Nosocomial infection rate as a function of human immunodeficiency virus type 1 status in hemophiliacs

Article Abstract:

A nosocomial infection (NI) is one that a patient acquires while in the hospital. Studies have shown that hospitalized patients with severe illnesses have a high risk of developing NIs. Also, it is well known that patients with AIDS are at risk for developing life-threatening infections. It is estimated that 35 to 70 percent of the people who have hemophilia (a disease in which the blood does not clot properly) test positive for the human immunodeficiency virus type 1 (HIV-1, the virus that causes AIDS). Therefore, a study was performed to determine the prevalence of NIs in hemophiliacs with and without HIV-1 infections. The study included 195 patients with hemophilia. Of these patients, 24 had AIDS, 104 had HIV-1 infections but had not developed symptoms of AIDS (HIV-positive), and 67 did not have an infection with HIV-1 (HIV-negative). The AIDS patients spent a longer time in the hospital (10.3 days) than those who were HIV-positive (9.0 days) or HIV-negative (7.7 days). During the study period, 11 patients got a total of 13 NIs. Blood and urinary tract infections were the most common types of infections. Of the 11 patients who developed NIs, four had AIDS, five were HIV-positive, and two were HIV-negative. These results translate to a NI rate of one out of every 15 hemophiliacs with AIDS, one out of every 61 who are HIV-positive, and one out of every 110 who are HIV-negative. Factors that increased the risk of NI in patients with AIDS included treatment with antibiotics and the use of central intravenous catheters. It is concluded that full-blown AIDS increases the risk of developing NIs, but HIV-1 infections that have not progressed to AIDS do not significantly increase the risk of NI. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Hemophilia, Nosocomial infections, Cross infection

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Primary pulmonary hypertension associated with human immunodeficiency viral infection

Article Abstract:

Acquired immunodeficiency syndrome (AIDS) is associated with various cardiovascular disorders, such as impaired heart function; accumulation of fluid in the membrane surrounding the heart; cancer; and opportunistic infections. Four cases are described consisting of two patients with AIDS, and two patients with human immunodeficiency virus (HIV) infection. The patients developed high pressure (hypertension) in the pulmonary artery, the major blood vessel supplying the lungs, and were diagnosed as having primary pulmonary hypertension. This disorder is characterized by increased pulmonary arterial pressure resulting from structural abnormalities in the blood vessels due to some unknown cause. Two of the patients died, and the diagnosis of pulmonary hypertension was confirmed by autopsy. Primary pulmonary hypertension is associated with three pathologic characteristics: disease of the pulmonary arteries; recurrent blood clot formation in the pulmonary arteries; and obstruction of the pulmonary veins. Structural changes in the blood vessels include enlargement of the muscle layer, followed by cell overgrowth in the inner layer. There have been nine reports of HIV-infected patients with primary pulmonary hypertension. The mechanisms underlying the development of pulmonary hypertension associated with HIV infection are not clear, but may be related to a reaction of the lungs to HIV; the production of abnormal growth factors; or impaired function of the right heart ventricle due to opportunistic infection with Pneumocystis carinii. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Pulmonary hypertension and HIV infection

Article Abstract:

A case is described of a 37-year-old man with human immunodeficiency virus (HIV) infection who developed pulmonary hypertension, high blood pressure within the lung. The patient was admitted with symptoms of difficult breathing upon exertion and Raynaud's phenomenon, which is characterized by blood vessel constriction in the extremities upon exposure to cold temperatures or emotional stress. Weight loss, distention of the neck veins, liver enlargement, abnormal sounds in the heart and lungs, and abnormalities of the right ventricle and atrium of the heart were also observed. The patient was diagnosed with pulmonary hypertension, although no known cause could be identified. Additional laboratory tests showed that he was infected with HIV. The patient was not a homosexual or intravenous drug abuser, but reported sexual intercourse with prostitutes. The incidence of pulmonary hypertension is low, and it is unlikely that pulmonary hypertension and HIV infection developed together by chance. Thus, it is suggested that HIV infection may have caused the development of pulmonary hypertension. (Consumer Summary produced by Reliance Medical Information, Inc.)

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