Acquired Immunodeficiency Syndrome ; diagnosis ; Adult ; Female ; Humans ; Larynx ; pathology

Acquired Immunodeficiency Syndrome ; blood ; pathology ; physiopathology ; Female ; Humans ; Infant

The virology of human immunodeficiency virus (HIV) infection is reviewed. The transmission of HIV is restricted to direct contact with the blood or other body fluids of infected human beings. Ordinary social contact with infected individuals holds no risk but in the health care setting all patients must be considered to be potentially infectious and universal precautions taken. The replication of HIV in cells of the immune system carrying the CD4 receptor creates a complex relationship between the virus infection and the host immune response. The pathogenesis and the principles of the laboratory diagnosis of HIV infection are reviewed. Since its discovery HIV has quickly become one of the most studied and best characterized of human pathogens. The diagnosis of HIV infection, because of its implications, has been made more accurate than for any other infection. This understanding has significantly improved treatment but has yet to provide curative therapy, and prevention of infection is still the basis of the fight against AIDS.
Acquired Immunodeficiency Syndrome - pathology ; Acquired Immunodeficiency Syndrome - transmission ; Animals ; HIV Antibodies - analysis ; HIV Infections - diagnosis ; Serologic Tests ; Virus Replication - physiology

BACKGROUNDAquired immune deficiency syndrome (AIDS) presents a challenge to medical researchers because of its unique pathological and clinical picture. The clinical data, particularly autopsy evidence, from China have failed to provide enough pathological and etiological evidence for AIDS diagnosis, which impairs the reliability of the diagnosis and our full understanding of the occurrence and development of AIDS complications. The purpose of this study was to investigate the imaging and pathologic characteristics of AIDS.

METHODSAutopsy, imaging and pathological data from 8 cases of AIDS were retrospectively analyzed. Routine CT scanning of different body parts was performed during their periods of hospitalization. Transverse CT scanning was conducted from the skull to the pelvis immediately after the occurrence of death. After routine formalin fixing, 7 cardevers were cross sectioned for autopsy in freezing state and 1 for gross autopsy. Tissues were obtained from each section and organs for pathological examinations.

RESULTSThe autopsy data indicated the presence of parasitic infections, bacterial infections, fungal infections, and virus infections in AIDS patients. Pneumocystis pneumonia, pulmonary tuberculosis, coccobacteria pneumonia, Aspergillus pneumonia, cytomegalovirus pneumonia, toxoplasma encephalitis, lymphoma and cerebrovascular diseases were found in these patients.

CONCLUSIONSDuring the course of AIDS progression, the concurrent multiple infections as well as tumor development may result in multiple organ pathological changes and clinically complex symptoms that further complicate the imaging and pathological manifestations, thus resulting in difficult differential diagnosis. A combination of imaging data and autopsy data can help to clarify the diagnosis.

Acquired Immunodeficiency Syndrome ; pathology ; Adolescent ; Adult ; Autopsy ; methods ; Child ; Diagnostic Imaging ; methods ; Humans ; Male ; Young Adult

BACKGROUNDHIV is a neurotropic virus which can cause brain white matter demyelination, gliosis, and other pathological changes that appear as HIV encephalitis or AIDS dementia. The purpose of this study was to investigate the change of the diffused condition of water molecules in brain white matter in early acquired immune deficiency syndrome (AIDS) patients using MR diffusion tensor imaging (DTI).

METHODSDTI examinations were performed on a Siemens 3.0T MR scanner in 23 AIDS patients with normal brain appearance by conventional MRI and 20 healthy volunteers as the control group. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured in nine regions; corpus callosum (CC) knee, CC body, CC splenium, periventricular white matter, frontal lobe white matter, parietal lobe white matter, occipital lobe white matter, and the anterior and posterior limbs of the internal capsule. The mean FA and ADC values from each region were compared in three groups: the symptomatic, asymptomatic and the control.

RESULTSThe mean FA values were significantly lower and the mean ADC values were significantly higher in all nine regions in patients in the symptomatic group than in the asymptomatic and control group patients. In the asymptomatic group, the mean FA values were significantly lower and the mean ADC values were significantly higher at the CC knee, CC body, CC splenium, periventricular white matter, frontal lobe white matter and parietal lobe white matter, than in the control group. There were no significant differences at other regions between the two groups.

CONCLUSIONSThe diffused changes of water molecules in brain white matter in AIDS patients are related to brain white matter regions. DTI examination can detect the brain white matter lesions early in AIDS patients.

Acquired Immunodeficiency Syndrome ; pathology ; Adolescent ; Adult ; Aged ; Brain ; pathology ; Diffusion Tensor Imaging ; methods ; Female ; Humans ; Male ; Middle Aged

PURPOSE: To describe an unusual case of rapidly progressive outer retinal necrosis (PORN) with vitreous hemorrhage in a 41-year-old woman with acquired immunodeficiency syndrome (AIDS), who had retinitis developed from what was probably varicellar-zoster virus combined with cytomegalovirus (CMV) and herpes simplex type 1,2, as proven by the polymerase chain reaction restriction fragment length polymorphism method (PCR-RFLP). METHODS: This study is a case report detailing clinical follow-up and an aqueous humor test by PCR-RFLP. RESULTS: The deep, white retinal lesions coalesced and progressively expanded in a circumferential manner, with sparing of the perivascular retina. However, retinal and vitreous hemorrhages, unusual findings for PORN, could be noted around the optic nerve. Varicellar-zoster virus (VZV), cytomegalovirus (CMV), and herpes simplex types 1,2 (HSV-1,2) were detected in the aqueous humor by PCR. CONCLUSIONS: PORN has been described as a variant of necrotizing herpetic retinopathy, occurring particularly in patients with AIDS. Although the etiologic agent has been reported to be VZV, concurrent or combined etiologic agents can include HSV-1, HSV-2, and CMV in AIDS patients. Therefore, combined antiviral therapy with acyclovir and ganciclovir could be more reasonable as an initial therapy.
Vitreous Hemorrhage/*complications ; Retinitis/*complications/pathology/*virology ; Necrosis ; Humans ; *Herpes Zoster ; Female ; Disease Progression ; Adult ; Acquired Immunodeficiency Syndrome/*complications

