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Biomedical subjects

J Tor

Publications and source records attributed to J Tor.

At least 37 records · Page 2Linked to original sources
PubMed1994

[HIV infection declines among intravenous drug addicts in Barcelona: 1987-1993].

BACKGROUND: The evolution of the prevalence of HIV infection in intravenous drug addicts who initiate hospital detoxication was analyzed. METHODS: Six hundred fifty intravenous drug addicts (535 males, 115 females) were analyzed for HIV and surveyed in regard to demographic variables and the use of drugs over a period of 7 years (1987-1993): age, sex, year of initiation of intravenous drug addiction, length of the habit and year of admission. RESULTS: Most of the subjects were men (82%) with a mean age of 19.7 years at the time of initiation to the use of i.v. drugs and an age of 25.9 years on admission to the unit. The mean time of i.v. drug addiction at admission was 74 months. The characteristics of the patients according to the year of admission were homogeneous in regard to age, length of drug addiction and male/female ratio. More than 50% of the subjects had initiated the use of i.v. drugs during the first half of the last decade. The global prevalence of HIV infection was of 66.3% with no differences being observed between sexes. The frequency of infection was shown to have globally decreased from 1987 to 1993 (p = 0.06) although the rates of HIV infection in women did not significantly modify (p = 0.08) in contrast to that of men (p = 0.05). CONCLUSIONS: The epidemia of HIV infection in intravenous drug addicts may have entered into remission following a decade characterized by a spread in the use of heroin and great diffusion of the disease.

Adult↗
PubMed1993

[Dyslipemia and HIV-1 infection in intravenous drug addicts].

BACKGROUND: It has been demonstrated that hypertriglyceridemia and hypocholesterolemia are frequent signs in homosexual patients with AIDS. Lipid abnormalities of the intravenous drug addict (IVDA) however, and its relation with infection by the human immunodeficiency virus (HIV) have not been sufficiently studied. METHODS: Four hundred thirty-five consecutive patients attended for infectious complications or for carrying out detoxication treatment were studied. Demographic (age, sex), anthropometric (weight, height), use of intravenous drugs (principal drug used, time of addiction) and analytic data (HIV-1 antibodies, total lymphocytes, CD4+ lymphocytes, serum albumin, total cholesterol, plasma triglycerides and transferrinemia) were collected. RESULTS: The age of the patients was found to be between 15-44 years of age. Ninety-five percent were heroin addicts with a time of addiction greater than 4 years. Those who were HIV-1 positive had been drug users for a longer period of time (p < 0.01), had less weight (p < 0.01), lower albuminemia (p < 0.05) and cholesterolemia (p < 0.01), as well as a lower number of CD4+ lymphocytes (p < 0.01). No differences were observed with regard to age, transferrinemia and plasma triglyceride concentration. The prevalence of hypertriglyceridemia (> 1.97 mmol/l; 175 mg/dl) was of 18% for the IVDA with HIV-1 infection and 23% for seronegative individuals (p = 0.3). Hypercholesterolemia was significantly more prevalent in HIV-1 positive individuals (20%) than in the seronegative subjects (9%) (p < 0.01). In the HIV-1 positive patients, most of whom where asymptomatic, a decrease in total cholesterol and an increase in plasma triglycerides was observed according to the decrease in the number of CD4+ lymphocytes. CONCLUSIONS: Infection by the human immunodeficiency virus is accompanied by an increase in plasma triglycerides and a decrease of total cholesterol in relation with the alteration of cellular immunity. However, heroin addicts present some differential characteristics similar to those of chronic alcoholics, poor diet, anorexia induced by opioids, autoimmunity phenomena and recurrent infections throughout drug addiction which may justify lipid abnormalities of multifactorial origin.

Acquired Immunodeficiency Syndrome↗
PubMed1993

HTLV-I/II infections in Spain. The HTLV-I/II Spanish Study Group.

