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Biomedical subjects

R Colebunders

Publications and source records attributed to R Colebunders.

At least 163 records · Page 9Linked to original sources
PubMed1990

Isolation of mycobacteria from stools and intestinal biopsies from HIV seropositive and HIV seronegative patients with and without diarrhea in Kinshasa, Zaïre. Preliminary results.

To determine the role of mycobacteria as etiologic agent in HIV related enteritis in Africa, the following study was performed in 1986, in the department of Internal Medicine in Mama Yemo Hospital in Kinshasa, Zaire. Stool and intestinal biopsies were obtained from HIV seropositive and HIV seronegative patients with and without diarrhea. Patients with known Mycobacterium tuberculosis infection were not enrolled. Acid fast bacilli were found in fecal smears of 6 (10%) of 59 HIV seropositive patients and in none of 41 HIV seronegative patients (p = 0.04). Isolation rates of mycobacteria were slightly lower in HIV seropositive patients than in HIV seronegative patients (25% vs 44%, p = 0.08) and significantly lower in patients with diarrhea than in patients without diarrhea (15% vs 44%, p = 0.02). Mycobacterium avium-intracellulare was the species most frequently isolated from stools, in 12% of the HIV seropositive and in 22% of the HIV seronegative patients. Mycobacteria were not isolated from any of the intestinal biopsies obtained in 17 HIV seropositive patients with persistent diarrhea and any of these biopsies showed histological evidence of a mycobacterial infection. This study suggests that mycobacteria do not seem to play a major role in causing diarrhea in HIV seropositive patients.

Adult↗
PubMed1988

Parotid swelling during human immunodeficiency virus infection.

In Europe and in the United States, bilateral parotid gland swelling has been observed as a sign of human immunodeficiency virus (HIV) infection in children, but it has not been associated with HIV infection in adults. We observed a chronic parotid gland swelling in nine HIV-seropositive patients during a nine-month period in Kinshasa, Zaire. Parotid gland enlargement was bilateral in seven patients (78%), slightly painful in seven patients (78%), and painless in two patients (22%). No evidence of inflammation was observed around Stensen's duct. One of the two patients in whom a parotid gland biopsy was performed had a malignant lymphoma of the large-cell, histiocytic type. In the other patient, the parotid gland showed normal morphology with minor inflammation. Among 284 adults and 40 children with symptomatic HIV infection, chronic parotid gland enlargement was observed in none of the patients. However, two (0.7%) of the adults presented with an acute pyogenic parotitis. Further studies are needed to determine whether parotid gland enlargement is associated with HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Herpes zoster in African patients: a clinical predictor of human immunodeficiency virus infection.

A recent episode or a history of herpes zoster was found in 30 (11%) of 284 patients hospitalized with human immunodeficiency virus (HIV) infection at Mama Yemo Hospital, Kinshasa, Zaire. Of 146 African patients with a history of herpes zoster who were referred to us by physicians at the Mama Yemo Hospital, 133 (91%) were HIV seropositive. The clinical characteristics of the herpes zoster episodes did not differ between HIV-seropositive and -seronegative individuals, except that 23% of the HIV-seropositive patients experienced recurrences compared with none of the HIV-seronegative patients (P = .05). No patient developed a generalized herpes zoster eruption, and only patients with ophthalmic zoster developed related complications. Patients who experienced severe pain during their herpes zoster attack lost more weight than did those who had only minor pain (P = .0003).

Acquired Immunodeficiency Syndrome↗
PubMed1988

Acute HIV illness following blood transfusion in three African children.

Three children are described in whom pre-transfusion samples were HIV-seronegative and post-transfusional samples, obtained within 1 week after transfusion, were HIV-seropositive. Two of them developed a transient fever within 1 week of receiving the blood transfusion, and a transient generalized skin eruption which lasted for about 2 weeks. All three developed persistent generalized lymphadenopathy. One child developed a lumbar herpes zoster 7 months after transfusion. IgM Western blots demonstrated the presence of antibodies to protein bands p17, p24 and p55 in all three children. These three case reports suggest that children who receive a seropositive blood transfusion are at high risk for developing acute manifestations of HIV infection.

