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Biomedical subjects

C Rouzioux

Publications and source records attributed to C Rouzioux.

At least 19 recordsLinked to original sources
PubMed1992

Passive immunotherapy in AIDS: a randomized trial of serial human immunodeficiency virus-positive transfusions of plasma rich in p24 antibodies versus transfusions of seronegative plasma.

To assess the place of passive immunotherapy in the treatment of AIDS, a randomized study was conducted that evaluated the safety and short-term efficacy of serial transfusions of human immunodeficiency virus type 1 (HIV-1) seropositive plasma in 18 patients. Heat-inactivated anti-HIV antibody-rich plasma was compared with seronegative fresh-frozen seronegative plasma given in addition to zidovudine and other conventional prophylactic treatments. Seven transfusions every 2 weeks of immune plasma significantly reduced (2 vs. 8, P = .016) the number of opportunistic infections. Antigenemia became undetectable. When transfusions were stopped, positive p24 antigenemia returned at a level higher than before treatment and was correlated with a severe clinical deterioration, suggesting a rebound effect. This trial suggests that passive immunotherapy is promising in AIDS treatment. It confirms also that plasma donation does not affect donors' CD4 cell count over a 1-year period. In patients with severe immunodeficiency, special attention should be paid to withdrawal of an effective therapy as virologic relapse may be explosive and poorly tolerated.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Comparative assessment of quantitative HIV viraemia assays.

OBJECTIVE: To compare two published methods for determining plasma viraemia in HIV-seropositive patients, with reference to a cellular viraemia assay. PATIENTS, PARTICIPANTS: Three patient groups were defined according to CD4 cell count: group I, less than 200 x 10(6)/l (23 patients); group II, 200-500 x 10(6)/l (18 patients); and group III, greater than 500 x 10(6)/l (13 patients). METHODS: The two reported methodologies were applied to all fresh samples, simultaneously and on the same day. RESULTS: The two techniques did not differ significantly in the detection of plasma viraemia: 82.3% of group I patients and 55% of group II patients were positive, while all group III patients were negative. Cellular viraemia was positive for 96% of the overall population. CONCLUSIONS: These results, obtained in a network of seven French laboratories involved in clinical trials, confirm that both plasma viraemia and cellular viraemia are useful virological markers.

AIDS Serodiagnosis↗
PubMed1992

Herpesvirus infection of the respiratory tract in patients with alcoholic hepatitis.

Respiratory herpesvirus infections have rarely been described in alcoholics. We report four cases of severe respiratory herpesvirus infections in patients with alcoholic liver disease. Two were related to Herpes Simplex Virus and two to Cytomegalovirus. Both chronic alcoholism and severe liver disease induce immunosuppression, which might account for these unusual herpesvirus infections of the respiratory tract. These cases suggest that infections with herpesviruses should be considered in patients with alcoholic liver disease and pulmonary or tracheobronchial disease unresponsive to standard antibiotic therapy. Bronchoscopy, viral culture, and serological tests appear warranted, particularly given the existence of specific therapy.

Adult↗
PubMed1992

[Survival of the human immunodeficiency virus (HIV-1) in Triatoma infestans (Klug, 1834)].

Triatoma infestans is the main domestic vector of Trypanosoma cruzi, the parasitic agent of Chagas' disease in South America. We investigated whether Triatoma infestans could shelter the HIV-1 virus. For this purpose, we measured the survival time of the virus in the alimentary tract. Fifth-instar nymphs of the blood-sucking bug were fed through an ad hoc apparatus with venous blood from asymptomatic HIV-1 seropositive patients. We attempted to evidence the virus by cultivating material from the insect gut (wall and content) on lymphocyte co-culture. Retrovirus activity was demonstrated in the culture supernatant by dosing the p24 antigen and the reverse transcriptase activity. The virus has been found alive in the gut content of Triatoma infestans up to the 7th day after the last infectious meal of the insect.

Animals↗
PubMed1992

Perinatal HIV transmission facts and controversies.

