Biomedical subjects
Publications and source records attributed to L Gürtler.
By December 1988 reports on 525 ARC- (AIDS-Related Complex) and AIDS-patients with neurological or neuropsychological signs treated with Zidovudine (AZT = 3'-Azido-2,3'Dideoxythymidine) had been published in literature. In 204 (38.8%) cases of HIV infection a temporary improvement in the neurological deficits was reported. Peripheral and central neurological side-effects were observed in 124 (23.6%) patients.
The long-range prognosis of viral diseases must be assessed differently according to their geographical occurrence. The genetic disposition, environmental factors and additional infectious diseases play a decisive part here. Vaccinations are the most important measures in the prevention of these infections. The spectrum of possible chemotherapeutic intervention for viral infectious diseases is very small, which usually makes specific treatment impossible. The most important infective viruses epidemiologically, which lead to persistent complications, are discussed in detail as follows: influenza virus, measles virus, human T-cell leukaemia virus, human immuno-deficiency virus, hepatitis B and C virus. In a discussion conclusions are drawn from the virologist's point of view for a possible long-range prognosis, which depends on the one hand on the infective agent and on the other on individual reactivity. The last chapter talks about insurance medical aspects of the most important infective viruses, which have already been discussed virologically. Some scientific developments are shown which could be future solutions of problems in diagnosis and prognosis. Such new developments could help insurance medical officers to important decision parameters for long-range prognosis, which are still largely missing at present.
Since 1986 the notation Human Immunodeficiency Virus (HIV) is used for the retroviral agent of the Acquired Immunodeficiency Syndrome (AIDS). At the beginning of the therapeutical interest in the immunodeficiency syndrome have been primarily focussed in the internal complications. 1982 one reported for the first time about nervous system manifestations (NS-M) in HIV-patients; according to the latest reports NS-M are diagnosed in 39-63% of these patients. In this review all important aspects of the pathogenesis, clinic and therapy for the HIV-associated peripheric- and central-neurological (like e.g. acute and chronic meningitis/meningoencephalitis, dementia, opportunistic infections, polyneuropathies and myopathies) and psychiatric diseases are described.
A seroepidemiological study on the prevalence of antibodies against hepatitis A virus (HAV), hepatitis B virus (HBV) and Treponema pallidum was conducted in various groups of the population of the state of Mauritus (Islands of Mauritus and Rodrigues). 618 sera were tested. The overall prevalence of anti-HAV was 86.1% and yielded and age-dependent increase. Serological evidence for acute or chronic HBV infection was found in 3.8%; 4.5% were positive for anti-HBc alone, and in 12.6% past HBV infection was detected. No age- or sex-dependent increase in the prevalence of anti-HBc was found. There were differences in the anti-HBc prevalence among the various groups of population ranging from 5.9 (flight personnel) to 58.3% (prison inmates). Treponemal antibodies were detected in 6.0% and showed a fairly marked age-dependent increase. Our study suggests that vaccination programmes against HAV and HBV would be beneficial for the Mauritian population.
The (K15R M52E) aprotinin is a recombinant molecule with a broader inhibition spectrum against serine proteinases and a higher affinity towards certain proteinases as compared to native aprotinin. This aprotinin variant was produced in E. coli, isolated and purified to homogeneity. The inhibitor was further tested for its effectiveness to reduce human immunodeficiency virus type 1 (HIV-1) replication. Virus growth was followed by an ELISA which detects the amount of virus core protein p24. At a concentration of 50 microM, the recombinant (K15R M52E) aprotinin clearly reduced HIV-1 replication in H9 cells.
Four instrument-free, visually read assays for detection of HIV-1 antibody were evaluated using 1,133 serum specimens from blood donors and patients in a rural hospital in Northern Zaire. Sensitivity for the four assays ranged from 85.9% to 95.0% and specificity ranged from 88.5% to 98.6%. Problems were caused by uninterpretable results in the range of 2.8% to 7.8%, decreasing somewhat the value of those systems. Based on our results, practicability and costs of the assays, we propose a hierarchy for testing for blood donors and for diagnosis of AIDS, adapted for hospitals in tropical countries.
