| [opportunistic infections--prevention and treatment]. | many people are exposed to opportunistic infections which can only be controlled by a healthy immune system. the hiv virus limits the development of the immune system. the prevention, diagnosis, and treatment of many opportunistic infections are described. pneumocystis carinii, mycobacterium avium complex infections (mai or mac), toxoplasmosis, cryptococcal meningitis, cytomeglovirus infections (cmv), tuberculosis, kaposi's sarcoma (ks), crytosporidiosis, aids dementia complex, and progressive m ... | 1995 | 11362439 |
| opportunistic infections studies update. | studies being conducted on opportunistic infections among people with hiv are presented in list form. the list includes new studies, those still in development, and those slated to begin in 1995. areas of interest include candidiasis, cryptosporidiosis/microsporidiosis, cytomegalovirus (cmv), mycobacterium avium complex (mac) infection, pneumocystis carinii pneumonia (pcp), toxoplasmosis, and tuberculosis (tb). enrollment information can be obtained by calling 1-(800)-trials-a (tdd 1- 800-448-04 ... | 1995 | 11362449 |
| rifabutin for mac questioned. | vanderbilt university researcher mark a. pierce remains doubtful about whether prevention is preferable to active surveillance and aggressive treatment of early infection in aids patients with mycobacterium avium complex (mac). problems of cost, compliance, drug toxicity, drug interactions, and long-term efficacy have limited the routine use of rifabutin. two recently reported mac prophylaxis trials have indicated the drug's effectiveness in preventing the opportunistic infection, but neither tr ... | 1995 | 11362571 |
| abbott files snda for mac prophylaxis. | clinical results suggest that clarithromycin may be effective in preventing the onset of disseminated mycobacterium avium complex (mac). among 667 patients treated with clarithromycin, the incidence of disseminated mac was reduced 69 percent by using the antibiotic prophylactically. mortality from all causes over the 2-year period of the study was reduced by 28 percent among those receiving clarithromycin compared to those receiving placebo. the prophylactic regimen was well tolerated with the o ... | 1995 | 11362606 |
| disseminated mac: current treatment strategies. | disseminated mycobacterium avium-complex (dmac) usually occurs in people with advanced hiv infection cd4 and t-lymphocyte counts under 100 cells/ml. recommendations for treating and preventing dmac in adults and adolescents were made by a u.s. public health service task force. the recommendations are: 1) all patients diagnosed with dmac should be treated; 2) treatment regimens outside a clinical trial should include at least two agents; 3) arithromycin or clarithromycin should be included as the ... | 1995 | 11362719 |
| mycobacterium avium complex and hiv. | mycobacterium avium complex (mac) is an increasingly common and severe complication of hiv infection that is associated with shortened survival. the epidemiology, pathogenesis, clinical features, prevention guidelines, and treatment options for the disease are provided. statistics given show estimates of aids or arc patients developing mac infection by baseline cd4+ count, and a list of the body organs most commonly involved with dissemination of mac, as well as areas that may become infected. f ... | 1995 | 11362745 |
| another perspective on mac prophylaxis. interview by gordon nary. | mark pierce, assistant professor of medicine and director of infectious disease outpatient services at vanderbilt university medical center, provides his observations on some new directions in mycobacterium avium complex (mac) prophylaxis. the usphs/isda guidelines for the prevention of disseminated infection with mac in persons infected with hiv are included. pierce discusses why physicians often do not follow the u.s. public health service task force's original recommendations on prophylaxis a ... | 1995 | 11362746 |
| clarithromycin prophylaxis against disseminated mycobacterium avium complex in patients with aids. | the author presents results of a study concerning clarithromycin prophylaxis against disseminated mycobacterium avium complex (mac) in 57 adult patients with aids. forty patients received 500 mg of clarithromycin two times a day by mouth as prophylaxis against disseminated mac; seventeen patients received no medication. results show that none of the forty patients developed mac, while eight of the seventeen patients in the control group did. data suggest that clarithromycin is successful as a pr ... | 1995 | 11362747 |
| physician's aggressive preventive therapy differs. | dr. bernard bihari, an aids specialist practicing in new york city, and other members of the community programs for clinical research on aids (cpcra), have determined that some of the public health services's recommendations for preventing opportunistic infections do not match the standards of care that the cpcra developed nearly five years ago. the basic treatments provided by bihari include using 1) tmp-smz and fluconazole to prevent, respectively, pneumocystis carinii pneumonia (pcp) and cryp ... | 1995 | 11362774 |
| new drug applications sought. | three drug companies have submitted applications to the food and drug administration (fda) for expanded labeling of their products, including bristol-myers squibb's d4t (stavudine), abbott laboratories' clarithromycin (biaxin), and chiron corporations's ganciclovir (intraocular vitrasert). approvals are being sought for stavudine's use in hiv-positive adults with cd4 counts between 50 and 500 who have been treated with at least 24 months of zidovudine; biaxin's use for prevention of mycobacteriu ... | 1995 | 11362777 |
| studies of rifabutin to prevent tuberculosis. | two studies are evaluating pharmacia, inc.'s rifabutin for efficacy in preventing tuberculosis (tb); one international study involving 2,000 participants will test its preventive abilities; and the other will test its effectiveness in preventing tb among anergic injection drug users. rifabutin is already fda-approved for the prevention of mycobacterium avium complex infection, and has also been used as part of combination regimens to treat active tb. | 1995 | 11362881 |
| opportunistic infection highlights from the 35th icaac. | hiv-related treatment and prevention strategies for opportunistic infections presented at the 1995 international conference on antimicrobial agents and chemotherapy (icaac) are highlighted. research highlights include valaciclovir for cmv prophylaxis, oral ganciclovir for preventing cmv, resistant cmv, and cidofovir (hpmpc) for cmv. other topics discuss treatments of mycobacterium avium complex, opportunistic infections and hiv viremia; and reports on the effects of influenza and pneumococcal im ... | 1995 | 11362919 |
