Effect of race on expression of acquired immunodeficiency syndrome-associated nephropathy

Article Abstract:

By March 1989, almost 91,000 cases of AIDS had been reported, and the number of new cases has continued to rise dramatically. Complications involving the kidneys (AIDS-associated nephropathy, AAN) are more prevalent in New York City and Miami, where there are high proportions of black patients and intravenous drug abusers (IVDA), compared with San Francisco. AIDS patients at a Washington, D.C. medical center were studied to assess the possible association between race and development of AAN; the patient population had a low rate of IVDA and a high prevalence of homosexuality. In all, 330 homosexual patients were studied. Of these patients, 62 percent were black and 37 percent were white. Although there were no differences in clinical characteristics between the racial groups, there was a highly significant difference in the prevalence of chronic renal (kidney) failure; blacks were far more likely to suffer from kidney complications. A previous suggestion that homosexuality confers some kind of kidney-protective effect is not supported by this study. Previously, racial differences in the prevalence of kidney disease as a complication of high blood pressure and of kidney disease resulting from heroin abuse have been noted, along with differences in circulatory responses, plasma volume, and hormonal responses. However, it is not clear whether these differences are racial, dietary, or the result of differences in socioeconomic level. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Kidney diseases

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Pneumocystis cariini infection of bone marrow in patients with malignant lymphoma and acquired immunodeficiency syndrome: original report of three cases

Article Abstract:

Pneumocystic pneumonia is the infection of the lungs with the microorganism Pneumocystis carinii (PC). It is common in patients receiving immunosuppressive agents, or drugs that suppress the immune or natural defense system, and in patients with acquired immunodeficiency syndrome (AIDS). The rate of occurrence of PC pneumonia in patients receiving immunosuppressive therapy for cancer depends upon the type of cancer, the nutritional status of the patient, the treatment center, and the anticancer drug regimen. It was reported that 41 percent of AIDS patients had serious lung problems, with PC pneumonia being the most common. PC infection rarely spreads to body sites other than the lungs. Three cases are described of patients with PC infection of the bone marrow. Two of these patients had malignant lymphoma, a cancer of the lymphoid tissue, with suppression of the immune system, whereas the third patient had AIDS. The bone marrow infection developed before or with PC pneumonia in all cases. Methods of sampling bone marrow tissue, including biopsy and aspiration, may be used to diagnose PC infection and evaluate its spread throughout the body in immunosuppressed and AIDS patients. Dissemination or spreading of PC infection to sites other than the lung necessitates changes in the treatment of PC infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Infection, Diagnosis, Causes of, Pneumocystis carinii pneumonia, Bone marrow, Lymphomas, Immunosuppressive agents

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