PubMed Health⌕ Search

Biomedical subjects

D Louria

Publications and source records attributed to D Louria.

13 recordsLinked to original sources

Lack of infection in HIV-exposed individuals is associated with a strong CD8(+) cell noncytotoxic anti-HIV response.

Individuals repeatedly exposed to HIV, but who remain uninfected, form a population enriched for persons likely to have either natural or acquired resistance to the virus. We have studied four such exposed uninfected cohorts, representing 60 individuals, for evidence of protective immunity. This population included participants exposed to HIV through anal or vaginal receptive intercourse on multiple occasions over many years. We observed CD8(+)-cell noncytotoxic inhibition of HIV replication in acutely infected CD4(+) cells in the vast majority of individuals most recently exposed to the virus (within 1 year). The levels of this CD8(+)-cell response were sufficient to inhibit the in vitro infection of the exposed subjects' peripheral blood mononuclear cells. We found no evidence of a significant role for CCR5 Delta32 mutation in this population, nor did CD4(+) cell susceptibility to infection or HIV-specific cytotoxic T-lymphocytes correlate with resistance to infection in the individuals tested. Therefore, the observed strong noncytotoxic CD8(+)-cell anti-HIV responses may be an antiviral immune activity contributing to the apparent protection from infection in these exposed uninfected individuals.

Adult↗

HLA antigens associated with susceptibility/resistance to HIV-1 infection.

We studied the distribution of HLA-A, B, C, DR and DQ antigens in a cohort of HIV-1+ individuals and their heterosexual HIV seropositive (concordant) or seronegative (discordant) partners of Black non-Hispanic, Hispanic or Caucasian non-Hispanic ethnicity. The prevalence of DQ7 and Cw7 was significantly higher in the HIV-1+ compared to seronegative Black and Hispanic individuals, respectively. The frequency of DQ4 was significantly elevated in the Black seronegatives, whereas B53 was increased in the Hispanic seronegatives in comparison to the seropositives. No significant differences were observed between the Caucasian HIV infected and non-infected individuals. Analysis of the primary concordant HIV+ and discordant HIV+ individuals showed a marked increase in the prevalence of B44 in the Hispanic discordant seropositives, whereas the Caucasian primary concordants had a marked increase in the prevalence of A26. The prevalence of DQ7 and Cw7 was significantly increased in the Black and Hispanic secondary concordant seropositives, respectively in comparison to the seronegatives. The proportion of couples with matching HLA antigens was similar among the HIV-1+ concordant and discordant groups. These results provide additional evidence that HLA polymorphism may confer a genetic risk or protection for HIV-1 infection in individuals of various ethnic backgrounds.

Alleles↗

Lymphocyte immunoregulatory cells present in semen from human immunodeficiency virus (HIV)-infected individuals: a report from the HIV Heterosexual Transmission Study.

The purpose of this study was to determine the types and distribution of immune subsets present in semen from human immunodeficiency virus (HIV)-infected (HIV+) individuals and to compare these values with those measures in semen from HIV-negative (HIV-) individuals. To accomplish this, a direct three-color monoclonal antibody labeling technique was employed to identify immune cells in fresh ejaculates. Once labeled, the percent of each immune subset present in the ejaculate was determined by flow cytometric analysis. The percent of CD3+ cells present in the semen of the HIV+ group showed no significant difference when compared with semen from the HIV- group. Analysis of the CD4+ subset yielded a significantly lower percent in the HIV+ group than in the HIV- group. The analysis of the CD8+ subset yielded a higher percent of cells present in semen from HIV+ individuals. The CD8 higher value along with lower CD4 value results in a lower CD4/CD8 ratio in the HIV+ group. Further subset studies showed that the percent of cells expressing naive (CD4+ CD45RA+) and memory (CD4+ CD45RO+) markers was lower in the HIV+ group. This study provides additional data supporting the utility of flow cytometry and monoclonal antibodies to immunophenotypic cells present in semen ejaculates. It is also the first reported application of the technique to a disease-based model and may be useful to better understand issues of mucosal immunity and transmission of sexually transmitted diseases such as HIV.

Acquired Immunodeficiency Syndrome↗

Micronutrient status and human immunodeficiency virus (HIV) infection.