| researchers find new drugs to fight mac. | studies have shown clarithromycin (biaxin) and rifabutin to be effective against mycobacterium avium complex (mac), and to improve survivability. abbott laboratories is seeking approval from the food and drug administration (fda) for clarithromycin use in preventing mac. marion merrell dow, the manufacturer of rifabutin, is planning a prophylaxis trial with a close cousin of the drug, rifapentine. rifapentine has a long half-life, and has the potential to lengthen intermittent treatment for tube ... | 1995 | 11362925 |
| mycobacterium avium complex disease. | current treatment and prophylaxis trends for mycobacterium avium complex (mac) are examined, and related issues and conflicts are provided. issues include how mac is acquired; its pathogenesis; its clinical manifestations, diagnosis, and treatment options; follow-up to treatment; treatment advances and future directions; issues about prophylaxis; and recent research reports. also included are discussions on rifabutin and the issues surrounding rifabutin prophylaxis, a review of resistance and th ... | 1995 | 11363006 |
| fda approves biaxin for mac prophylaxis. food and drug administration. | in 1995, the food and drug administration (fda) extended the label use of biaxin (clarithromycin) to include prophylaxis against disseminated mycobacterium avium complex (mac). clinical trials demonstrated that clarithromycin decreased the risk of developing disseminated mac disease in patients with advanced aids. a statistically significant survival benefit was also observed. taste perversion was the only common adverse effect among treated patients. the fda is considering another supplemental ... | 1995 | 11363096 |
| advances in prevention and treatment of mac. | several new studies are attempting to optimize prevention and treatment of mycobacterium avium complex infection. studies from california, france, and canada are creating new data showing that a three-drug combination using clarithromycin is superior to two-drug or four-drug combinations. it is also suggested that a three-drug combination which includes clarithromycin may also delay the emergence of clarithromycin-resistant organisms. | 1995 | 11363104 |
| icaac: what else is new? | three hiv-related topics were discussed at the 1995 interscience conference on antimicrobial agents and chemotherapy. 1) protease inhibitors given in high doses are able to delay resistance, even when given as monotherapy. combination therapies are more successful than monotherapies, and triple combinations are more effective than double combinations. 2) a cytomegalovirus (cmv) vaccine was well-tolerated and effective in healthy cmv-immune adults. a phase iii clinical trial found valaciclovir, a ... | 1996 | 11363114 |
| early intervention and prevention options. | in july 1993, the united states public health service and the infectious disease society of america gave a set of recommendations for early intervention and prevention of opportunistic infections in hiv-positive people. these guidelines follow cd4 counts. according to the guidelines, cd4 counts above 500 should be monitored every 4 to 6 months and screenings for tuberculosis, sexually transmitted diseases, and other diseases should also be done. at a cd4 count of 75, a prophylaxis of rifabutin a ... | 1996 | 11363117 |
| report from the 3rd conference on retroviruses and opportunistic infections. | the third conference on retroviruses and opportunistic infections offered hope for new treatments for aids-related illnesses. news about antiretroviral therapies, especially protease inhibitors, was enthusiastically received. anthony fauci, md, of the national institutes of health (nih), proposed an expanded model of hiv progression. carl grunfeld, md, discussed the issue of wasting and emphasized that secondary infections are the primary precipitants of wasting. the human growth hormone's role ... | 1996 | 11363313 |
| australia reports on aids: nef deletions, live vaccines, chinese travelers. | australian research shows that individuals who share hiv nef deletions and adjacent sequences in the long terminal repeat (ltr) segment of the viral genome may indicate a weakening of the virus. a cluster of long-term survivors who share this enfeebled virus has contributed to the attenuated hiv vaccine debate. the debate was discussed at the seventh annual australian conference for hiv medicine. the story began when a researcher discovered a relationship between a gay male blood donor and five ... | 1996 | 11363347 |
| palliative care and hiv, part i: ois and cancers. | a two-part report discusses palliative care for opportunistic infections and cancers of hiv-infected people, and addresses systemic manifestations. guidelines are provided for determining when palliation with traditional methods is best achieved, and when continuation of restorative treatments is an appropriate palliative measure. pneumocystis carinii pneumonia, cryptococcal meningitis, cytomegalovirus retinitis, and mycobacterium avium complex palliative care are examined. the hiv-related cance ... | 1996 | 11363409 |
| clarithromycin for mac prevention offers additional benefits. | the use of clarithromycin in preventing mycobacterium avium complex (mac) may also prevent a number of other opportunistic infections in aids patients. a large multinational study showed a reduction in pneumocystis carinii pneumonia (pcp), community-acquired pneumonia (cap), and giardiasis, an intestinal disorder. the study involved participants with cd4 counts below 100. | 1996 | 11363431 |
| hold the big mac. | the retrovirus conference provided information on two studies that examine the prevention of mycobacterium avium complex (mac). people with an active infection run fevers, lose weight, and have no appetite. rifabutin is currently the only drug with food and drug administration (fda) approval for the prevention of mac. it was found to be most effective in combination with azithromycin, but because the two drugs are chemically similar, resistance to both is a threat. thirty percent of the people t ... | 1996 | 11363450 |
| opportunistic infections update. | advances in the prevention and treatment of hiv-related opportunistic infections are showing better results and improved quality of life. there have also been advances in using the pcr and bdna tests for infections other than hiv. study data on advances in therapy and prevention are examined for infections caused by the following organisms: cytomegalovirus, fungi, mycobacterium avium complex, and toxoplasma. | 1996 | 11363510 |
| progress report: prophylaxis and therapy for mac. | study efforts are showing progress in the prevention and therapy of mycobacterium avium complex (mac) infection. a review of recent study developments highlights clinical findings on prophylactic use of rifabutin, clarithromycin, and azithromycin, used both as monotherapies and as combination therapies. three tables highlight study results from mac prophylaxis studies, mac treatment studies, and candidate regimens for mac prophylaxis in aids. treatment of disseminated mac is also addressed. the ... | 1996 | 11363599 |
