PubMed Health⌕ Search

Biomedical subjects

B S Peters

Publications and source records attributed to B S Peters.

15 recordsLinked to original sources
PubMed1991

Changing disease patterns in patients with AIDS in a referral centre in the United Kingdom: the changing face of AIDS.

OBJECTIVE: To study the changes in morbidity, mortality, and survival patterns in a population of patients with AIDS in the United Kingdom from 1982 to 1989. DESIGN: A retrospective analysis of inpatient and outpatient records of patients with AIDS. SUBJECTS: 347 Patients with AIDS, predominantly homosexual or bisexual men. SETTING: Departments of immunology and genitourinary medicine, St Mary's Hospital, London. MAIN OUTCOME MEASURES: Presenting diagnosis of AIDS, occurrence of other opportunist diseases, cause of death, and survival since AIDS was diagnosed, in particular for those patients with Pneumocystis carinii pneumonia or Kaposi's sarcoma. RESULTS: The overall proportion of patients who developed P carinii pneumonia dropped from 56% (20/36) in 1984 to 24% (46/194) in 1989, although it has remained the index diagnosis in about half of new patients. Kaposi's sarcoma has decreased as index diagnosis from 30% (20/67) to 20% (15/74) over the same period, though the prevalence has remained constant at around 35%. P carinii pneumonia accounted for 46% (16/35) of known causes of death in 1986 but only 3% (1/31) in 1989. Conversely, deaths due to Kaposi's sarcoma rose from 14% (1/7) to 32% (10/31) between 1984 and 1989. Lymphoma accounted for an increased proportion of deaths among these patients with 16% (5/31) of deaths in 1989. Their median survival increased from 10 months in 1984-6 to 20 months in 1987. CONCLUSIONS: The changing patterns of disease in patients with AIDS have important implications both for health care provision and future medical research. Medical and nursing provision must be made for the increased morbidity of these diseases and the increased survival of these patients. Research should now be directed towards developing effective treatments for the opportunist infections which are currently more difficult to treat, the secondary malignancies of AIDS, as well as more effective immunorestorative treatments. Future changes in disease patterns must be recognised at an early stage so that resources can be adequately planned and allocated.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Cytomegalovirus infection in AIDS. Patterns of disease, response to therapy and trends in survival.

Among 347 AIDS patients seen at St Mary's Hospital, London between 1983 and 1989, cytomegalovirus (CMV) disease was observed in 75 (22%). Of these, 58 (77%) had CMV retinitis, 26 (35%) CMV colitis, and 12 (16%) had CMV infection diagnosed at other sites. Relapse occurred in 71%. A favourable response to the use of ganciclovir as induction therapy for CMV retinitis was observed in 92%. Relapse of CMV retinitis occurred in 54% at a median time of 97 days. Neutropenia was the most frequent and serious side-effect of ganciclovir, 76% patients having neutrophil counts less than 1.0 x 10(9)/l and 48% less than 0.5 x 10(9)/l at some stage of therapy. Thrombocytopenia was also common, and platelet counts of less than 50 x 10(9)/l occurred in 43% patients on ganciclovir. The concurrent use of zidovudine made the development of severe neutropenia and thrombocytopenia more likely. Median survival following the diagnosis of CMV disease increased from 5-8 months between 1984 and 1987, to over 12 months in 1988. Patients with CMV colitis had a worse prognosis than patients with CMV retinitis, with median survival of 4.5 and 7 months respectively. In conclusion, CMV is an important opportunist infection in AIDS and both the disease and its treatment cause considerable morbidity. Hence, it is important to develop more effective and less toxic forms of therapy for CMV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Disseminated strongyloidiasis in AIDS: uncommon but important.

Disseminated Strongyloides stercoralis infection is a rare and severe but treatable complication of AIDS. We present a case where this infection was successfully treated and review the available literature. Cases may present many years after they have left an area endemic for Strongyloides infection, emphasizing the need for a full travel history. Symptoms are typically gastrointestinal and pulmonary, with infiltrates often seen on chest radiography. Diagnosis requires stool examination and biopsy of affected sites. Treatment with repeated courses of thiabendazole (25 mg/kg twice daily for 5 days) was successful in our case, but maintenance regimens have not yet been defined. The relative rarity of this complication of AIDS suggests that, where both infections are present, disseminated strongyloidiasis only arises either when HIV-induced immunodeficiency is profound or, possibly, when it is accompanied by impaired granulopoiesis.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Visceral leishmaniasis in HIV infection and AIDS: clinical features and response to therapy.

The development of visceral leishmaniasis with atypical features in an AIDS patient, and the recent flurry of reports of visceral leishmaniasis in HIV-infected individuals prompted the review of its manifestations in the 47 reported cases. Splenomegaly, which is almost always a feature of visceral leishmaniasis in the immunocompetent host, was absent in eight. Antibodies to Leishmania donovani, which are present in approximately 95 per cent of immunocompetent patients with visceral leishmaniasis, were absent in 29 of 45 (66 per cent) of HIV-infected patients tested. Nine HIV-positive patients with visceral leishmaniasis did not exhibit a primary clinical response to therapy with antimonials and of those who did show a response, relapse occurred in 13, at a mean 4.5 months after stopping therapy. Seventeen patients are known to have died often in association with respiratory disease; Leishmania was seen in one bronchial lavage specimen and in lung tissue in one post-mortem performed. In order to improve the prognosis of visceral leishmaniasis in HIV-infected patients diagnosis will have to be made earlier, taking account of the atypical features, and treatment will need to be improved, both initially and perhaps also by the use of long-term maintenance therapy.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

AIDS profile has changed.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