The acquired immunodeficiency syndrome (AIDS) dementia complex

Article Abstract:

The acquired immunodeficiency syndrome (AIDS) dementia complex is a devastating complication of AIDS, which is caused by the human deficiency virus, type 1 (HIV-1). AIDS dementia complex occurs in approximately 60 percent of AIDS patients. The clinical symptoms of the AIDS dementia complex include decreased memory, difficulty concentrating, apathy and social withdrawal, and headaches. Less commonly seen are problems with psychomotor functions, such as balance difficulties, clumsiness, and weakness. There is a decrease in verbal skills, without impairment of naming and vocabulary skills. Seizures occur in approximately 10 percent of the patients. Psychiatric symptoms such as depression, psychosis and mania may also be manifest. There is a normal level of consciousness, even in late stages of disease. The pathology of the nervous system includes disease in the brain, spinal cord, peripheral nerves and muscles. These neurological disorders are found in 80 to 90 percent of the cases, which is more frequent than the number of patients who have clinical symptoms of neurologic disease. The neuropathological findings include gliosis, or large numbers of a type of cell of the brain known as astroglial cells; areas of dead neurons; lesions which contain immune cells involved in inflammation; formation of nodules; the presence of multinucleated giant cells; and loss of myelin, the substance which surrounds and is necessary for the function of neurons. Infections, especially with the cytomegalovirus, but also by fungi, parasites and bacteria, also cause neuropathologic symptoms. HIV-1 has been found primarily in monocyte-macrophage cell types, which are immune system cells that engulf and usually destroy foreign organisms. However, the virus is not killed in these cells, which may actually act as a reservoir for the virus and may be involved in the transport of virus throughout the body and into the nervous system. Additional research is needed to understand the mechanism by which HIV-1 causes disease in the nervous system, so that different strategies can be developed for treatment of AIDS and AIDS dementia complex. (Consumer Summary produced by Reliance Medical Information, Inc.)

HIV infection, HIV infections, Dementia, AIDS dementia, AIDS dementia complex, Nervous system diseases

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Aphthous ulceration of the gastrointestinal tract in patients with the acquired immunodeficiency syndrome (AIDS)

Article Abstract:

A previous report by these authors described patients with AIDS (acquired immunodeficiency syndrome) who developed severe aphthous ulcers on the mucus membranes of the mouth, pharynx, and esophagus. The aphthous ulcers responded to treatment with steroids. These patients suffered severe disease due to ulcer-related pain and difficulty swallowing. This report describes another six AIDS patients with giant aphthous ulcers in the esophagus and colon. All of the patients developed symptoms due to the ulcers, including severe depletion of CD4 cells (helper T cells), a type of immune cell. Biopsies of these ulcers revealed inflammation, but no viral or fungus infection. Five patients responded rapidly to treatment with high doses of the steroid prednisolone. One patient with ulcers in the colon suffered a gastrointestinal hemorrhage. Although it is not known whether the esophageal and colonic ulcers are caused by the same factor, their microscopic features and response to therapy were similar. Infection with human immunodeficiency virus (HIV, which causes AIDS) is associated with more severe and persistent aphthous ulcers of the mouth, pharynx, and other regions in the gastrointestinal tract. These ulcers may be mistaken for lesions caused by herpes simplex virus and cytomegalovirus, but they will not respond to antiviral agents. Although various medications have been used to treat these lesions, corticosteroid drugs have been shown to be consistently effective for aphthous ulcer treatment. Clinicians who treat patients with AIDS should be aware of this syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Drug therapy, Stomatitis, Aphthous, Canker sores, Prednisolone

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Interferon therapy for Kaposi sarcoma associated with the acquired immunodeficiency syndrome (AIDS)

Article Abstract:

The most common tumor seen in patients with AIDS is Kaposi's sarcoma. About half of the patients with this tumor can be expected to respond to the agent interferon alpha. This group includes patients with a certain profile of white blood cells, an absence of previous infections, and a lack of other generalized or constitutional symptoms. In these patients, improved immune function and decreased viral activity may be seen. Patients outside this favorable group may benefit from a combination therapy (which includes interferon alpha) currently being investigated by the authors.

Care and treatment, Kaposi's sarcoma, Interferon

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