| missed tb in aids unit leads to tighter isolation. | the san francisco general hospital recently tightened its tuberculosis (tb) policies for isolating hiv-positive patients after learning that active tb patients had been admitted without respiratory protection. the new policy resulted from what was initially believed to be a tb outbreak on the aids unit. however, an investigation concluded that the patients were infected outside the hospital. the hospital now automatically screens patients for tb when they are admitted to the aids ward. hiv-posit ... | 1996 | 11363656 |
| old drug approved for mac prevention. | the food and drug administration (fda) approved the broad-spectrum antibiotic azithromycin for prevention of mycobacterium avium complex (mac) in people with advanced hiv disease. the treatment offers flexibility in that it can be taken once a week. clinical trials show that 1200 mg of azithromycin taken weekly reduced the risk of developing mac bacteria in the bloodstream. in a large double-blind study, the drug was more effective than rifabutin in preventing mac. a combination of azithromycin ... | 1996 | 11363659 |
| mac prophylaxis revisited. | mycobacterium avium complex (mac) infection occurs in 18 to 40 percent of people with aids, and most commonly in those with cd4 counts under 50. mac is a difficult infection to diagnose, as its symptoms mimic many other infections and tumors. mac infections can occur in the respiratory system or gastrointestinal tract, and the infection may spread through the bloodstream. clinical trials for mac prophylaxis include clarithromycin, rifabutin, or a combination of both. the individual drugs and the ... | 1996 | 11363706 |
| antivirals key to mac prevention regimen. | prophylaxis for mycobacterium avium complex (mac) should be considered standard treatment for all patients with advanced hiv disease. mac is the most common bacterial infection that affects aids patients. there are three effective agents that significantly reduce the risk of mac--rifabutin, clarithromycin, and azithromycin. mac prophylaxis is cost-effective, improves the quality of a patient's life, and improves overall survival by 25 to 32 percent. | 1996 | 11363722 |
| high-dose clarithromycin should be avoided. | high dosages of clarithromycin used to prevent mycobacterium avium complex (mac) in aids patients unexpectedly increased their risk of death. health officials are alerting clinicians to lower the prescribed doses. the new recommended dose is 500 mg. patients who took 1,000 mg twice a day experienced lower survival rates in the cpcra 009 clinical trial. the results were surprising and counterintuitive, and underscore the importance of having clinical endpoints in a trial rather than just dependin ... | 1996 | 11363723 |
| opportunistic infections in vancouver. | participants at the xi international conference on aids in vancouver appeared impressed by the improvements being made in the diagnosis, treatment, and prophylaxis of aids-related opportunistic infections. improvements in the following areas are discussed: cytomegalovirus infection prophylaxis and maintenance with oral ganciclovir, prophylactic effects of azithromycin against mycobacterium avium complex infection and its potential for preventing pneumocystis carinii pneumonia, and the use of dox ... | 1996 | 11363841 |
| azithromycin effective in preventing mac. | a study concluded that for the prevention of disseminated mycobacterium avium complex in patients with advanced hiv infection once-weekly dosing of azithromycin is a simpler and more effective regimen than daily rifabutin. the california collaborative treatment group researchers found that azithromycin alone or in combination with rifabutin is more effective than rifabutin alone. azithromycin does not interact with other commonly-prescribed medicines for aids patients. azithromycin achieves high ... | 1996 | 11363857 |
| or is it the host, sir? | scientists at the ninth international symposium on infections in the immunocompromised host offered evidence that the rate of hiv disease progression may be determined by how vigorously host defenses are mobilized in the first weeks of infection. others report on the use of thalidomide or il-10 for curtailing or suppressing tumor necrosis factor alpha in coincident hiv and tuberculosis patients. the success of shoring up weakened host defenses against the onslaught of opportunistic pathogens, su ... | 1996 | 11363895 |
| opportunistic infections update. | an update is presented on some of the treatment developments for opportunistic infections (ois) associated with hiv infection. treatments discussed include clarithromycin and clofazimine for treatment of mycobacterium avium complex (mac), azithromycin for prevention of mac, fluconazole for prevention of fungal infections, msl109 for treatment of cytomegalovirus retinitis, and two new approaches for the treatment of kaposi's sarcoma. azithromycin's positive role in preventing pcp provides evidenc ... | 1996 | 11363899 |
| opportunistic infections: the growing challenge. | a great deal of attention at the xi international conference on aids was focused on new approaches to managing and preventing aids-related opportunistic infections (ois). aside from a similar prevalence of pneumocystis carinii pneumonia (pcp) in developed countries, a different spectrum of ois is seen in less developed areas, such as latin america, where many endemic diseases are included among ois. candidiasis has been the most common fungal pathogen, but a broader spectrum of mycoses is being ... | 1996 | 11363908 |
| cpcra researchers present oi studies at vancouver. | the community programs for clinical research on aids (cpcra) presented several recent findings from clinical trials at the international conference on aids. weekly doses of fluconazole can safely prevent persistent yeast infections in hiv-infected women who frequently develop yeast infections of the mouth, vagina and throat. combination antibiotic therapy given intermittently is an effective initial treatment for persons with hiv-related tuberculosis. high dosages of clarithromycin should not be ... | 1996 | 11363924 |
| mac management. | results from recent studies are shedding light on ways to prevent and treat mycobacterium avium complex (mac) disease, a leading cause of death for people with aids. a two-drug combination treatment appears to be best. the food and drug administration (fda) has approved three drugs for the treatment of mac disease: rifabutin (mycobutin), clarithromycin (biaxin), and azithromycin (zithromax). two studies using clarithromycin show promising results and indicate that clarithromycin is superior to r ... | 1996 | 11363967 |
