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PubMed1987

Mechanism of defective NK cell activity in patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex. II. Normal antibody-dependent cellular cytotoxicity (ADCC) mediated by effector cells defective in natural killer (NK) cytotoxicity.

Our studies and other investigations have shown that NK effector cells can also mediate antibody-dependent cellular cytotoxicity (ADCC) through the use of the Fc gamma receptor on the NK cell membrane. Peripheral blood lymphocytes (PBL) derived from patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex exhibit a poor NK activity due to a defective "trigger" required for activation in the lethal hit stage of the NK lytic pathway. Consequently, it was important to delineate whether the defect in AIDS NK cells affected the ADCC function. By using the 51Cr-release assay, the ADCC cytotoxic activity of AIDS PBL was found to be within the normal range, despite the absence of significant NK activity. Several experiments corroborated that the same effector cells mediate both NK CMC and ADCC. Depletion of Fc gamma R-bearing cells resulted in elimination of both the ADCC and NK cytotoxic functions. Single cell analyses, using one- and two-target cell conjugates, revealed that the frequency of ADCC effector:target conjugates and the frequency of killer cells from AIDS PBL were comparable to the frequencies seen in the normal controls. However, when mixtures of NK and ADCC targets were used to form mixed two-target conjugates, the AIDS effector cells lysed only the bound ADCC target, whereas the normal effector cells lysed both the bound NK and ADCC targets. These results demonstrate clearly that the same NK/K effector cells from AIDS PBL, defective in NK activity, are not impaired in mediating ADCC activity. These findings were supported by the demonstration that AIDS PBL stimulated with ADCC targets, but not with NK targets, released NK cytotoxic factors, postulated mediators of the NK CMC reaction. These findings indicate that the NK/K cells in AIDS are triggered normally for ADCC activity but are not triggered for NK activity. Furthermore, the results indicate that the lytic machinery is not impaired in the AIDS NK/K cells.

AIDS-Related Complex↗
PubMed2000

German nursing students' knowledge of and attitudes to HIV and AIDS: two decades after the first AIDS cases.

German nursing students' knowledge of and attitudes to HIV and AIDS: two decades after the first AIDS case This study describes German nursing students' (n=180) knowledge and attitudes relating to HIV/AIDS, their homophobia level, willingness to care for people with AIDS, and their approach to possible sexual risk behaviours. A questionnaire was used to collect the data (response rate 97.8%). The results indicated that the nursing students had a rather high knowledge level concerning AIDS. However, there were gaps of knowledge, such as regarding AIDS immunopathology or the symptoms of the disease. Single nursing students and those having cared for a person with AIDS had a more thorough knowledge about the disease. In general, the attitudes towards AIDS and people with AIDS were tolerant and positive, and homophobia was only found with a small minority. Students having positive attitudes towards people with HIV/AIDS had less homophobia compared to those having negative attitudes towards persons suffering from AIDS. Those with positive attitudes were more willing to care for patients with HIV/AIDS, while those with a high homophobia level were less willing to do so. In addition, students having a high AIDS knowledge level tended less towards negative attitudes and homophobia than those with a low level of knowledge. The implications of the research for nursing education will be discussed.

Adolescent↗
PubMed1998

Knowledge of HIV-positivity had no impact on AIDS survival time among Danish AIDS patients 1980-95.

OBJECTIVE: To examine the impact of the time period from first positive HIV test to AIDS diagnosis and other variables on survival after AIDS diagnosis. MATERIALS AND METHODS: All adult AIDS patients diagnosed and reported to the national surveillance unit in Denmark in the period 1980 through June 1995. RESULTS: A total of 1745 patients was diagnosed in the period, and for 1631 (93.5%) the date of first positive HIV test was known. The median interval between this test and AIDS diagnosis was 912 d. Overall, 473 patients (29.0%) were found to be HIV-positive close to the AIDS diagnosis (< or = 4 months). The time interval between first positive HIV test and AIDS diagnosis varied by transmission categories. Patients older than 40 y had a higher mortality than younger patients. Patients infected by blood products had the highest mortality. The survival time was shortest for patients presenting with HIV-wasting or HIV-encephalopathy or with > or = 1 AIDS-defining disease. The time interval between first positive HIV test and AIDS diagnosis had no impact on survival. CONCLUSION: No association was found between survival time and the time interval between first positive HIV test and AIDS diagnosis. Older age and transmission by blood or blood products were associated with shorter survival from AIDS diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Predictors of medical and nursing students' levels of HIV-AIDS knowledge and their resistance to working with AIDS patients.