In 1992, HIV infection in children is essentially due to vertical or perinatal transmission, i.e. from the mother to the fetus and neonates. This is a particularly serious public-health problem in Africa where the percentage of infected women of child bearing age is as high as 20% in some suburban areas. During the last few years, three important points have been established. (i) In Europe and North America, the rate of perinatal transmission is between 15 and 25% and appears to have remained relatively stable with time in various prospective cohorts. (ii) Considerable efforts have been directed at defining the optimal methods for early diagnosis of HIV infection in the infants. At present viral cultures and gene amplification of HIV DNA by polymerase chain reaction are the most promising procedures for early diagnosis within the first 6 months of life. (iii) Finally, the course of the disease in the infected infant has been well characterised, it takes two main forms--that of an early and severe disease or that of a slowly progressive infection: In addition, follow-up is now sufficient to confirm that children with negative tests at 15 months are indeed uninfected. However, knowledge is lacking in a number of essential areas. These include the exact timing of transmission (in utero, during delivery or post-partum), the relative frequency of transmission during each period, the mechanism(s) involved (particularly the role of the placenta), and, finally, the influence of maternal, fetal and viral factors. Answers must be found rapidly in order to develop preventive therapy, to identify women who may have an increased risk of transmitting the virus, to develop a reliable antenatal diagnostic test and, finally, to be in a better position to inform HIV-seropositive women of the relative risks.

Animals↗
PubMed1992

[Virologic diagnosis of HIV infection in children].

The rate of mother-to-infant transmission of the HIV approximates 20%. Early treatment and monitoring of infected infants are feasible only if diagnosis is established promptly. Diagnosis at birth relies on techniques that demonstrate presence of the virus (viral cultures, Polymerase Chain Reaction (PCR) antigenemia). However, beyond six months of age, detection of evidence of an immune response to the virus can also be used (anti-HIV IgA, in vitro production of antibodies: ELISPOT or in vitro antibody production (IVAP). In practice, it should be borne in mind that the sensitivity of each technique varies with age.

Blotting, Western↗
PubMed1991

[Virologic diagnosis of human immunodeficiency].

The reference tests for HIV diagnosis are the ELISA and Western-Blot assays. Their rapid development has made it possible to obtain a reliable, specific and highly sensitive diagnosis. The follow-up of HIV-infected subjects includes HIV-p24 antigenaemia, but viral culture and PCR will perhaps permit a quantification of viral load in order to evaluate the results of antiviral therapy.

HIV Infections↗
PubMed1991

[Passive immunotherapy in AIDS: transfusion of plasma rich in anti-p25 antibody (phase I trial)].

The present study is a therapeutic trial of phase I, based on the principle of passive immunotherapy in acquired immunodeficiency syndrome (AIDS). Eighteen patients with full blown AIDS (stage IV C2 of CDC) were subdivided into two groups: nine receiving every two weeks 300 ml of plasma collected from HIV-1 seropositive symptomless (stage II or III of CDC) individuals, and nine (control group) receiving 300 ml of seronegative plasma at the same rythm and for the same period. Each patient received seven transfusions. Clinical and biological results during the transfusional and post-transfusional periods are reported.

Acquired Immunodeficiency Syndrome↗
PubMed1991

HIV proteins absent from placentas of 75 HIV-1-positive women studied by immunohistochemistry.

Recent epidemiological and virological data suggest that the incidence of maternofetal transmission of HIV-1 infection is between 20 and 30%. The available evidence points to a possible role of peri- and postnatal contamination, but the isolation of HIV from fetuses shows that transplacental transmission also occurs. We attempted to detect, by means of an immunohistochemical method, HIV proteins in frozen placentas from 75 HIV-1-positive women (30 at term, 45 induced abortions). In addition, in situ hybridization using HIV-specific probes was performed in three cases. Neither HIV proteins nor nucleic acid sequences were detected, but CD4+ mononuclear cells were present in the chorion and villi, regardless of the clinical and biological status of the mother (particularly in the nine cases in which the infants were infected). There are several possible mechanisms involving the placenta in the maternofetal transmission of HIV, including active transport of the HIV-immunoglobulin G complex via Fc receptors on trophoblastic cells, passive transplacental passage of HIV during a viraemic episode, the passage of infected maternal cells, and infection of the placenta itself. The methods we used could not rule out the presence of HIV DNA provirus within the genome of placental cells. In any event, immunohistochemical detection of HIV proteins in the placenta is not a technique suitable for the prenatal diagnosis of HIV infection or for identifying newborns likely to develop HIV infection.

Adult↗
PubMed1991

Several groups among human herpesvirus 6 strains can be distinguished by Southern blotting and polymerase chain reaction.

Eight human herpesvirus 6 (HHV-6) strains were studied by Southern blot and polymerase chain reaction. DNA from infected cells was digested by a panel of restriction enzymes and hybridized with cloned BamHI fragments corresponding to about 30% of the HHV-6 strain SIE genome. In parallel, this DNA was amplified by polymerase chain reaction using pairs of primers derived from the strain SIE nucleotide sequence. Subsequently, amplification products were analyzed by hybridization, digestion with restriction endonucleases, and partial nucleotide sequencing. Overall results indicated that all strains were closely related to one another. However, concordant differences in restriction patterns allowed at least two groups to be distinguished, typified by strains SIE and HST, respectively. Differences between the two groups were found to reflect a limited number of punctual changes in nucleotide sequences. These results strengthen the idea of a unique HHV-6 species with genetic polymorphism. In addition, this study provides useful markers for the diagnosis and molecular epidemiology of HHV-6 infections.