| icaac update on opportunistic infections. | recent research on the effects of opportunistic infections (ois) on hiv replication suggests that the ois can actually increase hiv replication through the production of cytokines. treatment options for thrush include antifungal treatments for early episodes and reserving fluconazole for patients with difficult to treat infections. other studies show that prevention and treatment of mycobacterium avium complex (mac) increases survival rates. drugs and dosages are described. | 1996 | 11363974 |
| jaw swelling in an hiv-infected man. | a case study is presented in the diagnosis and treatment of a late-stage hiv-infected male who presented with an irregularity in his jawline, a 4-cm firm mass near his left mandibular angle. the mass was diagnosed by ct scan as a greatly enlarged cervical node with a necrotic center, including enlargement of several other nodes. treatment ultimately involved the use of rifabutin and ethambutal. differential diagnosis ruled out a malignancy and pathologic studies showed that the mass was typical ... | 1996 | 11363991 |
| tuberculosis-like illness in a young man from thailand. | a case study is presented of a mid-20's, hiv-infected male visitor from thailand who became increasingly ill with tuberculosis-like symptoms. the question addressed is whether the patient should be treated for miliary tuberculosis or for disseminated mycobacterium avium complex (mac) infection pending further evaluation. it is argued that due to the frequency with which penicillium marneffei infection occurs in thai aids patients and the similarity of the symptoms to mac infection, such treatmen ... | 1996 | 11363992 |
| don't have a mac attack. how to fight aids-related mac. national institutes of health. | mycobacterium avium complex (mac) is a common opportunistic infection in people with hiv. it causes fever, night sweats, weight loss, fatigue, diarrhea and abdominal pain, and the bacteria that causes it is found everywhere. medicines can be given to strengthen the immune system and increase resistance to mac. patients need to consult with their doctors and follow their medical regimens to prevent mac. | 1997 | 11364037 |
| oral manifestations of hiv infection. | all physical examinations of hiv-infected individuals should include a detailed examination of the mouth, since oral lesions are common. there are about 40 oral manifestations of hiv infections that may be the first clinical features of the disease. hiv-related cancers, such as kaposi's sarcoma or lymphoma, may present as oral lesions. a variety of bacterial infections may be found in the mouth, including linear gingival erythema, necrotizing ulcerative periodontitis, tuberculosis, mycobacterium ... | 1997 | 11364217 |
| recent development in the treatment and prevention of disseminated mycobacterium avium complex (mac). | disseminated mycobacterium avium complex (dmac) is the third most common opportunistic infection in people with aids, infecting up to 50 percent of them. symptoms include high fever, weight loss, fatigue, diarrhea, poor appetite, night sweats, and anemia. diagnosis is by blood culture. results of two recent studies are presented, as well as treatment guidelines issued by a national panel. | 1996 | 11364267 |
| [the new age of hiv/aids. a special report on the xi international conference on aids]. | new treatments that are available promoted optimism at the xi international conference on aids, held in vancouver in july 1996. topics that were presented at the conference are highlighted, including a global analysis of the epidemic, possible eradication of the virus, pathogenesis of the hiv virus, detection of the viral load change in the blood, and the status of protease inhibitors. a brief report on the combination and activity of crixivan, azt and 3tc is presented. the dangers of opportunis ... | 1996 | 11364380 |
| clinical trials. | the national institutes of health (nih) is seeking participants for a variety of trials. all patients will be tested in the washington, dc area, and some will be compensated. trials currently enrolling are testing treatments for mac, cmv retinitis, immune system function, and the effectiveness of several experimental medications. enrollment information is provided for each trial. | 1997 | 11364635 |
| latest opportunistic infection prevention guidelines. | although people with hiv are living longer than ever before, they continue to suffer from infections that are associated with low t4-cell counts. the u.s. public health service (phs) and the infectious diseases society of america (idsa) have updated the guidelines for preventing opportunistic infections, including their positions on when prophylaxis is indicated. summaries are given for preventing the following infections: cytomegalovirus (cmv), cryptosporidiosis, fungal infections, human papill ... | 1998 | 11365000 |
| update: prophylaxis for hiv opportunistic infections. | the u.s. public health service and the infectious diseases society of america recently updated the 1995 guidelines on prevention of opportunistic infections in hiv infected individuals. pcp prophylaxis has not been changed in the new guidelines. primary prevention strategies for toxoplasmosis encephalitis are described. preventive medication for tuberculosis is generally not recommended, especially for persons in high risk groups such as the homeless and injection drug users. significant changes ... | 1998 | 11365025 |
| lacarp opens clinical trials to patients of all primary care providers. | the louisiana community aids research program (lacarp) is enrolling participants in several studies. the studies will be open to patients who meet enrollment criteria whether or not they are part of the tulane university/lacarp health care network. the clinical trials open for enrollment include nelfinavir vs. ritonavir, bis-pom pmea, cd4 rebound-mycobacterium avium complex (cr-mac), and genotypic antiretroviral resistance testing (gart). each study is briefly described, and criteria for partici ... | 1998 | 11365129 |
| clinical trials are now open to patients of all primary care providers. | the louisiana community aids research program (lacarp) based at tulane university school of medicine is enrolling eligible patients into its clinical trials. no restrictions on primary care providers are made provided physicians are willing to work with the research team. the studies include nelfinivir vs. ritonavir, cd4 rebound-mycobacterium avium complex, adefovir dipivoxil, and gart (genotypic antiretroviral resistance testing). descriptions and enrollment information for the clinical studies ... | 1998 | 11365349 |