Antibodies to HTLV-I/II were investigated in sera from 7521 individuals living in Spain. They were classified in four major groups: a) subjects at high risk of retroviral infections e.g. parenteral drug addicts, homosexuals, prostitutes, and multiple-transfused individuals; b) patients suffering illness associated with HTLV-I in endemic regions; c) immigrants from endemic areas; and d) blood donors. Sera were collected from 1984 to December 1991. Repeatedly reactive ELISA was found in 211 samples (2.8%), but Western blot only confirmed the presence of HTLV-I/II antibodies in 23 samples (0.30%), corresponding to eight (0.25%) out of 3207 drug abusers, six (0.72%) out of 894 immigrants (five Africans and one South American), three (0.41%) out of 727 patients with HTLV-related diseases (one woman with HTLV-I associated myelopathy had received blood transfusions in an endemic area), four (0.54%) out of 793 prostitutes, one multiple-transfused native woman, and one (0.16%) out of 603 native seamen. The Western blot antibody pattern confirmed HTLV-II infection instead of HTLV-I in nine (39%) subjects. The remaining 14 (61%) HTLV-reactive samples were interpreted as HTLV-I seropositive, most of which were from immigrants. None of 857 blood donors analysed was reactive for HTLV antibody. These results suggest that both HTLV-I and HTLV-II are present in Spain, although at a low rate and mostly restricted to individuals coming from endemic areas, drug addicts, and prostitutes. Furthermore, diseases related to HTLV-I (particularly lymphoproliferative disorders, and subacute myelopathies) seem to be rarely associated with these viruses in Spain, a non-endemic area.

Adult↗
PubMed1992

[Haemophilus influenzae pulmonary infection in patients infected with the human immunodeficiency virus].

BACKGROUND: Haemophilus influenzae has frequently been identified as the etiologic agent in pneumonias of patients with the human immunodeficiency virus (HIV) infection. The experience of the authors is reviewed and the significance of isolating this microorganism in respiratory samples commented upon. METHODS: The clinical, radiological and microbiological data of patients with HIV infection in whom H. influenzae was identified in blood, lung tissue, or samples of the lower respiratory tract obtained by fibrobronchoscopy were retrospectively evaluated. RESULTS: Twenty cases were diagnosed with 75% presenting bilateral lung infiltration. In 70% the isolation sample was that of bronchoalveolar lavage. In 40% of the total another microorganism was identified in coinfection with H. influenzae, of which Mycobacterium tuberculosis was the most frequent. Thirty-five percent of the cases presented antecedents of one or several previous pulmonary infections. H. influenzae infection was not observed with either concomitant or previous infections in 20% of the patients. CONCLUSIONS: A high frequency of pneumonias by Haemophilus influenzae with bilateral radiologic presentation have been found. H. influenzae is frequently demonstrated as in coinfection with other agents. The role that this microorganism has in pulmonary infection of patients with HIV infection is not clearly defined.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Multicenter study of the prevalence of type 2 human immunodeficiency virus infection in Spain (1990)].

BACKGROUND: HIV-2 is a new retrovirus which may produce AIDS and has been mainly described in individuals from West Africa. More than 400 cases have been reported in France and Portugal while in Spain very few cases of HIV-2 infection have been reported with few studies having been made concerning the prevalence of the disease. This multicentric study analyzes the prevalence of HIV-2 infection in subjects of different risk groups in Spain and evaluates the diagnostic efficacy of different methodologies. METHODS: The presence of HIV-2 antibodies was analyzed in 902 serum samples of high risk individuals collected in 1990 from: 386 drug addicts, 246 not drug addict prostitutes, 184 West Africans and 86 homo/bisexual individuals. These samples were from Barcelona, Sevilla, and Malaga. The detection of antibodies was carried out by enzymatic immunoanalysis (EIA), Western blot (WB) and an enzymoimmuno-dot (EID) designed with synthetic peptides. RESULTS: Positive serology only for HIV-2 was detected in 7 samples from African immigrants. Two drug addicts presented double reactivity HIV-1/HIV-2 in all the tests suggesting double infection. No prostitutes or homo/bisexual males were identified with positive serology for HIV-2. Cross-reactivity between HIV-1 and HIV-2 was more frequently detected in WB than in EID. Greater discordance was found in the results obtained by EIA, WB, and EID in the West Africans than in the analysis of the samples of native subjects. CONCLUSIONS: This study demonstrates that, for the time being, HIV-2 infection in Spain is rare although from among immigrants from endemic areas subjects with behavior to risk of transmission to the autochthonous population have been identified. The use of techniques designed with synthetic peptides may be of use to discriminate HIV-1 and HIV-2 infection in positive samples by enzymatic immunoanalysis (EIA) and Western blot which use a viral lysate as antigenic material.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Risk factors for the heterosexual transmission of HIV from man to woman: a Spanish multicenter study].