Hemophagocytic lymphohistiocytosis (HLH) has been described in patients with advanced stages of human immunodeficiency virus (HIV) infection, but rarely occurs during the seroconversion stage of acute HIV infection. We report a case of acute HIV syndrome that presented with virus-associated HLH. The patient recovered spontaneously without any immunomodulating therapy. This case suggests that acute HIV infection should be included in the differential diagnosis of HLH and indicates that HLH associated with acute HIV infection can have a favorable outcome.
Acquired Immunodeficiency Syndrome/complications/*diagnosis ; Adult ; Diagnosis, Differential ; HIV Infections/complications/*diagnosis ; Humans ; Korea ; Lymphohistiocytosis, Hemophagocytic/etiology/*pathology ; Male

OBJECTIVETo develop a model of SHIV-KB9/Chinese origin rhesus (Ch Rh) macaques for vaccine research and to compare the pathogenesis of SHIV-KB9 in Ch Rh macaques with that reported in Indian rhesus (Ind Rh) macaques.

METHODSSeven mamu-A*01 negative Ch Rh macaques were inoculated intravenously with 1-10000 MID50 of SHIV-KB9. The monkeys were monitored for viral load, CD4, CD8, SHIV-specific antibody and virus genetic variation. The results were compared with those previously observed in Ind Rh macaques.

RESULTSAs compared to that observed in Ind Rh macaques, SHIV-KB9 in Ch Rh macaques displayed three identical disease progression patterns. However, the primary pattern was not identical between the two subspecies. The level of plasma viremia differed in SHIV-KB9-infected Ch Rh macaques which exhibited different outcomes from those in Ind Rh macaques. Generally, the values of viral load and the maintenance of CD4+ T cells were associated with humoral responses. Otherwise, the viral genetic distances (divergence, diversity) were larger in animals (M419, M425) with their CD4+ T cells profoundly depleted.

CONCLUSIONThe model of SHIV-KB9/Ch Rh macaques displays a relatively slow progression to AIDS compared with Ind Rh macaques, which may more accurately reflect the potential of candidate vaccines in humans.

Animals ; CD4-CD8 Ratio ; China ; Disease Progression ; India ; Macaca mulatta ; Simian Acquired Immunodeficiency Syndrome ; pathology ; Species Specificity ; Viral Load

OBJECTIVETo establish a method for detecting circulating brain microvascular endothelial cells (cBMECs), a novel biomarker of blood-brain barrier (BBB) injury.

METHODSBlood samples were collected from 33 patients with AIDS encephalitis and 13 healthy subjects for detection of cBMECs, cECs and EPCs using magnetic affinity isolation and immune identification technology.

RESULTSThe numbers of cBMECs, cECs and EPCs were significantly higher in the AIDS patients than in the control subjects (t=4.298, P<0.01; t=4.886, P<0.01; t=4.889, P<0.01). An significant association was also noted between HIV load and cBMEC number (r=0.928, P<0.01).

CONCLUSIONWe have successfully established a method for detecting peripheral blood cBMECs, which can be of important value in non-invasive assessment of BBB injury.

Acquired Immunodeficiency Syndrome ; physiopathology ; Biomarkers ; Blood-Brain Barrier ; pathology ; Cell Separation ; methods ; Cells, Cultured ; Endothelial Progenitor Cells ; cytology ; Humans

OBJECTIVETo study the relationship between simian acquired immunodeficiency syndromn (SAIDS) and autoimmunity in simian immunodeficiency virus (SIV)-infected monkeys.

METHODSIndirect immunofluorescence assays were performed to detect plasma or serum autoantibodies in SIV-infected monkeys. The heart, liver, spleen, lung, kidney, and lymph node of BALB/c mice, a strain of endothelial cell ECV304, and granulocytes were used as target antigens. These results were compared with HE stained slides of SIV-infected monkeys.

RESULTSThe levels of various autoantibodies, including anti-lymphocyte autoantibodies, anti-endothelial cell autoantibodies, and anti-granulocyte antibodies, increased after SIV infection in monkeys. Moreover, pathological examinations showed injuries in the lymphoid tissue and vascular pathological changes in cerebral cortex, submucosa of gastrointestinal tract, interstitial capillaries of myocardium, nephron of the kidney, and sinusoid cell of liver.

CONCLUSIONThe increased autoantibodies and the pathological changes of tissues and organs confirm the existence of autoimmunity in SIV-infected monkeys.

Animals ; Autoantibodies ; blood ; Autoimmunity ; Endothelial Cells ; immunology ; Granulocytes ; immunology ; Lymphocytes ; immunology ; Mice ; Mice, Inbred BALB C ; Simian Acquired Immunodeficiency Syndrome ; immunology ; pathology ; Simian Immunodeficiency Virus