| phs guidelines on opportunistic infections. us public health service. | the u.s. public health service (phs) issued new guidelines for the prevention and maintenance of hiv-related opportunistic infections. guidelines are presented for the following: pneumocystis carinii pneumonia, toxoplasmosis, mycobacterium avium complex infection, cytomegalovirus infection, herpes simplex, cryptococcal disease, histoplasmosis, varicella-zoster virus infection, candidiasis, cryptosporidiosis, and tuberculosis. | 1997 | 11365371 |
| update on opportunistic infections. | the use of highly active antiretroviral therapy (haart) can be effective for reducing the first onset of opportunistic infections (ois) and preventing their recurrence. while clinical studies are trying to determine the relationship between haart and delayed recurrence, it is recommended that patients currently on haart for oi prevention and maintenance not stop the therapy. updates are presented for the following topics: pneumonia vaccination, pneumocystis carinii pneumonia (pcp) prevention, my ... | 1997 | 11365373 |
| good news about hiv treatments. | new and stronger anti-hiv treatments are decreasing aids mortality and opportunistic infections statistics. studies in baltimore, new orleans, and france showed significant drops in new cases of cytomegalovirus (cmv), mycobacterium avium complex (mac), kaposi's sarcoma, and pcp. drug side effects and drug adherence remain problematic. it appears that even a short-term reduction in viral load can produce long-term improvement in health and increase t4 cell count. researchers speculate that hiv is ... | 1998 | 11365424 |
| investigational interleukins: the cutting edge of immune reconstitution. | hiv disables the immune system by destroying cd4+ cells, leading to increased risk of potentially life-threatening opportunistic infections, such as mycobacterium avium complex (mac), pneumocystis carinii pneumonia (pcp), and cytomegalovirus (cmv). boosting the immune cell counts will help combat these diseases. cutting-edge immune therapies involve one of several naturally occurring chemicals produced by immune cells, called cytokines. interleuken-2 (il-2) has been studied since 1983, and in th ... | 1998 | 11365485 |
| azithro once a week for mac. | azithromycin (zithromax) has been used to treat a number of infections, including mycobacterium avium complex (mac). a study using azithromycin to prevent mac shows the drug's effectiveness in reducing the outbreak of mac and also protecting from other infections, including pcp. this study involved 180 hiv-positive subjects, of which 89 received 1200 mg of azithromycin once a week, and 91 received a placebo once a week. fifteen percent of the treated subjects developed mac infections compared to ... | 1998 | 11365625 |
| i hear you knockin' (but you can't come in): potent new hiv therapies are shutting out opportunistic infections. | highly active antiretroviral therapy (haart) has positively impacted the epidemiology of opportunistic infections in hiv- infected patients. the following opportunistic infections and their responses to haart and prophylaxis recommendations are examined: pneumocystis carinii pneumonia (pcp), cytomegalovirus (cmv) disease, mycobacterium avium complex (mac) disease, and fungal diseases. the question of whether opportunistic infection prophylaxis should be continued in persons who respond to haart ... | 1998 | 11365645 |
| opportunistic infections update. | the reduction in the incidence of opportunistic infections (ois) can be attributed to the use of highly active antiretroviral therapy (haart). several ois are discussed, including: mycobacterium avium complex, tuberculosis, and pneumocystis carinii pneumonia. at its highest efficacy, haart causes a positive immune response and may reduce the need for preventive and maintenance therapies. however, there is not a definitive way of determining who is a good candidate for eliminating preventive and ... | 1998 | 11365715 |
| opportunistic infections update. | highly active antiretroviral therapy (haart) has effectively decreased the incidence of opportunistic infections (ois), and thereby reduced research efforts to find alternative treatments to prevent or treat ois. however, research on treating ois is still needed. for instance, it is suggested that people who are co-infected with hiv and hepatitis c virus (hcv) should not use protease inhibitors (pis), because both pis and hcv significantly strain the liver, and that could increase the risk of li ... | 1998 | 11365840 |
| no news is good news: opportunistic infections. | the 38th interscience conference on antimicrobial agents and chemotherapy (icaac) was notable for not having any oral sessions on opportunistic infections. this is an indication of the enormous success of combination antiretroviral therapy, which has greatly reduced the occurrences of opportunistic infections. hepatitis c was discussed at the conference, but it was treated as a co-morbid condition rather than an opportunistic infection. two studies addressed the question of stopping pneumocystis ... | 1998 | 11366129 |
| dark skies challenge management of hepatic disorders in patients with hiv disease. | most advanced hiv patients have abnormal liver function, and laboratory findings are distinguishing other forms of liver disease in these patients. liver biopsy studies commonly reveal mycobacterium avium complex, chronic active viral hepatitis, and hepatic lymphoma. postmortem liver histology results are abnormal in about 90 percent of hiv patients. in additions, liver toxicity is common in persons receiving highly active antiretroviral therapy (haart). however, negative effects of protease inh ... | 1999 | 11366254 |
| cmv. | cytomegalovirus (cmv) occurs 25 percent less often than it did before the advent of highly active antiretroviral therapy (haart), according to a recent study by the university of california at san francisco. cmv is the most common infection in hiv-positive persons with t-cell counts below 50, and it can cause blindness. researchers have also found that macrolide antibiotic treatment for mycobacterium avium complex (mac) may lead to resistance in people with aids who have been treated for mac in ... | 2000 | 11366342 |
| beware what you eat and drink, even while on haart. | people infected with hiv who are treated with highly active antiretroviral therapy (haart) are staying healthier for longer than ever before, but they still need to be cautious of exposure to foodborne and waterborne bacteria. the centers for disease control and prevention (cdc) lists several pathogens which can be dangerous to persons with hiv/aids, including mycobacterium avium complex (mac) and cryptococcosis. people with hiv who are infected by these pathogens tend to suffer from more severe ... | 1999 | 11366423 |
| opportunistic infections update. | the incidence of opportunistic infections (ois) has been steadily decreasing due, in part, to the use of effective combination therapy with a protease inhibitor. recently, however, an increase in ois has been noted, suggesting that some people have depleted much or all of the available therapies and can no longer keep their cd4+ counts high enough to fight off infections. this demonstrates the need to initiate or re-initiate preventative medications for ois. treatment of mycobacterium avium comp ... | 1999 | 11366735 |