Among health professionals, knowledge about the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is often limited, inaccurate, or both. Many health professionals also resist working with AIDS patients. This 1988 survey examined exaggerated risk estimates for HIV contagion in relationship to HIV-AIDS knowledge and resistance to working with AIDS patients among medical and nursing students at a large Northwestern teaching hospital. The results indicate that among the respondents, exaggerated risk estimates were associated both with a lack of HIV-AIDS knowledge and with greater resistance to working with AIDS patients. Results from multiple regression analyses revealed that (1) a lack of clinical experience with AIDS patients and (2) antihomosexual attitudes were significantly associated with the students' lack of HIV-AIDS knowledge, even after controlling for the effects of exaggerated risk estimates. The first two variables also were shown to be significantly predictive of the students' resistance to working with AIDS patients, as was an intolerance of drug use and drug users, beyond the influence of exaggerated risk estimates. Specific approaches of developing effective HIV-AIDS educational programs for health professionals are proposed.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Rates of non-AIDS-defining cancers in people with HIV infection before and after AIDS diagnosis.

OBJECTIVE: To describe the incidence of non-AIDS-defining cancers in people with HIV infection before and after the occurrence of AIDS, and to examine the association of cancer risk with immune deficiency. DESIGN: Cohort study involving nation-wide linkage of HIV, AIDS and cancer registry data. METHODS: Association of cancer risk with immune deficiency was examined by analysing cancer risks in four periods between HIV diagnosis, AIDS and death. RESULTS: Linkage identified 196 cases of non-AIDS-defining cancer in 8351 people notified with HIV infection and 8118 registered with AIDS (total of 13 067 individuals). Overall, we found significantly increased rates of cancer of the lip, anus, Hodgkin's disease, myeloma and leukaemia. Of these cancers, in people with HIV infection who did not develop AIDS, or were more than 5 years prior to development of AIDS, only cancer of the anus occurred at increased rates. A significant trend of increasing relative risk of cancer with increasing time since HIV diagnosis was found for Hodgkin's disease and multiple myeloma. CONCLUSIONS: People with HIV with mild immune deficiency prior to AIDS were at increased risk of anal cancer, but this may reflect other risk factors. Other cancers occurred only later in the course of HIV infection. This is reassuring evidence that people with HIV who are only mildly immune deficient may not be at increased risk of non-AIDS-defining cancers, but larger studies with longer periods of follow-up are needed to confirm this.

Acquired Immunodeficiency Syndrome↗
PubMed1996

High incidence and aggressive growth of non-AIDS-defining cancers among AIDS patients in Oslo.

The spectrum of cancers advanced by AIDS is disputed. To supplement the register-based investigations, we have studied the occurrence of non-AIDS-defining malignancies in a closely followed population of AIDS patients. The population comprises 255 patients fulfilling CDC's clinical AIDS definition, representing 91% of all adult AIDS patients from Oslo 1983-1995. Full autopsy was performed on 73% of the 211 fatal cases. Adding patients with CD4 cell counts below 200 cells/mm3 to match the US AIDS definition, the population increases to 344, including 225 deceased. The expected number of cancer cases was calculated from age- and sex-specific cancer incidence rates for Oslo 1988-1992. The number of non-AIDS-defining cancers was six (clinical CDC criteria) or eight (US AIDS definition), compared to expected numbers of 0.54 and 1.0, respectively. At autopsy, four of eight cases showed extensive tumor dissemination with involvement of the heart. These observations suggest that (at least some) non-AIDS-defining cancers occur at increased rates and show aggressive growth pattern in AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Relationship of AIDS education and knowledge to AIDS-related social skills in adolescents.

