Brief report: primary infection with zidovudine-resistant human immunodeficiency virus type 1

Article Abstract:

A 20-year-old homosexual man was infected with a strain of HIV already resistant to the drug zidovudine. Acquired zidovudine resistance has been observed in HIV strains isolated from patients who had been treated with the drug for six months or more. They are generally associated with late stage HIV disease and with low levels of CD4 T-cells, a type of white blood cell that is depleted in HIV infection. The patient had tested negative for HIV infection one year prior and one month prior to hospitalization. One of his recent sexual partners was an HIV-positive man who had been taking zidovudine. The patient tested positive for HIV and began treatment with zidovudine. His CD4 T-cell count dropped steadily over the next few months despite zidovudine treatment, reaching a low of 300 cells per cubic millimeter. The drug didanosine was substituted for zidovudine and his CD4 T-cell count rose to 457 cells per cubic millimeter. DNA analysis confirmed that he had initially been infected with a strain of HIV resistant to zidovudine.

Case studies, HIV infection, HIV infections, HIV (Viruses), HIV, Genetic aspects, Drug resistance in microorganisms, Microbial drug resistance

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Progressive disease due to ganciclovir-resistant cytomegalovirus in immunocompromised patients

Article Abstract:

Patients with compromised immune systems suffer a high rate of illness and death from exposure to cytomegalovirus (CMV). Ganciclovir, an antiviral agent, appears to be useful in the treatment of CMV infection of the retina, gastrointestinal tract, and liver, but it has not proven effective in CMV-induced encephalitis. Strains of ganciclovir-resistant CMV were discovered in the blood of three patients who were being treated for CMV with this drug. Genetic analysis of the viral strains taken from each patient revealed that each of the viruses was distinct. The biochemical and genetic basis of ganciclovir resistance by CMV remains under study. AIDS patients in particular may be infected with multiple strains of CMV, and therefore researchers speculate that ganciclovir therapy may select a resistant virus that is already present in a patient. Efforts are underway to purify a resistant clone of CMV for purposes of further research.

Research, Testing, Drug therapy, Antiviral agents, AIDS (Disease), Ganciclovir, Cytomegaloviruses, Cytomegalovirus, column

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Parainfluenza virus respiratory infection after bone marrow transplantation

Article Abstract:

Patients who have undergone a bone marrow transplant may be at risk for developing a lower respiratory tract infection caused by parainfluenza virus. Of 1,253 adults and children who underwent a bone marrow transplant, 27 patients (2.2%) developed a respiratory tract infection caused by this virus either before or after the transplant. Eight of these patients had an upper respiratory tract infection, eleven had a lower respiratory tract infection, and eight had both lower and upper respiratory tract involvement. Six of the patients with lower respiratory tract infections developed respiratory failure and died. An average of nine days elapsed between the onset of symptoms and a positive test for parainfluenza virus. Tests to detect parainfluenza virus may not be useful, and parainfluenza virus infections in bone marrow transplant patients may be underdiagnosed.

Causes of, Bone marrow, Bone marrow transplantation, Respiratory tract diseases

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