Acute Disease↗
PubMed1988

Comparison of sensitivities and specificities of latex agglutination and an enzyme-linked immunosorbent assay for detection of antibodies to the human immunodeficiency virus in African sera.

The sensitivities, specificities, and positive and negative predictive values of the Cambridge BioScience Corp. (Worcester, Mass.) human immunodeficiency virus latex agglutination assay were compared by using three different blood preparations. By using the manufacturer's standard test method with diluted sera, the sensitivity of latex agglutination was 100%, the specificity was 99.58%, and the positive and negative predictive values were 99.26 and 100%, respectively. Use of diluted whole blood or undiluted whole blood did not significantly affect the sensitivity (mean, 99.72%), specificity (mean, 99.47%), positive predictive value (mean, 99.07%), or negative predictive value (mean, 99.89%). The latex agglutination assay is a simple, rapid assay for the detection of human immunodeficiency virus that would be useful in Third World countries or other areas where enzyme-linked immunosorbent assays are not available or cannot be used.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Persistent diarrhoea in Zairian AIDS patients: an endoscopic and histological study.

To determine the aetiology of persistent diarrhoea in African patients with acquired immunodeficiency syndrome (AIDS), 42 patients with human immunodeficiency virus (HIV) and persistent diarrhoea were enrolled in a microbiological, endoscopic, and histological study. Cryptosporidium was the intestinal parasite most often identified (30%); Isospora belli was found in 12% of the patients. Histological examination of the duodenal mucosa showed a non-specific inflammatory reaction in a significantly higher number of HIV-seropositive patients (82%) than HIV-seronegative controls without diarrhoea (52%) (p = 0.02). Lymphocytes were more likely to be found in inflammatory reactions in HIV-seropositive patients than in controls (p less than 0.0001). Pathogens were observed in histological sections of the duodenum of HIV-seropositive patients only (p = 0.002) and included cryptosporidia (four patients) Isospora belli (one), Strongyloides stercoralis (one), and Cryptococcus neoformans (one). On histological examination the rectal mucosa of HIV-seropositive patients and controls was similar, except eosinophils were more likely to be present in inflammatory reaction in HIV-seropositive patients (p = 0.05) and enteric pathogens were observed only in HIV-seropositive patients (cytomegalovirus inclusion bodies (one) and Schistosoma mansoni (two). The aetiology of persistent diarrhoea in most African AIDS patients remains unclear.

Democratic Republic of the Congo↗
PubMed1988

Evaluation of the WHO clinical case definition for AIDS in rural Zaire.

The clinical case definition for AIDS proposed by WHO for use in Africa was evaluated against HIV antibody status in 72 patients in rural Zaire. Twenty-one (29%) of the patients were antibody-positive. For diagnosing anti-HIV seropositivity, the case definition had a sensitivity of 52%, a specificity of 78%, a positive predictive value of 50% and a negative predictive value of 80%. Calculation of the positive predictive value at different levels of prevalence of HIV infection suggests that the case definition operates at maximum reliability in selected high-risk groups. Modifications to the case definition should be evaluated to try and improve its sensitivity and positive predictive value.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Evaluation of a clinical case-definition of acquired immunodeficiency syndrome in Africa.

A provisional clinical case-definition for acquired immunodeficiency syndrome (AIDS) developed by the World Health Organisation (WHO) for use in Africa was tested on 174 inpatients at Mama Yemo Hospital, Kinshasa, Zaire. In this hospital population with a 34% infection rate of human immunodeficiency virus (HIV), the clinical case-definition had a specificity of 90%, a sensitivity of 59%, and a predictive value of 74% for HIV seropositivity. These results support the use of the WHO clinical definition for AIDS in Africa. However, since HIV prevalence and disease expression vary, similar evaluations should be carried out in different regions.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Generalized papular pruritic eruption in African patients with human immunodeficiency virus infection.