| stopping preventive treatments. | although combination therapy with haart (highly active antiretroviral therapy) can increase cd4 (t-cell) counts, doctors have been cautious about stopping preventive treatments, or prophylaxis, for pcp (pneumocystis carinii pneumonitis). two studies, however, suggest that if haart increases t-cell counts to over 200 for an extended time period, pcp prophylaxis may be safely stopped. partly as a result of these study findings, the united states public health service has rewritten guidelines on th ... | 1999 | 11367080 |
| smoking: it doesn't make living with hiv any easier. | smoking is a well-recognized risk to health, particularly for people with hiv. hiv-positive smokers are more likely to develop pneumocystis carinii pneumonia (pcp), thrush, and oral hairy leukoplakia. the bacteria that causes mycobacterium avium complex (mac), a life-threatening infection found in many people with hiv, has been found in tobacco products and can survive the smoking process. suggestions to help people with hiv quit smoking include choosing the right approach, using smoking cessati ... | 1999 | 11367324 |
| foregoing prophylaxis: better safe than sorry? | the widespread use of highly active antiretrroviral therapy (haart) has coincided with a dramatic decline in the incidence of opportunistic infections. this effect has lead some people to question whether they should continue taking prophylaxis medications against diseases such as pneumocystis carinii pneumonia (pcp) and mycobacterium avium complex (mac). research on this topic presented at the 39th interscience conference on antimicrobial agents and chemotherapy (icaac) is described. | 1999 | 11367330 |
| opportunistic infections update. | the u.s. public health service and the infectious disease society of america issued new guidelines for the prevention of opportunistic infections (ois). the guidelines, which deal with the issues of starting and stopping both preventative and maintenance therapy, are provided in chart form. the ois addressed include candidiasis, cytomegalovirus (cmv), mycobacterium avium complex (mac), and tuberculosis (tb). contact information is provided. | 1999 | 11367355 |
| prophylaxis of opportunistic infections in adults and children with hiv infection. | preventing opportunistic infections is an important part of effective hiv care. prophylaxis is recommended in cases in which the incidence of the disease is high, the disease is associated with high levels of morbidity and mortality, and if there are treatments available that are effective and well tolerated. diseases for which prophylactic treatments are recommended include tuberculosis, pneumocystitis carinii pneumonia (pcp), and toxoplasmosis. treatment for mycobacterium avium complex (mac) a ... | 1995 | 11367408 |
| accuracy of self-reports of acquired immunodeficiency syndrome and acquired immunodeficiency syndrome-related conditions in women. | to investigate the validity of self-reported acquired immunodeficiency syndrome (aids) among women enrolled in a prospective study of human immunodeficiency virus (hiv) infection, the authors compared the self-reported occurrence of aids-specific diagnoses with aids diagnoses documented by county aids surveillance registries. also examined was the association between participant characteristics and the validity of self-reports. among the 339 hiv-infected participants in the northern california w ... | 2001 | 11390333 |
| two cases of long lasting bacteremia due to mycobacterium avium complex despite new macrolides-containing regimens in patients with acquired immunodeficiency syndrome. | the prognosis of mycobacterium avium complex (mac) infection has been improved by new macrolides-containing regimens and the use of highly active antiretroviral therapy (haart) in the treatment of acquired immunodeficiency syndrome (aids). we report on two aids cases with long lasting bacteremia due to mac under this regimen. both patients experienced problems due to side effects from the anti-mac regimen and from an immune-reconstitution syndrome related to haart. mac infection persisted despit ... | 2001 | 11393423 |
| nef-deleted hiv-1 inhibits phagocytosis by monocyte-derived macrophages in vitro but not by peripheral blood monocytes in vivo. | hiv-1 infection impairs a number of macrophage effector functions, but the mechanism is unknown. we studied the role of hiv-1 nef in modulating phagocytosis by human monocytes and monocyte-derived macrophages (mdm). | 2001 | 11399976 |
| the significance of bronchoscopy for the diagnosis of mycobacterium avium complex (mac) pulmonary disease. | to investigate the usefulness of bronchoscopy for the diagnosis of mycobacterium avium complex (mac) pulmonary disease, we retrospectively reviewed the clinical charts, and radiographic and bacteriologic findings of all patients who were admitted to our hospital between 1994 and 2000, and who fulfilled the 1997 american thoracic society (ats) criteria for mac pulmonary infection. a total of 132 patients were diagnosed as affected by mac pulmonary disease during that period. of these, bronchoscop ... | 2001 | 11402614 |
| relation between cd4 cell counts and hiv rna levels at onset of opportunistic infections. | to evaluate the relation between cd4 and hiv rna levels at the onset of specific opportunistic infections (ois) in hiv-infected patients. | 2001 | 11404519 |
| expression profiles of low molecular mass heat shock proteins by mycobacterium avium and mycobacterium intracellulare. | closely related non-tuberculous mycobacterial species, mycobacterium avium and mycobacterium intracellulare, were compared for the profiles of their production of low molecular mass heat shock proteins at 45 degrees c, by performing polyacrylamide gel electrophoresis analysis of bacterial cell lysate proteins. all of the m. intracellulare but not m. avium strains potently increased the production of the 18-kda heat shock protein, when cultured at 45 degrees c. half of the m. intracellulare strai ... | 2001 | 11425464 |
| [roxithromycin therapy of patients with mycobacterium avium complex lung infection]. | | 2001 | 11436830 |
| a luciferase-based method for assessing chlorine-susceptibility of mycobacterium avium. | a rapid and quantitative assay for the disinfection of the water-borne pathogen, mycobacterium avium, was developed using firefly luciferase as a reporter gene. there was a correlation between the quantity of light produced and the number of colony-forming units. in chlorine-disinfection studies of a luciferase-carrying derivative of m. avium, there was a strong correlation (r2=0.96) between colony forming units and relative light units. it was discovered that chlorine was rapidly lost from susp ... | 2001 | 11438185 |