The AIDS Social Assertiveness Scale (ASAS) and a measure of AIDS knowledge were administered to 490 high school students from 10 South Australian schools selected across a range of public/private, rural/urban, and socioeconomic statuses. Age, grade, hours of AIDS education, and sexual experience (and condom use) also were ascertained. Data indicated the factor structure of the ASAS was similar to that obtained in a previous sample. A close association existed between both age and hours of AIDS education, and AIDS knowledge. Students from country and working class area schools were less knowledgeable about AIDS. These data suggest AIDS social assertiveness is measurable and that it is associated with AIDS knowledge, age, and previous sexual experience. AIDS knowledge in high school students differed between country and urban adolescents and between students in working and middle class areas, but AIDS education is associated with the same level of improvement in all schools sampled.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Pennsylvania dental hygienists' knowledge, attitudes, and infection control practices in relation to AIDS and AIDS patients.

PURPOSE: Limited documentation is found on dental hygienists' attitudes toward acquired immunodeficiency syndrome (AIDS) patients and their knowledge and practice of clinical infection control to prevent disease transmission to themselves and their patients. The purpose of this paper was to survey practicing Pennsylvania dental hygienists to document 1) their infection control practices; 2) their attitudes towards AIDS patients; and 3) their knowledge of clinical infection control practices. METHODS: A self-administered survey questionnaire, with fixed-alternative responses, was mailed in January 1991 to a random sample (N = 300) of licensed, practicing Pennsylvania dental hygienists. The questionnaire comprised eight multiple-choice questions for demographic purposes and 89 Likert-type questions eliciting information in five areas: AIDS-related knowledge, attitudes toward AIDS patients, knowledge of recommended Centers for Disease Control and Prevention (CDC) infection control measures, individual infection control measures, and individual laboratory infection control measures. Means and modes for individual questions and for specific categories were determined and analyzed utilizing Spearman rho correlation coefficients (p < .05). Mean scores were also tabulated for actual operator/laboratory infection control practices for both a routine patient and an AIDS patient. Those scores were analyzed utilizing the Wilcoxen signed-ranks test. RESULTS: Two hundred twenty questionnaires were returned for a 73.3% initial response rate. One hundred fifty-four of those returned were usable, for a 64% response rate. Results indicated that 94.2% of surveyed dental hygienists had comprehensive knowledge about AIDS and 92% had comprehensive knowledge of CDC-recommended infection control procedures. Eighty-five percent of respondents possessed a moderate or high feeling of worry concerning treatment of AIDS patients. The majority of surveyed dental hygienists routinely practiced the use of glasses, masks, and gloves; the use of disposable items; and surface disinfection of light handles, instrument bracket trays, and patient chair switches. Knowledge of recommended infection control procedures for dentistry was found to be associated (r = .22) with adherence to recommended infection control practices. Accurate knowledge about AIDS showed a weak (r = -.088) and nonsignificant relationship with dental hygienists' attitudes toward AIDS patients. Use of recommended infection control practices was found to be associated (r = -.20) with less fear concerning the treatment of AIDS patients. In addition, dental hygienists' infection control practices varied according to their perception of patient HIV status. CONCLUSIONS: Since Pennsylvania dental hygienists, within the limitations of this study, appear not to follow CDC guidelines on proper and responsible operatory/laboratory aseptic techniques stringently, and to differentiate infection control procedures based on perceived patient HIV status, recommendations are that 1) the Commonwealth of Pennsylvania should mandate that all Pennsylvania-licensed dental hygienists take at least one state-approved course on operatory/laboratory infection control every two years to qualify for relicensure; 2) all dental and dental hygiene education institutions and professional organizations should place more emphasis on strict adherence to the various agency recommended clinical guidelines for infection control; and 3) all dental hygienists should continually strive to update their own knowledge of current infection control practices.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Haemophilus influenzae pneumonia in young adults with AIDS, ARC, or risk of AIDS.

