Fatal infection with a novel, unidentified mycobacterium in a man with the acquired immunodeficiency syndrome

Article Abstract:

A case study is provided of a patient infected with human immunodeficiency virus (HIV), the virus associated with AIDS. The patient developed a fatal infection of what was probably mycobacteria, but the specific agent is unknown. Mycobacteria are the group of organisms that cause tuberculosis and leprosy. The patient was an intravenous drug user and was identified as HIV-positive in 1985. When he entered the hospital in 1987 with AIDS symptoms, acid-fast rods (typical of mycobacteria) were located in biopsy specimens taken from intestine and bone, as well as in feces and urine. However, attempts to grow the organism under laboratory conditions were not successful. The patient received drug treatment, but stopped voluntarily and left the hospital. When he returned the following year, acid-fast rods were found in blood samples. He died in 1988. Material from the patient's liver and spleen was prepared for inoculation into mice (athymic mice, which lack a functional immune system). Although it appeared that the organism associated with the acid-fast rods had killed this immunocompromized patient, the organism could not be identified. Some features of the patient's symptoms were suggestive of infection with Mycobacterium avium-intracellulare, but these can be grown in tissue culture. Other specific agents were also ruled out. Immunocompetent mice did not become infected with the agent, but almost all the athymic mice tested developed lesions similar to the patient's. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Complications and side effects, Identification and classification, Mycobacterium, Mycobacterial infections, Mycobacterium infections

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Progress and problems in the fight against AIDS

Article Abstract:

Highly active antiretroviral therapy appears to be responsible for the drop in mortality from AIDS but most patients in developing countries will not be able to afford the drugs. A 1998 study found that the death rate from AIDS dropped 75% between 1994 and 1997, as did the incidence of opportunistic infections. During this period, AIDS patients were given two or more AIDS drugs, often including a protease inhibitor. The combination is very effective in the sickest patients but there is little data on healthier patients. The drug combination costs $12,000 per year and may be out of reach of most AIDS patients.

Health aspects, Editorial, Usage, Patient outcomes, Mortality, Drug therapy, Combination, Combination drug therapy

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Beware of drug holidays before HIV salvage therapy

Article Abstract:

HIV patients may want to continue taking AIDS drugs even if the virus becomes resistant to one or more of the drugs. A study published in 2003 showed that patients who stopped taking the drugs for four months actually had worse outcomes than patients who continued taking the drugs. This may occur because the resistant virus is weaker than the normal virus. Stopping treatment allows the normal virus to thrive, which would adversely affect the patient.

HIV infection, Drug therapy, HIV infections, Anti-HIV agents

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