Immunodeficiency Syndrome↗