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A newly developed recombinant antigen-based anti-HIV-1/HIV-2 enzyme immunoassay (Abbott Recombinant HIV-1/HIV-2 EIA) was evaluated against a second generation anti-HIV-1 EIA (Abbott Recombinant HIV-1 EIA). Five thousand and twenty-nine sera from European blood donors and 403 sera from central African blood donors were used in the evaluation, along with four panels and one cohort. The panels included 99 'problem' sera, 733 sera with antibodies to HIV-1 from asymptomatic people and from patients at different disease stages, 25 serial bleeds from five plasmapheresis donors seroconverting for antibodies to HIV-1, and 202 sera with antibodies to HIV-2 collected from healthy and diseased people of European or west African origin. In addition, 734 sera collected from a west African cohort were tested. Using Western blot as the reference standard, the specificity obtained by the recombinant anti-HIV-1 EIA (HIV-i EIA) was 99.90% [99.81-99.99%; 95% confidence limits (95% CL)] with European blood donor sera; 99.50% (98.78-100%) with Central Africa blood donor sera; 92.93% (87.78-98.08%) with 'problem' sera and 99.43% (98.87-100%) with sera from a west African cohort. Using the same samples, the recombinant anti-HIV-1/HIV-2 EIA (HIV-1/HIV-2 EIA) yielded a specificity of 99.84% (99.73-99.95%), 99.50% (98.78-100%), 95.96% (92.00-99.92%) and 98.58% (97.69-99.47%), respectively. All 776 Western blot-confirmed anti-HIV-1 sera were reactive in both EIAs, and the EIA-reactive samples from seroconverting plasma donors were always observed for both assays in the same serial bleed. For HIV-2, the HIV-1 EIA yielded an overall sensitivity of 75.83% (69.93-81.72%) compared with 99.53% (98.58-100%) for HIV-1/HIV-2 EIA. The addition of a recombinant env-protein of HIV-2 to the recombinant env and core proteins of HIV-1 on the solid phase of HIV-1 EIA improved the detection of anti-HIV-2 while preserving the assay's overall specificity and sensitivity for the detection of anti-HIV-1.
Between March 30 and July 31, 1989, 117,874 blood donations were tested for anti-HIV-1 and in a combined ELISA for anti-HIV-1/HIV-2 (both Abbott). On each repeat reactive (14 = 0.01% for anti-HIV-1 and 400 = 0.34% for anti-HIV-1/HIV-2), a Western blot (WB) was performed. Two donors, who tested repeatedly reactive in both ELISAs, were confirmed anti-HIV-1 positive by WB. As the specificity of anti-HIV-1/HIV-2 ELISA is considerably lower (99.66%) than of anti-HIV-1 (99.99%), introduction of a different HIV-2 specific ELISA should be discussed to prevent loss of too many blood donations and donors through anti-HIV screening.
The terminal carbohydrate residues of HIV I and II were detected by ferritin labeled lectins in electron microscopy. Different cell lines, which were infected with HIV I and II, expressed different terminal carbohydrate residues, which could also be detected on the viral envelope by electronmicroscopy. Especially N-Acetylgalactosamine residues were detected by Vicia villosa agglutinin only on Jurkat cells. This may have functional implications, since this lectin recognizes contrasuppressor T cells.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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After incubation of H9 cells infected with human immunodeficiency virus (HIV) with pepstatin A at 10(-4) M for 2, 4, or 11 days, the culture medium contained significantly less HIV core antigen (p24) than controls without pepstatin A and no or only borderline activity of reverse transcriptase was detected. In addition, after pepstatin A treatment no infectious HIV at 2 or 4 days and only minimal amounts at 11 days were detectable in the culture medium.
Recent data suggest that the pathogenicity of HIV is mediated by the production of metabolised viral components which act as hormones. In particular the replication and maturation of T-lymphocytes, and the cellular interaction of immunocompetent cells and nerve cells are affected. The recognition of HIV by the immune system and consequently also the progression of the disease, is influenced by the HLA-type (DR-1) of the infected person. Replication of HIV may be accelerated by the simultaneous presence of other viruses (i.e. cytomegalovirus). So-called apathogenic, attenuated HIV variants have been described.
The prevalence of 1) hepatitis C virus (HCV), an agent likely to be responsible for parenterally transmitted hepatitis non-A, non-B, 2) hepatitis B virus (HBV) and 3) human immunodeficiency virus (HIV) infection was studied in 211 patients with clotting disorders (78% of the patients had residual factor activities of less than or equal to 2%). Of these patients 71% were positive for HBV markers and 44% for HIV markers. Using a new ELISA technique, 80% were anti-HCV-positive. The prevalence of anti-HCV was greater in patients with more severe clotting disorders and was related to the total amount of replacement therapy received; the prevalence was less in older patients. Seroconversion after a single exposure to dry heat-treated factor concentrates was documented in 3 patients 3-4 months after exposure.