PURPOSE: Since the acquired immunodeficiency syndrome (AIDS) was first described in 1981, we have observed an increasing number of cases of Haemophilus influenzae pneumonia, particularly in young adult patients. To confirm this observation, we systematically identified and reviewed all cases of H. influenzae pneumonia that occurred in adult patients recently hospitalized at our institution. PATIENTS AND METHODS: Using a strict case definition, we identified all cases of adult H. influenzae pneumonia that were observed during a recent 32-month period at our institution, a large teaching hospital in New York City. We further reviewed each case record for evidence of AIDS, AIDS-related complex (ARC), or risk of AIDS. RESULTS: H. influenzae pneumonia was diagnosed in 51 adults. Thirty-four cases occurred in young adults (mean age = 33.9 years) with AIDS risk factors, including 23 (67 percent) intravenous drug abusers, six (18 percent) homosexual men, and five (15 percent) with both risks. Nine patients (26 percent) had a previous or concurrent diagnosis of AIDS, four (12 percent) developed AIDS later, and 13 (38 percent) others had ARC. The common presenting symptoms in young adult patients with H. influenzae pneumonia were fever (100 percent), productive cough (100 percent), chest pain (53 percent), and dyspnea (47 percent). Lung consolidation was detected on physical examination in 20 (59 percent), and chest radiograph demonstrated unilateral infiltrates in 18 (53 percent) and bilateral infiltrates in 16 (47 percent), with pleural effusions in three (nine percent). Most patients had an elevated white blood cell count (mean = 9.6 X 10(9)/liter) with a left shift in 22 (65 percent), and hypoxia on room air (mean partial pressure of oxygen = 69 mm Hg). Four patients with H. influenzae pneumonia and coexisting Pneumocystis carinii pneumonia had diffuse, bilateral infiltrates on chest radiograph, with significantly more dyspnea and a higher serum lactate dehydrogenase level than the others. All but one patient showed improvement with appropriate therapy. CONCLUSION: We conclude that potentially serious pneumonia caused by H. influenzae occurs in young adult patients with AIDS, ARC, or AIDS risk.

AIDS-Related Complex↗
PubMed1992

Hearing aid saturation and aided loudness discomfort.

Clinical measurements of the loudness discomfort level (LDL) are generally performed while the subject listens to a particular stimulus presented from an audiometer through headphones (AUD-HP). The assumption in clinical practice has been that the sound pressure level (SPL) corresponding to the sensation of loudness discomfort under AUD-HP conditions will be the same as the corresponding to LDL with the hearing aid. This assumption ignores the fact that the distortion produced by a saturating hearing aid could have an influence on the sensation of loudness. To examine these issues, 5 hearing-impaired subjects were each fit with four linear hearing aids, each having a different saturation sound pressure level (SSPL90). Probe-tube microphone measurements of ear canal SPL at LDL were made while the subjects listened to continuous discourse in quiet under aided and AUD-HP conditions. Also using continuous discourse, real-ear coherence measures were made at various output sound pressure levels near LDL. All four hearing aid types produced mean LDLs that were lower than those obtained under AUD-HP conditions. Those hearing aids with higher SSPL90 produced significantly higher LDLs than hearing aids with lower SSPL90. A significant negative correlation was found between real-ear SPL and real-ear coherence. Quality judgments made at LDL indicated that sound quality of hearing aids with higher SSPL90 was preferred to that of hearing aids with lower SSPL90. Possible fitting implications regarding the setting of SSPL90 from AUD-HP LDL measures are discussed.

Amplifiers, Electronic↗
PubMed1999

A comparison of the aided performance and benefit provided by a linear and a two-channel wide dynamic range compression hearing aid.

