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Biomedical subjects

R Brindle

Publications and source records attributed to R Brindle.

25 records · Page 2Linked to original sources
PubMed1991

Cutaneous hypersensitivity reactions due to thiacetazone in HIV-1 seropositive patients treated for tuberculosis.

The effects of the human immunodeficiency virus (HIV) on tuberculosis management was investigated in 227 patients initially treated with a regimen containing streptomycin, isoniazid, and thiacetazone (STH). 93 of these 227 were HIV-seropositive. 60 patients, of whom 18 were HIV-seropositive, received a regimen consisting of streptomycin, isoniazid, rifampicin, and pyrazinamide (SHRZ) in the initial phase, and thiacetazone and isoniazid (TH) in the continuation phase. Cutaneous hypersensitivity reactions occurred in 22 of 111 (20%) HIV-seropositive patients, and in 2 of 176 (1%) HIV-seronegative patients (RR = 18, 95% CI 4.4-76, p less than 10(-7]. During the first 8 weeks of treatment 18 reactions occurred among the 93 HIV-seropositive patients on STH, whereas no reaction occurred in 17 HIV-seropositive patients during the initial phase of SHRZ/TH (p = 0.04). None of the 18 HIV-seropositive patients with cutaneous reactions who were subsequently challenged with isoniazid reacted, nor did any of the 10 tested with streptomycin, but 6 of the 7 challenged with thiacetazone reacted. 3 patients (all HIV-positive and with toxic epidermal necrolysis) died as a result of the cutaneous reaction. These results have major implications for tuberculosis control programmes in Africa.

Adult↗
PubMed1991

Comparative humoral responses to HIV-1 p24gag and gp120env in subjects from East Africa and the UK.

We compared 1616 sera from HIV-1-infected subjects and matched HIV-negative local controls in Uganda, Kenya and the UK. Sera were screened for specific antibody to HIV-1 p24 Gag and gp120 Env proteins and for p24 antigenaemia. In contrast to the UK, the majority of African HIV-1-infected subjects maintained detectable anti-p24 antibodies. However, lower reactivity of anti-p24 was observed in African AIDS patients, compared with those with asymptomatic HIV-1 infection. This reduction in anti-p24 reactivity with more advanced clinical stage was less marked in African HIV-1 infection than in the UK. Correspondingly, p24 antigenaemia was more common in patients with AIDS from the UK than in African patients (65 versus 4%). Reductions in anti-gp120 reactivity were observed in African AIDS patients, compared with the asymptomatic group. However, median reactivity of anti-gp120 in UK patients remained unchanged in both asymptomatic and AIDS subjects. The differences in humoral response to p24 and gp120 between Africa and the UK are semi-quantitative rather than qualitative and could be explained by initial higher antibody response to HIV-1 in African subjects.

Cross-Sectional Studies↗
PubMedDate not supplied

Toxoplasma antibodies in HIV-positive patients from Nairobi.

Sera from 94 patients infected with human immunodeficiency virus (HIV) 1, together with 86 controls, attending the Kenyatta National Hospital, Nairobi were examined for antibodies to Toxoplasma gondii using enzyme immunoassay and latex and dye tests. 54% had Toxoplasma-specific immunoglobulin G (IgG) by dye test. 22% of the HIV-positive group had IgG levels in excess of 180 units/ml (approximating to a dye test titre of 1:1300) compared to 1% of the HIV-negative group. There was no correlation between high levels of IgG and clinical stage of HIV disease or features indicative of active toxoplasmosis. It is proposed that the elevated serum IgG is a reflection of early Toxoplasma reactivation, not necessarily associated with disease.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Aspects of tuberculosis in Africa. 2. The value of microbiology in the management of tuberculosis in Nairobi, Kenya.

A group of African patients with tuberculosis were followed over the first month of treatment to assess the bactericidal response to 2 treatment regimens (streptomycin/thiacetazone/isoniazid and streptomycin/rifampicin/isoniazid/pyrazinamide). Patients also infected with human immunodeficiency virus (HIV) had lower pre-treatment counts of viable Mycobacterium tuberculosis and a greater proportion became culture-negative by 28 d. The response to therapy in HIV positive and HIV negative patients was similar. Because of the combination of these findings and the higher early mortality in patients with HIV, the causes of acute infection in patients with tuberculosis were studied. It was found that HIV positive patients were frequently bacteraemic and that the principal pathogen was Salmonella typhimurium, but recurrent pneumococcal bacteraemia was also seen.

Antitubercular Agents↗
PubMedDate not supplied

Brucellosis: imported and laboratory-acquired cases, and an overview of treatment trials.

Following the successful eradication of Brucella abortus infection in cattle, human brucellosis in England and Wales has become an uncommon imported disease. Culture of the organism presents a major laboratory hazard, and difficulties in identification may occur using a biochemical test-strip method. An overview of recent treatment trials of brucellosis indicates that regimens combining streptomycin and doxycycline are associated with a higher success rate (judged by the frequency of treatment failure and relapse following therapy) than combinations of rifampicin and doxycycline.

Adolescent↗