High incidence of hepatitis B infection and evolution of chronic hepatitis B infection in patients with advanced HIV infection

Article Abstract:

Initial infection with hepatitis B virus (HBV) may develop into chronic infection more frequently among patients whose cellular immune systems are impaired, such as in patients who are infected with the human immunodeficiency virus (HIV). However, it has been shown that the natural course of HBV infection in those that are infected with HIV may be altered, in that the replication time of HBV seems to be longer than normal and less severe liver infection develops. The outcome of HBV infection depends on the stage of HIV infection. Two hundred eleven patients with advanced HIV infection, including those with AIDS, AIDS-related complex (ARC) or those with a very low helper CD4+ T cell count, were examined for HBV infection. At the beginning of the study, 138 patients (65 percent) had antibodies to HBV in their blood, indicating past infection and 16 (8 percent) had detectable HBsAg, a protein associated with the virus, indicating infection with the virus. Fourteen of the 16 had chronic HBV infection. Six of the 57 patients who did not have antibodies to HBV at the start of the study became infected during the follow-up period, which was an average of 18 months later. Four out of the six (67 percent) developed chronic infection, with only two recovering from an acute infection. Therefore, the development of HBV infection is not infrequent among HIV-infected individuals. The course of infection is modified, with an increased risk of infection developing into a chronic state. Reactivation of HBV to cause recurring infections was not seen in the patients with advanced HIV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Risk factors, Hepatitis B, AIDS (Disease), Hepatitis B virus

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Ranitidine improves certain cellular immune responses in asymptomatic HIV-infected individuals

Article Abstract:

Patients who are infected with the human immunodeficiency virus (HIV) have a dysfunctional immune system, which leads to the disease state of AIDS or ARC (AIDS-related complex). The chemical histamine also is known to impair the function of the immune system. Drugs which act as antagonists to the histamine-2 receptor block the effect of histamine and thus inhibit dysfunction of the immune system. These drugs have been tested to see whether they can restore the function of the immune system in ARC patients. The effect of treatment for 28 days with one histamine receptor antagonist, ranitidine, on 18 patients who were infected with HIV was examined. The patients did not have any symptoms of AIDS and did not appear to have any other infections. In addition, they were not being treated with any other drug that affects the immune system. Several immunological functions improved, including activity of natural killer cells, both spontaneous and that stimulated by the cytokines interleukin-2 and interferon-alpha. T cells from treated patients could be stimulated to divide. However, the number of CD4+ cells (immune cells that are killed by HIV) did not increase. Therefore, ranitidine did not stop the infection, nor prevent additional cells from being killed, but improved the ability of the immune cells that were present to be active. The drug can possibly be effective in patients with early infection, where the immune system is not yet dysfunctional. Additional studies on the effectiveness of the histamine blocker ranitidine on patients infected with HIV is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Care and treatment, Physiological aspects, T cells, Antihistamines, Killer cells, Ranitidine

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Aerosolized pentamidine for primary prophylaxis of Pneumocystis carinii pneumonia: a controlled, randomized trial

Article Abstract:

Aerosolized pentamidine can reduce the number of episodes of Pneumocystis carinii pneumonia (PCP) in HIV patients, but it may not improve survival. PCP is the most common opportunistic infection in these patients. Of 209 HIV patients, 105 were treated with 300 milligrams (mg) of aerosolized pentamidine followed by 60 mg every two weeks and 104 were treated with a placebo, or inactive substance. They were followed for 2 to 31 months. Fifteen patients taking pentamidine developed PCP, but 32 patients taking a placebo developed the infection. By 18 months, 13% of those taking pentamidine had developed the infection, compared to 30% of those taking a placebo. However, there was no significant difference between the groups in the number of patients who died. Aerosolized pentamidine was well-tolerated; few of the patients stopped the treatment because of side effects.

Evaluation, Prevention, Pneumocystis carinii pneumonia, Pentamidine isethionate, Pentamidine, Aerosol therapy

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