The aided performance and benefit achieved with linear and two-channel wide dynamic range compression (WDRC) in-the-canal (ITC) hearing aids were established in 55 individuals. Study participants had been wearing either linear or adaptive-frequency-response (Bass Increase at Low Levels, BILL) ITC hearing aids for approximately one year before participation in this study. Outcome measures included aided performance and objective benefit in quiet and noise at a variety of speech levels (50, 60, and 75 dB SPL), at various levels of babble background (quiet, signal-to-babble ratios of +5 and +10 dB), and for various types of test materials (monosyllabic words and sentences in connected speech). Several subjective measures of aided performance (sound-quality judgments and magnitude estimates of listening effort) and relative benefit (improvement in listening effort and the Hearing Aid Performance Inventory, HAPI) were also obtained. Finally, self-report measures of hearing-aid use were also obtained using daily logs. Participants completed all outcome measures for the linear ITC hearing aids first, following 2 months of usage, and then repeated all outcome measures for the WDRC instruments after a subsequent 2-month period of use. In general, although both types of hearing aids demonstrated significant benefit, the results indicated that the WDRC instruments were superior to the linear devices for many of the outcome measures. This tended to be the case most frequently when low speech levels were used. Many of the performance differences between devices most likely can be ascribed to differences in gain, and prescriptive approaches (DSL[i/o] vs. NAL-R), for the fixed volume control testing performed in this study.

Adolescent↗
PubMed1999

Nitric oxide synthase expression and apoptotic cell death in brains of AIDS and AIDS dementia patients.

OBJECTIVES: To determine the occurrence and cellular localization of inducible nitric oxide synthase (iNOS), NOS activity and its association with cell death in brains of AIDS and AIDS dementia complex (ADC) patients. DESIGN AND METHODS: Post-mortem cerebral cortex tissue of eight AIDS patients, eight ADC patients and eight control subjects was processed for iNOS immunocytochemistry, NADPH-diaphorase activity staining as an index of NOS activity, and in situ end-labelling to detect cell death. RESULTS: iNOS-positive cells were present in the white matter of 14 out of 16 AIDS and ADC patients, whereas two out of eight control subjects showed iNOS-positive cells. iNOS immunoreactivity was exclusively localized in activated macrophages and microglial cells that both showed NADPH-diaphorase activity. In addition, NADPH-diaphorase activity, not related to iNOS immunoreactivity, was observed in astrocytes in both white and grey matter of AIDS and ADC patients. All AIDS and ADC patients, and only one control subject showed characteristic features of apoptotic cell death. CONCLUSIONS: Different forms of NOS are present in microglial cells and astrocytes of AIDS and ADC patients but are largely absent in control subjects. Although more NOS-expressing cells occur in ADC than in AIDS patients, apoptotic cell death was found in both patient groups to the same extent. We postulate that NO production in brains of AIDS patients results in cumulative cortical cell loss, which becomes neurologically evident at later stages of disease and is expressed as ADC.

AIDS Dementia Complex↗
PubMed2005

Who wants a hearing aid? Personality profiles of hearing aid seekers.

OBJECTIVE: Evidence indicates that elderly hearing-impaired people who use amplification live happier, healthier, and longer lives than those who do not. Nevertheless, only a small fraction (approximately 23%) of hearing-impaired adults actually seek and use hearing aids. This study explored the personalities of hearing aid seekers in an attempt to determine whether those who seek hearing aids are systematically different from the general population. DESIGN: In this cross-sectional survey, self-report data were obtained from 230 older adults with bilateral, symmetrical, sensorineural, mild to moderately severe hearing impairment. Subjects were representative of patients served either in a publicly funded hospital-based system (VA) or in a free-standing private practice system (PP). All subjects were seeking new hearing aids. Subjects completed a comprehensive personality questionnaire (NEO-Five-Factor Inventory) as well as questionnaires determining locus of control and preferred coping strategies. RESULTS: Individuals who seek amplification are not simply a random sample of the general population and presumably not a random sample of the hearing-impaired population. Compared with the typical adult, hearing aid seekers tended to be more pragmatic and routine-oriented and probably less imaginative in coming up with novel approaches to dealing with a complex problem such as hearing impairment. These individuals also were found to feel relatively more personally powerful in dealing with life's challenges. Further, hearing aid seekers reported using social support coping strategies less frequently than their non-hearing-impaired peers. In addition, there were significant differences in personality patterns between hearing aid seekers in the PP and VA systems. Differences noted in the personality traits of Openness and Neuroticism might be a useful guide to selecting treatment approaches and expectations for patients in each setting. Additional differences in Agreeableness imply that patients in the private practice system were more trusting than those in the general population, whereas this was not seen for patients in the public health VA system. One interpretation of this finding is that hearing-impaired individuals who are more suspicious and cynical are reluctant to try amplification in the PP system. This observation underscores the need to improve the public image of hearing health care to increase the uptake of hearing aids in general. CONCLUSIONS: Although individual hearing aid seekers display personality characteristics within the range of normal, this study suggested that they are not simply a random sample of the general population. Possible explanations are offered for significant personality differences, and potential clinical relevance is noted for some effects. The data also point to a need to improve the public image of hearing health care in the PP system.