Of 284 patients hospitalized with HIV infection, 52 (18%) presented with a generalized pruritic papular eruption. No significant association between this eruption and other HIV manifestations or any opportunistic infection was found. Fifty-three of 61 (87%) consecutive African patients referred for a generalized papular pruritic eruption of unknown etiology of at least 1 month's duration were HIV seropositive, including 15 (65%) of 23 in good general condition. Thirty-seven (95%) of 38 patients with this eruption and severe weight loss (greater than 10% of normal body weight) were seropositive. The initial skin lesions were small, firm, intensely pruritic papules which released a small drop of clear fluid when scratched. Scratched papules became later hyperpigmented macules. Lesions were symmetrically distributed over the body and were most frequently found on the extensor surfaces of the arm, the dorsal surface of the hands, the inferior part of the legs, the ankles and the dorsum of the feet. Histologic examination showed a non-specific inflammatory reaction. Thirty-three (51%) patients reported that the skin eruption was their initial disease manifestation. In African patients, the presence of an unexplained generalized pruritic papular eruption is highly indicative of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1987

AIDS in Africa: a public health priority.

AIDS and HIV infection are now endemic in many parts of Africa. The infection is mainly transmitted by heterosexual activity, as illustrated by a 1:1 female to male case ratio and high HIV seroprevalence rates in people at risk for sexually transmitted diseases and female prostitutes. Transmission by blood transfusions, contaminated injections and from mother to child is occurring more frequently than in Europe. AIDS will probably have a profound impact on health care programmes and economic development in the continent, and its control should be a public health priority.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Clinical manifestations and the natural history of HIV infection in adults.

The clinical expression of infection with the human immunodeficiency virus (HIV) appears increasingly complex. It includes manifestations due to opportunistic diseases, as well as illness directly caused by HIV itself. Neurologic disease may include involvement of the brain, spinal cord and peripheral nerves and is probably directly caused by HIV, as is lymphocytic interstitial pneumonia. The etiology of the chronic diarrhea and a papular pruritic skin eruption associated with HIV infection is unclear. Between 2% and 8% of HIV-infected persons progress to the acquired immunodeficiency syndrome (AIDS) per year, with no apparent decrease in the rate of disease progression over time. A chronically activated state secondary to chronic microbial antigenic exposure may increase both the susceptibility to HIV infection and development of disease. Increased HIV gene expression, followed by persistent antigenemia, appear to be triggering factors in clinical deterioration. The role, if any, of environmental and/or genetic cofactors remains unclear.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Persistent diarrhea, strongly associated with HIV infection in Kinshasa, Zaire.

Ninety-eight (40%) of 243 acquired immune deficiency syndrome inpatients at Mama Yemo Hospital, Kinshasa, Zaire, presented with a history of diarrhea for at least 1 month. To determine the predictive value of persistent diarrhea for human immune deficiency virus (HIV) infection, 128 consecutive patients presenting at Mama Yemo Hospital with persistent diarrhea were tested for the presence of HIV antibodies. One-hundred seven (84%) of the 128 patients with diarrhea lasting at least 1 month were found to be HIV seropositive. HIV seropositive patients with persistent diarrhea more often had a generalized papular pruritic eruption (p = 0.02), a genital herpes simplex infection (p = 0.05), a history of herpes zoster (p = 0.08), and infection with cryptosporidia (p = 0.006) than HIV seronegative patients with persistent diarrhea. Bacterial enteric pathogens were found in 5 (7%) of the 76 seropositive and in none of the 14 seronegative patients in whom stool cultures were performed. Presently persistent diarrhea in adults in central Africa is strongly associated with HIV infection, but the pathophysiological mechanisms causing this diarrhea remain unclear.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Evidence of functional cellular immune impairment in an adult Belgian with visceral leishmaniasis acquired in Spain.

An adult Belgian patient with visceral leishmaniasis acquired while on holiday in Spain is described. This patient's cellular immunity was assessed by skin testing using six different antigens and was normal just before leaving for Spain. During the leishmaniasis, skin tests with the same antigens showed complete anergy. Lymphocyte transformation tests to antigens and mitogens were severely impaired but normal T cell subsets determined by OKT monoclonal antibodies were found. Immune complexes, containing antibodies to Leishmania antigen were isolated during the patient's illness. It is most likely that visceral leishmaniasis caused the functional cellular immune impairment of the patient.

Antigen-Antibody Complex↗