Base Sequence↗
PubMed1991

Low-dose zidovudine in children with an human immunodeficiency virus type 1 infection acquired in the perinatal period.

This report describes the one-year results of a noncomparative study designed to assess the safety and tolerance of low-dose zidovudine (azidothymidine) given orally to 60 human immunodeficiency virus type 1-infected infants and children. At baseline, the mean age was 1.9 years (+/- 1.4), and all were symptomatic: 43% were P2A and 57% were P2B to F according to the Centers for Disease Control classification. All the patients received zidovudine for at least 6 months, and 52 of them (87%) completed a full year of therapy. The mean duration of follow-up was 346 days (+/- 42) (range, 183 to 366 days). The initial therapy consisted of four daily doses of 100 mg/m2 (400 mg/m2 per day, equivalent to 20 mg/kg per day). However, this treatment was modified when neutropenia or anemia was observed. Twenty-nine children (48%) remained at the initial therapy for the entire study. Zidovudine dosage was adjusted 92 times in the other 31 children (52%), mostly due to neutropenia (83%). Altogether, the time under full-dose therapy represented 81% of the total duration of the protocol for all patients. Children with mild symptoms, P2A at study entry, were more likely to remain under full-dose therapy than children with severe symptoms, P2B to F: the time under full-dose therapy represented 91% of the duration of the protocol for the former group and only 74% for the latter one (P less than .02). No clinical adverse experiences were attributed directly to zidovudine. Thirty-seven children were prescribed trimethoprim-sulfametoxazole as a prophylaxis for Pneumocystis carinii pneumonia.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Virologic diagnosis of HIV infection in the pregnant woman and newborn infant].

The virological diagnosis of HIV infection in pregnant women mainly consists of detecting antibodies to structural viral antigens. The difficulty lies more in the interpretation of the confirmatory assay than in technical problems. The result is critical since the continuation or interruption of pregnancy is dependent upon it. The diagnosis of HIV infection in newborns has been hampered by the presence of passively acquired maternal antibodies. The diagnosis at birth therefore must include culture of peripheral blood mononuclear cells for virus isolation and detection of serum antigen. However, due to the difficulty or lack of sensitivity of these tests new diagnostic procedures, such as the polymerase chain reaction, must be developed to improve the accuracy of the early diagnosis. Such new approaches must be evaluated very carefully before being introduced in routine diagnosis.

AIDS Serodiagnosis↗
PubMed1990

Longitudinal study of 94 symptomatic infants with perinatally acquired human immunodeficiency virus infection. Evidence for a bimodal expression of clinical and biological symptoms.

To better define the clinical and biological evolution of infants after vertical human immunodeficiency virus type 1 infection, we analyzed 94 consecutive infected patients followed up after their first clinical symptoms. The expression of clinical symptoms and biological abnormalities followed a bimodal distribution, some patients having an early and severe disease and the others having a slowly progressive one. One third of our patients suffered from early onset of opportunistic infection (OI). These patients had a significantly higher incidence of severe encephalopathy compared with patients without OI. The rate of survival at 3 years was 48% +/- 24%. In contrast, the patients without early OI or severe encephalopathy had a probability of survival at 3 years of 97% +/- 3%. This probability was not modified by the occurrence of bacterial infection or lymphoid interstitial pneumonitis. Lymphoid interstitial pneumonitis occurred at a mean age of 29 months, significantly later than OI or severe encephalopathy. Laboratory results at initial examination were correlated with clinical symptoms. Thus, when the number of CD4 lymphocytes was less than 500/mm3, children suffered more frequently from life-threatening symptoms (OI and severe encephalopathy): 15 of 22 vs 14 of 69. The same was true when the lymphocytes did not proliferate after antigenic stimulation, when anti-p18 and/or anti-p25 antibodies were absent in the serum, and when p24 antigen was detected in serum. Finally, severe encephalopathy was associated with low anti-human immunodeficiency virus cerebrospinal fluid antibody titer, whereas 88% of patients with moderate or no encephalopathy had signs of intrathecal anti-human immunodeficiency virus antibody synthesis. In conclusion, a subgroup of patients expressed very early signs of severe immunodeficiency and encephalopathy, whereas the majority of patients had a longer survival and less severe clinical symptoms during their first years of life than previously thought.

AIDS Dementia Complex↗