BACKGROUND: The aims of this study were to estimate the rate of heterosexual transmission of HIV in a population of intravenous drug users (IVDU), as to well as to identify the possible risk factors associated. METHODS: One hundred thirty heterosexual couples were analyzed in which the male was seropositive for the human immunodeficiency virus (HIV) with the only possible risk factor for the companion being the sexual intercourse with the case index. RESULTS: The rate of global transmission estimated was 16% (confidence interval of 95% = 10-22.4%). The risk factors significantly associated to HIV transmission were: case index of over 30 years of age (OR = 3.1), clinical status IV (OR = 4.1), less than 0.8 x 10(8) lymphocytes/I (OR = 7), antecedents of sexually transmitted disease (STD) in the woman (OR = 4), and the practice of anal intercourse (OR = 3.1). In the multivariate analysis only the clinical status of the case index and the STC antecedents of the woman were statistically significant (p less than 0.05). CONCLUSIONS: In this study some of the classical risk factors for the heterosexual transmission of HIV have been confirmed, and the importance of decreasing the prevalence of STD in the IVDU collective in Spain has been corroborated to lower heterosexual transmission and, indirectly the vertical transmission of AIDS.

Chi-Square Distribution↗
PubMed1992

Risk stratification for dissemination of tuberculosis in HIV-infected patients.

The location of tuberculosis (TB) early in the course of HIV-induced immunosuppression was located, and an attempt was made to determine the correlation between the degree of immune suppression and prognostic variables to stratify the risk for dissemination of TB in HIV-infected patients. Clinical and laboratory characteristics were reviewed in 73 HIV-infected patients with TB admitted between 1984 and 1990. The presence of Mycobacterium tuberculosis was investigated in different clinical samples to verify the diagnostic yield of different sources. TB was extrapulmonary in 46.6 per cent of patients in whom it was their first opportunistic infection, and in 46.7 per cent of patients with previously diagnosed AIDS (p = NS). TB was frequently associated with other opportunistic infections, particularly oesophageal candidiasis (p = 0.006). Patients with localized extrapulmonary or disseminated TB presented more often with cytopenias, hypoalbuminaemia and oral thrush. The existence of extrapulmonary TB or another opportunistic coinfection allowed AIDS to be diagnosed in the same admission in 30 patients and a mean of 8.4 months later in another eight. Extrapulmonary TB was found to be as common in early HIV infection as in patients with established AIDS. Haematological derangements were common in these patients, and cytopenias, hypoalbuminaemia and oral thrush were useful predictors of TB dissemination. The location of TB and its dissemination were not significantly linked to a more advanced CDC stage of HIV infection or a more profound fall in CD4 count.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Multifocal tubercular osteitis in a female patient infected with the human immunodeficiency virus].

We discuss the case of a 22-year-old female, carrying of antibodies to against human immunodeficiency virus (HIV), who developed several tumors on different bone localizations, which corresponded to plurifocal bone tuberculosis. We reviewed multifocal bone tuberculosis reports in the literature. The exceptionally of this case in underlined and the relationship between this atypical clinical presentation and immunodeficiency in discussed.

