The spectrum of Mycobacterium kansasii disease associated with HIV-1 infected patients

Article Abstract:

Mycobacterium is a family of disease-causing bacteria, and includes the tubercle bacillus which causes tuberculosis. Mycobacterial infections are increasing in the United States, especially among patients with AIDS. Mycobacterium kansasii (MK) occurs in about 3 percent of AIDS patients who have a nontuberculous mycobacterial infection. Increased rates of MK infection in particular geographic regions might be expected to closely follow rates of HIV-1 (the agent that causes AIDS) for that region. This study examined the incidence of MK infection in the New Orleans area because MK is endemic to the area (it is usually found there, but causes low mortality). It was expected that increased rates of MK infection would reflect the incidence of HIV-1 infection. The study compared patients who tested positive for MK infection with patients who tested positive for HIV infection. Tests for the former were conducted at a mycobacteriology laboratory in New Orleans, while information about the latter was obtained by reviewing state public health lists. The tests were conducted from the period beginning in June, 1983 and ending in June, 1988. Results revealed that 72 patients tested positive for MK during the study, meaning they has been infected with the agent. The number of positive MK tests were relatively stable for each year of the period. Of the 72 MK-positive patients, 23 (31.9 percent) were also HIV positive. The first year of the study, none of the patients who tested positive for MK were positive for HIV, but by the last year, 50 percent of those positive for MK were also HIV-positive. Disseminated disease (found outside the area of the body where a disease is normally seen) due to MK occurred in 6 of the 23 HIV-infected patients, but in only 1 of the 49 patients not infected with HIV. Chest X-rays were abnormal in 12 of 19 of the HIV-infected patients. These results indicate a relation between infection with HIV and MK, but the specifics are unclear. Present treatments for MK should be given with the awareness that resistance varies among the drugs used to treat this infection. A better treatment of MK for AIDs patients needs to be formulated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Demographic aspects, AIDS patients, Mycobacterial infections, Mycobacterium infections

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Nitrite inhalant abuse and AIDS-related Kaposi's sarcoma

Article Abstract:

Other factors besides infection with the human immunodeficiency virus (HIV) appear to be involved in the development of Kaposi's sarcoma (KS) in AIDS patients. The incidence of KS is much higher in homosexual and bisexual men than in other AIDS risk groups such as heterosexuals, hemophiliacs, and intravenous drug abusers. Thus agents, or cofactors, other than HIV infection are thought to be involved in the development of KS. Possible cofactors include: infection with cytomegalovirus; other sexually transmitted infectious agents; and the use of nitrite inhalants. Nitrite inhalants are used more commonly by homosexual men than by other groups of individuals. Studies have shown that extensive use of nitrite inhalants is associated with the development of KS in individuals with AIDS. An increased frequency of KS lesions has been observed on the face (especially the nose) and the chest, areas which are more likely to be exposed to the nitrite vapors. Nitrites cause dilation of blood vessels, and it is possible that this favors the transmission of some type of infectious agent. The identification of cofactors involved in the development of KS is important in order to prevent KS in groups at high risk. More research is needed to understand possible interactions between HIV infection and use of nitrite inhalants. Until more information is available, homosexual patients should be told not to use nitrite inhalants. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Kaposi's sarcoma, Amyl nitrite

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Invasive aspergillosis in patients with HIV infection: report of two patients and a review of the literature

Article Abstract:

Because patients who are infected with the human immunodeficiency virus (HIV) have defective immune systems, so-called opportunistic infections often develop. Infection with the fungus Aspergillus (aspergillosis) can occur when the ability of neutrophils and macrophages, cells of the immune system, to destroy or engulf invading organisms (phagocytosis) becomes impaired. Phagocytosis in patients with AIDS is defective. However, aspergillosis is not common in patients with AIDS. Between May 1983 and June 1984, 3,170 cases of AIDS were reported to the Centers for Disease Control, with only five of these cases involving aspergillosis (0.16 percent). Two case studies of patients with AIDS who had invasive aspergillosis are reported, and other cases described in the literature are reviewed. Infection with aspergillus is serious and survival rates are very low, even with antifungal therapy and surgical resection. Risk factors for the development of aspergillosis include low numbers of neutrophils, treatment with corticosteroids, and prior underlying lung disease. AIDS patients who receive drugs that adversely affect neutrophils, and those who have underlying lung disease (usually pneumonia caused by Pneumocystis carinii), must be aware of the possibility of the development of the serious, and often fatal aspergillosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Development and progression, Neutrophils, Aspergillosis, Lung diseases, Fungal, Fungal lung diseases

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