Adaptation, Psychological↗
PubMedDate not supplied

Dietary intake in patients with acquired immunodeficiency syndrome (AIDS), patients with AIDS-related complex, and serologically positive human immunodeficiency virus patients: correlations with nutritional status.

One of the major clinical manifestations of the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) is the development of cachexia. This most likely results from a multifactorial interplay of poor diet, malabsorption, and altered metabolism. To assess the potential role of nutrient intake in the development or persistence of malnutrition, a detailed analysis was performed of a 72-hr diet record in clinically stable patients with AIDS (N = 18), ARC (N = 12) and in human immunodeficiency virus (HIV) seropositive controls without significant manifestations of disease (N = 13). Total calorie intake was 39.1 +/- 13.2 kcal/kg/day in AIDS patients vs 34.6 +/- 7.8 kcal/kg/day in ARC patients or 31.9 +/- 17.7 kcal/kg/day in HIV seropositive cases (all p = NS). Likewise, mean protein intakes were similar among the groups and exceeded recommended daily dietary allowance (RDA) guidelines. The mean body weight changes from the inception of illness were -11 +/- 1% in AIDS, -6 +/- 7% in ARC, vs +3 +/- 2% in HIV-seropositive-only cases (p less than 0.05 vs AIDS and ARC). Dietary vitamin and mineral analysis revealed that 88% of AIDS, 88% of HIV seropositive, and 89% of ARC patients were ingesting less than 50% RDA for at least one nutrient. The mean number of deficiencies per patient was 1.8 +/- 1.3 in AIDS, 3.8 +/- 3.5 in ARC, and 2.9 +/- 2.5 in HIV-seropositive-only cases (p less than 0.05 AIDS vs ARC). There were no significant correlations between specific anthropometric measurements and dietary intakes of protein or fat.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Complex↗
PubMed1997

Tuberculous pleurisy is more common in AIDS than in non-AIDS patients with tuberculosis.

OBJECTIVE: To investigate the incidence, clinical features, and treatment of tuberculous pleurisy in AIDS patients. METHODS: We reviewed all cases of pleural tuberculosis in AIDS patients in South Carolina from 1988 through 1994. Clinical findings, test results, treatment, and outcome were analyzed. MAIN RESULTS: Twenty-two (11%) of the 202 AIDS patients with tuberculosis had pleural involvement compared to 6% (169/2,817) pleural involvement in non-AIDS patients (p=0.01). Associated features of AIDS tuberculous pleurisy included substantial weight loss (7.65+/-1.35 kg) and lower lobe infiltrates (12/22; 55%). No difference in pleural fluid characteristics was found when comparing AIDS patients with a serum CD4 count > or =200/microL to patients with CD4 count <200/microL. Two (9%) of the 22 patients died of tuberculosis. Chest radiograph follow-up of 20 patients showed complete resolution in 7, improvement in 10, and no improvement in 3. CONCLUSIONS: In South Carolina, pleural involvement is more common in AIDS patients than in non-AIDS patients with tuberculosis. Tuberculous pleurisy has several atypical features in AIDS patients such as substantial weight loss and lower lobe infiltrates. The outcome of treatment is good for most patients.

AIDS-Related Opportunistic Infections↗
PubMed1987

Phenotypic changes in monocytes and alveolar macrophages in patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC).