Adult↗
PubMed1991

[Serologic and genomic markers of the hepatitis C virus in transfusion recipients with non-A, non-B hepatitis].

BACKGROUND: The exclusion of donors with antibodies against the c-100 protein of the hepatitis C virus (HCV) has permitted a considerable reduction in post transfusional (PTH) non A non B hepatitis in those receiving transfusions. However, the risk has not been completely eliminated and there is evidence that some HCV carriers do not present detectable antibodies against protein c-100. In these cases a new diagnostic methodology, named polymerase chain reaction (PCR), permits the detection of the viral genome. METHODS: One hundred fifty eight prospective transfusion recipients were studied. Nineteen (12%) developed non A non B PTH criteria. The presence of anti c-100 and the viral genome were investigated by PCR in 17 of the patients. RESULTS: Nine of the 17 receptors (53%) with non A non B PTH presented antibodies against the HCV. In all patients and in two seronegative patients genomic sequences of HCV were detected by PCR. CONCLUSIONS: By a combination of genomic (PCR) and serological technique, 11 of the 17 transfusion recipients (64%) with non A non B PTH demonstrated evidence of HCV infection. In two cases the infection was seronegative. Although the HCV appeared to be the principal agent of the non A non B PTH in this study it could not be recognized in a third of the recipients who developed non A non B PTH.

Adult↗
PubMed1991

[The evidence of human immunodeficiency virus infection in the seronegative subjects of high-risk groups].

BACKGROUND: Polymerase chain reaction (PCR) is a new diagnostic procedure which has been used to recognise HIV-infected individuals who remain seronegatives. METHODS: Genomic DNA isolated from the peripheral blood mononuclear cells of 90 high-risk individuals were analyzed by PCR using gag primers SK 38/39. Subjects were classified in four groups: 42 drug abusers, 35 heterosexual partners of HIV-infected individuals, 9 homosexual men, and 4 health care workers accidentally exposed to HIV. Liquid hybridization using radiolabelled probes was done to confirm the results. All samples were also tested for HIV antigen and antibodies (Ab) using EIA and Western blot (WB). RESULTS: Two out of 11 (18%) drug abusers and 5 out of 34 (14%) couples were PCR positive in absence of HIV antibodies. This silent HIV infections were not recognized in homosexuals and health care workers. All 38 seropositive samples were PCR positive. None of the samples PCR+/Ab- was positive for HIV antigenemia or showed indeterminate results in the WB assay. CONCLUSIONS: Silent HIV infections were recognized in drug abusers (18%) and couples of HIV-infected individuals (14%). Mechanisms involved in the production of this "occult" HIV infections are reviewed.

HIV Antibodies↗
PubMed1991

[Abdominal tuberculosis in patients with acquired immunodeficiency syndrome].

BACKGROUND: In individuals with HIV infection, extrapulmonary forms of tuberculosis are considered as opportunistic infections and are included in the diagnosis of AIDS. They often have atypical clinical features. Abdominal participation is uncommon and its diagnosis may be difficult. METHODS: The clinical, radiological and pathological features of patients with a diagnosis of AIDS with abdominal tuberculosis in a series of 254 AIDS cases in a general hospital from 1984 to October 1990 were reviewed. RESULTS: Tuberculosis developed in 104 (41%) of AIDS patients. In 25 (24%) the disease was exclusively pleuropulmonary and in 79 (76%) extrapulmonary tuberculosis was present, either alone or in association. Extrapulmonary tuberculosis was the first opportunistic infection in 66 AIDS cases (26%). The abdominal participation was demonstrated in 19 patients, with the following localizations: lymph nodes (9), liver (8), spleen (5), ileum (1) and peritoneum (1). Four patients with splenic tuberculosis also had multifocal nodular lesions. CONCLUSIONS: Abdominal participation was found in 19 of the 104 AIDS patients with tuberculosis (18%). Lymph node involvement was the most common type. Hepatosplenic tuberculosis had a miliary form or showed multifocal images in echography or computed tomography.

Abdomen↗