| patterns and implications of naturally acquired immune responses to environmental and tuberculous mycobacterial antigens in northern malawi. | interferon (ifn)-gamma responsiveness to 12 purified protein derivative (ppd) and new tuberculin antigens from 9 species of mycobacteria was assessed, using a whole blood assay, in 616 young adults living in northern malawi, where mycobacterium bovis bacille calmette-guérin (bcg) vaccination provides no protection against pulmonary tuberculosis. the prevalence of ifn-gamma responsiveness was highest for ppds of m. avium, m. intracellulare, and m. scrofulaceum (the mais complex). correlations bet ... | 2001 | 11443558 |
| [profiles of expression of the therapeutic efficacy of krm-1648 in mice infected with mycobacterium avium complex at different challenge doses]. | studied were made on the profiles of the therapeutic efficacy of krm-1648 (krm) against mycobacterium avium complex (mac) infection, which was induced in mice at different challenge doses, in reducing bacterial growth in the visceral organs and altering the profiles of cytokine mrna expression at the sites of infection. first, bacterial growth in the lungs of mice infected with either high or low challenge doses of mac, was reduced due to krm treatment. this effect was noted even in the early ph ... | 2001 | 11449696 |
| telithromycin is active against mycobacterium avium in mice despite lacking significant activity in standard in vitro and macrophage assays and is associated with low frequency of resistance during treatment. | the activity of telithromycin, a new ketolide, was evaluated in vitro and in vivo against mycobacterium avium complex (mac) strains. the mic of telithromycin for several m. avium isolates obtained from the blood of aids patients ranged from 16 to >128 microg/ml (mic at which 90% of isolates are inhibited, >128 microg/ml), and the compound did show activity in the macrophage system at concentrations greater than 8 or 16 microg/ml, but this was dependent on the mac strain used. telithromycin was t ... | 2001 | 11451676 |
| impairment of mycobacterial but not viral immunity by a germline human stat1 mutation. | interferons (ifn) alpha/beta and gamma induce the formation of two transcriptional activators: gamma-activating factor (gaf) and interferon-stimulated gamma factor 3 (isgf3). we report a natural heterozygous germline stat1 mutation associated with susceptibility to mycobacterial but not viral disease. this mutation causes a loss of gaf and isgf3 activation but is dominant for one cellular phenotype and recessive for the other. it impairs the nuclear accumulation of gaf but not of isgf3 in hetero ... | 2001 | 11452125 |
| obstructive granulomatous bronchiolitis due to mycobacterium avium complex in an immunocompetent man. | while the development of pulmonary disease due to mycobacterium avium complex (mac) infection is most commonly associated with underlying predisposing factors, this organism occasionally causes symptomatic disease in otherwise normal individuals. patients with mac pulmonary disease most often present with cavitating granulomas, but a spectrum of pathologic changes has been described. the authors present a case of mac pulmonary disease in an immunocompetent, middle-aged man with no identified pre ... | 2001 | 11464091 |
| blocking the receptor for il-10 improves antimycobacterial chemotherapy and vaccination. | novel approaches are required for the prevention and therapy of mycobacterial infections since the only vaccine in use, bacillus calmette-guérin, is poorly effective and chemotherapy is long and often ineffective in sterilizing the infection. we used a mouse model of mycobacterium avium infection to address the usefulness of a mab able to block il-10r both in treatment of primary infections and in conventional multidrug therapy and subunit vaccination. treatment of infected mice with this mab du ... | 2001 | 11466374 |
| clinical manifestations and predictors of survival in aids patients with disseminated mycobacterium avium infection. | | 2001 | 11476447 |
| induction of disseminated mycobacterium avium in simian aids is dependent upon simian immunodeficiency virus strain and defective granuloma formation. | mycobacterium avium complex (mac) is the most common disseminated bacterial disease in patients infected by the human immunodeficiency virus. although murine models of disseminated mac exist, they are primarily based on underlying genetic susceptibilities and cannot adequately address the complex interactions that occur between host, mycobacteria, and immunosuppressive lentivirus. to address this problem we have developed an experimental system to co-inoculate rhesus macaques with the simian imm ... | 2001 | 11485927 |
| [components of monitoring drug resistance of tuberculosis agent in the evaluation of effectiveness of the national tuberculosis control program]. | the authors analyzed the changes and pattern of drug-resistance in tuberculosis pathogen by using the reports of over 700 microbiological laboratories of tuberculosis control service in russia in the past 20 years (1979-1998), which yielded a monitoring system for drug resistance in the pathogen in this country. seven underlying informational blocks were identified. these included more than 20 different quantitative and qualitative parameters covering the characteristics of a patient and the pat ... | 2001 | 11490457 |
| unilateral bronchiectasis and esophageal dysmotility in congenital adult tracheoesophageal fistula. | tracheoesophageal fistulas (tef) in adults are most commonly neoplastic, and very rarely congenital in nature. we report a 45-year-old hispanic male with tef and initial presentation of minimal hemoptysis. the patient had radiographic evidence of unilateral upper lobe (rul) bronchiectasis, massive esophageal dilatation, and dysmotility. however, there was no evidence of esophageal malignancy, achalasia, or chagas' disease. bronchoscopy revealed a large tef in the posterior wall of trachea, which ... | 2001 | 11506303 |
| perspective on animal models: chronic intracellular infections. | systemic human disease caused by organisms of the mycobacterium avium-mycobacterium intracellulare complex (mac) represent a chronic intracellular infection in human hosts who are usually immunocompromised. to develop improved treatment and prophylaxis, and to obtain a better understanding of pathogenesis, we studied the beige mouse (c57 beige(+)/beige(+)) challenged orally or intravenously with a human isolate that causes lethal disease in patients with aids (mac 101, serovar 1). encouraging an ... | 2001 | 11524722 |
| nontubercular mycobacterial pulmonary infection in immunocompetent men. | nontubercular mycobacteria (ntm) are increasingly recognized to cause lung disease in immunocompetent patients. we studied the occurrence of pulmonary infection due to ntm in immunocompetent men. | 2001 | 11531180 |