The expression of Class II histocompatibility antigens (HLA-DR and HLA-DQ), leukocyte function associated antigen (LFA-1) and complement receptor type 3 (CR3) on peripheral blood monocytes and alveolar macrophages (M phi) from patients with acquired immune deficiency syndrome (AIDS) and AIDS-related complex (ARC) and age-matched controls was studied. The percentage of HLA-DR+ monocytes from 4 AIDS patients and 12 ARC patients was 52.4 +/- 16.4% (p less than 0.05) and 50.2+21.2% (p less than 0.01) respectively (Controls, 75.4 +/- 12.6%). HLA-DQ expression in monocytes from one AIDS and two ARC patients was 31%, 39% and 18% respectively (in normal individuals, DQ was expressed by approximately 40% monocytes). HLA-DR and HLA-DQ expression on alveolar M phi from one AIDS patient and 2 ARC patients were also depressed. CR3 was expressed by 65.9 +/- 11.1% monocytes from normal controls. Patients with AIDS had a slightly, but significantly lower, proportion of CR3+ monocytes (43.9 +/- 15.9%, p less than 0.05) (in normal controls, CR3 monocytes were 65.9 +/- 11.1%). However, monocytes from ARC patients and alveolar M phi from one AIDS and 2 ARC patients expressed CR3 in a normal range. LFA-1 was significantly depressed in monocytes from both AIDS (45.7 +/- 1%, p less than 0.005) and ARC (57.5 +/- 10.9%, p less than 0.005) patients in comparison with controls (87.4 +/- 8.7%). Only alveolar M phi from one AIDS patient could be studied for LFA-1 antigen and this was into the normal range.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Complex↗
PubMed1994

Survival of patients receiving zidovudine before or after AIDS diagnosis: results of a German multicenter study. German AIDS Study Group.

While efficacy of zidovudine (ZDV) in the acquired immunodeficiency syndrome (AIDS) is well established, the issue of survival after early ZDV treatment is still controversial. To assess survival benefits of ZDV treatment prior to AIDS, as compared to treatment after the onset of AIDS, we used an observational analysis of infected individuals infected with human immunodeficiency virus treated with ZDV and/or prophylaxis against Pneumocystis carinii pneumonia prior to or after AIDS in comparison to patients never treated with ZDV. Nine German AIDS treatment centers entered case reports dating from January 1988 to January 1992. A total of 1425 HIV-infected patients were included, mainly homo-/bisexuals: 1338 males and 87 females, with a mean age of 38.9 years. Of these, 262 had received ZDV prior to AIDS, 376 after AIDS, and 787 had never received ZDV. Survival from a first CD4 lymphocyte count below 0.200 x 10(9)/l (or below 0.500 x 10(9)/l) to death was assessed by means of Kaplan-Meier analysis. Survival did not differ significantly when the first CD4 count below 0.200 x 10(9)/l was taken as baseline. The median survival of patients receiving ZDV prior to AIDS was 662 days as compared to 572 days in patients treated after AIDS. Patients with earlier therapy showed longer survival in a subset of patients who were observed from their first CD4 count below 0.500 x 10(9)/l.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Opportunistic Infections↗
PubMed1990

Safety and tolerance of dideoxycytidine as a single agent. Results of early-phase studies in patients with acquired immunodeficiency syndrome (AIDS) or advanced AIDS-related complex. Study Group of the AIDS Clinical Trials Group of the National Institute of Allergy and Infectious Diseases.

Phase I and II clinical studies have been conducted to test the safety and potential activity of the reverse transcriptase inhibitor, dideoxycytidine (ddC), in treating human immunodeficiency virus-1-infected patients. Although ddC appears to be active in combating viral infection, as judged by its ability to decrease human immunodeficiency virus-1 p24 antigen titers and increase the number of CD4+ lymphocytes, it is also capable of causing severe peripheral neuropathy in a dose-dependent manner. The studies discussed here indicate that low-dose ddC treatment regimens substantially reduce the toxic side effects of this drug, and yet retain the ability to affect p24 antigen and CD4+ lymphocyte levels. These studies also define the window of therapeutic usefulness for ddC, and suggest that both safety and activity can be maintained during long-term, low-dose use of ddC.

AIDS-Related Complex↗