This study surveyed serum concentrations of vitamins, electrolytes, and trace elements in subjects seropositive for HIV-1 by ELISA and confirmatory Western blot. Thirty subjects (26 males, 4 females) were recruited at a hospital clinic. Seventeen were classified as having mild or severe ARC (AIDS-related complex), 7 had AIDS, and 6 were asymptomatic. Eight had experienced weight loss of 10 pounds or more in the past 6 months. Most (93%) were anergic to skin test antigens. Percentages of subjects with below normal plasma concentrations include: zinc-30%, calcium-27%, magnesium-30%, carotenes-31%, total choline-50%, and ascorbate-27%. Eighty-seven percent of the subjects had at least one abnormally low value. Percentages with above normal values include: folate-37% and carnitine-37%. Some subjects with above normal values for plasma vitamins reported self-supplementation, usually with large doses. The results suggest that one or more abnormally low concentrations of the plasma micronutrients studied here are likely to be present in the majority of HIV seropositive patients.

AIDS-Related Complex↗

Comparison of parenteral ciprofloxacin with clindamycin-gentamicin in the treatment of pelvic infection.

A prospective, randomized study of intravenous followed by oral ciprofloxacin compared with the combination of intravenous clindamycin and gentamicin was conducted in 122 women hospitalized with pelvic infections. Clinical diagnoses included endometritis (97 patients) and uncomplicated pelvic inflammatory disease (25 patients). Treatment successes for endometritis included 42 of 50 (84 percent) patients treated with ciprofloxacin compared with 35 of 47 (75 percent) treated with the clindamycin-gentamicin combination. Treatment successes for acute salpingitis included 10 of 10 (100 percent) treated with ciprofloxacin and 13 of 15 (87 percent) treated with clindamycin-gentamicin. Ciprofloxacin successfully eradicated Chlamydia trachomatis in 11 of 12 patients as did clindamycin-gentamicin in six of seven patients. In this study of pelvic infection, ciprofloxacin demonstrated efficacy comparable with the combination of clindamycin and gentamicin, and is effective against C. trachomatis.

Acute Disease↗

Prospective evaluation of combinations of antimicrobial agents for endometritis after cesarean section.

Two hundred and thirty-six women were studied for the development of endometritis following cesarean section. Cultures were taken of the amniotic fluid and endocervix through the internal os during the operative procedure. Of the 236 patients, clinical evidence of endometritis developed in 105. Positive cultures of the amniotic fluid or the endocervix, or both, were not helpful in predicting significant clinical infection. The patients with endometritis were treated with a combination of either clindamycin and gentamicin or cefazolin and gentamicin. All of the 54 patients, receiving clindamycin and gentamicin improved, but eight of the 51 patients in the cefazolin group failed to respond but, subsequently, improved after the administration of clindamycin. No serious toxicity was observed in either group.

Amniotic Fluid↗

Pseudomonas putrefaciens as a cause of septicemia in humans.

Septicemia due to Pseudomonas putrefaciens was found in an elderly man with chronic leg ulcers. This organism is rarely cultured from human material and has been reported to cause skin and ear infections in only a few patients. Its potential for invasiveness is documented in this case for the fourth time.

Humans↗

Nosocomial Salmonella epidemic.

A patient admitted to the hospital with diarrhea due to Salmonella heidelberg subsequently developed fatal disseminated salmonellosis, despite vigorous antimicrobial treatment. Beginning five weeks after the initial patient's death, nine patients developed hospital-acquired S heidelberg infections characterized by diarrhea (in seven) and bacteremia (in two). A careful search for salmonellosis among patients and hospital staff revealed two asymptomatic excretors. Extensive culturing of samples from the environment did not show any contaminated objects or reservoirs. The epidemic ended after initiation of an energetic handwashing campaign and isolation procedures. The strain of S heidelberg isolated was resistant to chloramphenicol, ampicillin, and gentamicin. Especially interesting in the epidemic were the prolonged time between death of the index case and the appearance of nosocomial cases, the high fatality rate, and the marked antibiotic resistance.

Adolescent↗

Wealth from Health: an incentive program for disease and population management: a 12-year project.

The future of healthcare is linked with its ability to face the challenges of consumerism. Disease and population management will represent the dominant style of healthcare delivery in the future. This article describes the Wealth from Health programs which utilize current and future technologies to help the healthcare system become a leader in healthcare delivery and to assist many communities at an affordable cost.

Asthma↗