| the changing pattern of aids-defining illnesses with the introduction of highly active antiretroviral therapy (haart)in a london clinic. | to quantify the progressive impact of combination antiretroviral therapy (art) on the incidence of aids-defining illnesses (adis) over a 9-year period. | 2001 | 11531320 |
| remember mycobacterial disease in hairy cell leukaemia (hcl). | | 2001 | 11545557 |
| studies on macrolide antibiotics i. synthesis and antibacterial activity of erythromycin a 9-o-substituted oxime ether derivatives against mycobacterium avium complex. | a series of erythromycin a 9-o-substituted oxime ether derivatives have been synthesized and evaluated for antibacterial activity against mycobacterium avium complex (mac) and staphylococcus aureus. these compounds possessed stronger in vitro activity against mac including macrolide-resistant strains than clarithromycin (2), although in vitro antibacterial activities of these compounds were less than that of 2 against staphylococcus aureus. our studies found that several factors contribute to th ... | 2001 | 11558597 |
| changes in incidence and risk factors of mycobacterium avium complex infections in patients with aids in the era of new antiretroviral therapies. | the aim of the study presented here was to determine the incidence, risk factors and prognostic indicators of mycobacterium avium complex (mac) infection in hiv-infected subjects prior to and after the introduction of highly active antiretroviral therapy (haart). in the haart era, the incidence of mac infection decreased significantly from 3.7 to 0.9 per 100 person-years. using logistic regression analysis, a high acute physiology and chronic health evaluation (apache) iii score, a low number of ... | 2001 | 11561808 |
| molecular and immunological characterization of mycobacterium avium 65 kda heat shock protein (hsp65). | the heat shock protein hsp65 has been characterized previously in several mycobacterial species. this is the first report of the complete sequence of the coding region of the mycobacterium avium homologue. the sequence was highly homologous to the hsp65 of other mycobacterial species, as well as being related closely to the murine and human homologues. recombinant hsp65 (rhsp65) was expressed in escherichia coli to high levels and the recombinant protein tested for its immunogenicity in a murine ... | 2001 | 11564153 |
| fluorescent acid-fast microscopy for measuring phagocytosis of mycobacterium avium, mycobacterium intracellulare, and mycobacterium scrofulaceum by tetrahymena pyriformis and their intracellular growth. | fluorescent acid-fast microscopy (fam) was used to enumerate intracellular mycobacterium avium, mycobacterium intracellulare, and mycobacterium scrofulaceum in the ciliated phagocytic protozoan tetrahymena pyriformis. there was a linear relationship between fam and colony counts of m. avium cells both from cultures and within protozoa. the ziehl-neelsen acid-fast stain could not be used to enumerate intracellular mycobacteria because uninfected protozoa contained acid-fast, bacterium-like partic ... | 2001 | 11571139 |
| simple and rational approach to the identification of mycobacterium tuberculosis, mycobacterium avium complex species, and other commonly isolated mycobacteria. | a novel pcr-restriction fragment length polymorphism analysis of the hsp65 gene was developed. the restriction patterns for mycobacterium tuberculosis and mycobacterium avium complex (mac) species were designed to be highly distinct, and the overall number of restriction patterns was designed to be limited. four hundred specimens (17 reference strains and 383 clinical isolates) were tested, of which 98 were m. tuberculosis and 132 were mac species. the assay was virtually 100% sensitive and spec ... | 2001 | 11574614 |
| plasma bioavailable interleukin-6 is elevated in human immunodeficiency virus-infected patients who experience herpesvirus-associated immune restoration disease after start of highly active antiretroviral therapy. | this study compared plasma bioavailable interleukin (il)-6 levels in 3 groups: human immunodeficiency virus (hiv)-infected patients who had a human herpesvirus (hhv)-associated immune restoration disease (ird) during highly active antiretroviral therapy (haart); patients who experienced an ird initiated by mycobacterium avium complex, hepatitis c virus, or human papillomavirus; and control patients who had uneventful immune reconstitution. total il-6, soluble il-6 receptor (sil-6r), and soluble ... | 2001 | 11574925 |
| [preventing opportunistic infections in patients infected with the human immunodeficiency virus]. | highly active antiretroviral therapy (haart), which has been provided since 1995 to patients infected with human immunodeficiency virus (hiv), has produced noticeable results in regard to preventing opportunistic infections in this population. nevertheless, it is still useful to administer specific prophylactic treatment against opportunistic infections in patients treated with haart and also in patients who do not respond to haart or who cannot or do not wish to take that treatment. prophylacti ... | 2001 | 11575240 |
| a new naphthopyrone derivative from cassia quinquangulata and structural revision of quinquangulin and its glycosides. | a novel naphthopyrone derivative, named quinquangulone (1), has been isolated from cassia quinquangulata, along with the known compounds quinquangulin (2) and its two glycosides (3 and 4), rubrofusarin (5) and its two glycosides (6 and 7), nor-rubrofusarin (8) and its 6-o-glucoside (9), and three stilbenes (10-12). the structure of quinquangulone was established by spectral interpretation as 5,9-dihydroxy-8-methoxy-2,9-dimethyl-6-oxo-4h,6h,9h-naphtho-[2,3-b]pyran-4-one. reinvestigation of the nm ... | 2001 | 11575947 |
| [mycobacterium avium complex septicemia: a new cause of thrombocytopenic thrombotic purpura]. | | 2001 | 11586527 |
| skin indurations in response to tuberculin testing in patients with nontuberculous mycobacterial lymphadenitis. | mantoux results were examined for 29 children with culture-proven nontuberculous mycobacterial lymphadenitis, and 4 species were isolated: mycobacterium avium-intracellulare complex (from 14 patients [48%]), mycobacterium haemophilum (from 12 [41%]), mycobacterium simiae (from 2 [7%]), and mycobacterium scrofulaceum (from 1 [3%]); the median indurations for each species were 15.5 mm, 14.5 mm, 20 mm, and 23 mm, respectively, and in 17 cases (59%), they were > or =15 mm. in regions with a low inci ... | 2001 | 11595991 |
| mycobacterial and nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus infection: a prospective, cohort study. | a prospective observational study was done to describe nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus (hiv) infection. | 2001 | 11602023 |