Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association
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J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. · Sep 1998
A study of sexual behavior among rural residents of China.
Although the recent spread of HIV/AIDS and other sexually transmitted diseases (STDs) in China has been associated with sexual activities, little information has been available about sexual behavior in rural areas with high HIV prevalence. Studies identifying high-risk sexual behaviors are needed to formulate effective prevention programs. ⋯ Sexual norms in rural China are changing rapidly and high-risk sexual behavior among young rural residents is increasing. Strategies to prevent HIV/AIDS should include education to promote delayed onset of sexual activity, safer sexual behavior, and condom use.
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J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. · Aug 1998
CD8+ T-lymphocyte activation in HIV-1 disease reflects an aspect of pathogenesis distinct from viral burden and immunodeficiency.
The CD8+ T-cell response is central to control and eventual elimination of persistent viral infections. Although it might be expected that CD8+ T-cell activation would be associated with a better clinical outcome during viral infections, in long-term HIV-1 infection, high levels of CD8+ T-cell activation are instead associated with faster disease progression. ⋯ The pathogenetic reason why CD8+ T-cell activation is associated with poor outcome in HIV-1 disease remains unknown. Possibly CD8+ T-cell activation contributes to immunologic exhaustion, hyporesponsiveness of T cells to their cognate antigens, or perturbations in the T-cell receptor repertoire.
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J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. · Mar 1998
Nontunneled central venous catheters in patients with AIDS are associated with a low infection rate.
Patients with AIDS frequently require long-term central venous access devices for intravenous (IV) therapy. We reviewed the medical records of all HIV-infected patients at a single large urban hospital who had a central venous catheter (CVC) placed during a 1-year period to assess the overall complication rate, infection rate, and the microbiology of infectious complications. One hundred fifty-six catheters were inserted in 87 patients for 11,041 catheter days. ⋯ None of the following parameters was associated with an increased infection rate: HIV risk factor, indication for catheter, medications received via catheter, number of catheter ports, anatomic site of catheter insertion, or the presence of neutropenia. NT-CVCs were associated with low complication and infection rates that were comparable with historical rates seen in AIDS patients with tunneled and totally implantable central venous access devices. NT-CVCs may be a safe, cost-effective alternative to other central venous access devices in patients with HIV/AIDS.
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J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. · Feb 1998
Clinical TrialManagement of elevated intracranial pressure in patients with Cryptococcal meningitis.
The most important predictor of early mortality in patients with HIV-associated cryptococcal meningitis is mental status at presentation; patients who present with altered mental status have up to 25% mortality. Historically, cerebrospinal fluid (CSF) diversion in HIV-negative patients with cryptococcal meningitis and signs of elevated intracranial pressure (ICP) has improved survival. In an effort to affect survival and morbidity rates in patients with HIV-associated cryptococcal meningitis, we have initiated aggressive management of elevated ICP in patients with focal neurologic deficits, mental obtundation, or both. ⋯ Elevated ICP in patients with HIV-associated cryptococcal meningitis is a significant source of morbidity and mortality. The use of lumbar drainage and selective placement of lumbar peritoneal shunts in the management of elevated ICP in patients with HIV-associated cryptococcal meningitis can ameliorate the sequelae of elevated ICP.
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J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. · Nov 1997
Enhancement of natural killer and antibody-dependent cytolytic activities of the peripheral blood mononuclear cells of HIV-infected patients by recombinant IL-15.
Natural killer (NK) cells are an important subset of lymphocytes capable of killing virus-infected target cells without prior sensitization. HIV-infected individuals show impairment of their NK cell activity. Although the mechanism responsible for this defect remains unclear, NK cytotoxicity of lymphocytes from these individuals can be partially restored by interleukin (IL)-2. ⋯ IL-15 did not exert any modulatory effect on the expression of CD16 or CD56 molecules. Our results show that IL-15 can increase the NK and ADCC activities of the PBMCs of HIV-infected individuals in vitro. In view of its higher therapeutic index as determined using murine models, IL-15 may represent a better immunotherapeutic agent than IL-2 to restore these functions in HIV-seropositive patients.