A diffuse infiltrative CD8 lymphocytosis syndrome in human immunodeficiency virus (HIV) infection: a host immune response associated with HLA-DR5

Article Abstract:

HIV (human immunodeficiency virus) infection may not progress in the same manner in all patients; instead it may give rise to a variety of clinical manifestations depending on the immune response of the individual. Studies have found that a particular antigen, HLA-DR5, is associated with generalized lymphadenopathy (disease of the lymph nodes) and Kaposi's sarcoma (a type of cancerous lesion), two complications of HIV infection. The levels of certain white blood cells, lymphocytes, follow typical patterns in most patients with HIV infection. Levels of one type of lymphocyte, the CD4 cell, decline progressively, while CD8 cells may initially rise and then decline. But some HIV-positive patients have persistently elevated levels of CD8 cells. This was one aspect of a clinical syndrome that is described in 17 patients. Besides the elevated CD8 cell level (CD8 lymphocytosis), the syndrome involved infiltration of the lungs and gastrointestinal tract by lymphocytes. The clinical signs and immunologic aspects of the syndrome are described in detail. Several of the most prevalent clinical signs were enlargement of the parotid gland (a salivary gland), xerostomia (dry mouth), and generalized lymphadenopathy. None of the patients in the study had died and only one had manifested an opportunistic infection over 544 patient-months of monitoring. It was concluded that the diffuse infiltrative lymphocytosis syndrome may result from a specific host immune response to HIV infection; the response was associated with HLA-DR5 and was probably genetically determined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Physiological aspects, HIV (Viruses), HIV, Human immunogenetics, CD8 lymphocytes

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Genetic determination of susceptibility and severity in rheumatoid arthritis

Article Abstract:

Genetic differences may cause the differences in disease severity seen in patients with rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disorder that causes chronic and progressive deformity and disability. A research study found that patients with rheumatoid arthritis were more likely to have certain genes of the major histocompatibility complex (MHC) than individuals without rheumatoid arthritis. The MHC is involved in the immune response to foreign antigens and certain autoimmune disorders such as rheumatoid arthritis. Individuals susceptible to rheumatoid arthritis have the gene for the HLA-Dw4 antigen on the surface of lymphocytes, or white blood cells. Analysis of the genes for the HLA-Dw4 antigen may identify individuals with an increased risk of rheumatoid arthritis or a more severe form of the disease. Early identification of at-risk individuals would enable earlier, more aggressive treatment.

Editorial, Rheumatoid arthritis, HLA histocompatibility antigens, HLA antigens

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Hepatitis B in patients with HIV infection: relationship to AIDS and patient survival

Article Abstract:

Individuals in the more advanced stages of HIV infection may be more likely to develop hepatitis B or to experience re-activation of the disease than individuals in a less advanced stage of infection. Hepatitis B is an infection common among male homosexuals and intravenous drug users, two populations with a high risk of HIV infection. Among 511 individuals infected with HIV, 233 had progressed to AIDS and 278 had not. Eighty-nine percent of the patients who had progressed to AIDS had markers of hepatitis B infection, compared with 80% of those who had not progressed to AIDS. Eleven percent of the patients with AIDS had hepatitis B surface antigen - a mark of persistent infection - compared with five percent of those without AIDS. Survival was similar among AIDS patients with hepatitis B surface antigen and those without. The majority of the patients had become infected with HIV through male homosexual activity.

Patient outcomes, Mortality, HIV infection, HIV infections, Hepatitis B

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