Assessment of HIV-intrathecal humoral immune response in AIDS-related neurological disorders.

Intrathecal synthesis of IgG directed to HIV antigens was investigated by antibody specific index (ASI), affinity-mediated immunoblot (AMI) and Western blot (WB) assay in a group of 88 AIDS patients of which 28 with HIV-associated neurological disorders (HAND), 13 without associated neurological disorders (WAND) and 47 with non-HIV-associated neurological disorders (non-HAND). CD4+ count was above 50 cells/mm3 (CD4+>50) in 30 and below 50/mm3 (CD4+<50) in 58 patients, respectively. A significantly higher frequency for CSF complete anti-gag profile (p<0.001), and for HIV-specific oligoclonal patterns ("mixed" pattern=p<0.01) was observed in HAND as compared to patterns from the other clinical groups. A decrease in complete anti-env, anti-pol and anti-gag reactivity was present in CSF of patients with CD4+<50 as compared to those with CD4+>50. Our findings suggest that AIDS appears to be characterized by an anti-HIV intrathecal humoral immune response which is principally directed to env products with a prevalence of oligoclonal patterns and CSF complete anti-gag profile in HIV-associated neurological involvement.

[Zinc and lymphocyte subsets in patients with HIV infection]. / Zinco e assetto linfocitario in pazienti con infezione da HIV.

Serum zinc levels were assayed in patients with AIDS and related syndromes, using spectrophotometry and atomic absorption. Statistical data have shown that serum zinc levels, in addition to being significantly lower (p less than 0.001) among different groups and controls, decrease progressively with the worsening of the clinical and immunological picture from LAS to AIDS. Serum zinc levels in patients with AIDS and ARC have, moreover, been demonstrated to be related (r = 0.8240; p less than 0.001) to the lymphocyte subset CD4 helper-induced. These results suggest that serum zinc determination and possibly zinc therapy might be reasonably considered in the management of patients with symptoms of HIV infection.

Treatment of cerebral malaria by erythrocyte exchange.

A 33-years-old male presented with a severe malaria, caused by a chloroquine resistant strain of Plasmodium falciparum. The number of parasitized erythrocytes reached 20% and the patient had cerebral complication. During the second hospital day, an erythrocyte exchange was performed as an in addition to chemotherapy. The patient's clinical condition improved and the parasitemia disappeared. The erythrocyte exchange is recommended in severe malaria, when parasitemia greater than 10%, with or without cerebral, renal or blood coagulation complications.

[Staphylococcal scalded-skin syndrome in AIDS]. / Staphylococcal scalded-skin syndrome in corso di AIDS.

The Authors report a case of SSSS in a patient with AIDS. SSSS in adults is rare. Immunosuppression for several causes could predispose towards SSSS. The principal diagnostic differential to be made is from toxic drug induced epidermal necrolysis. Exfoliative cytology and histology can be useful in the diagnosis.

Analysis of psychiatric consultations in patients with HIV infection and related syndromes.

Patients referred to the consultation-liaison psychiatry department of the University of Ferrara over a 12 month period were studied. About 13% of referrals concerned HIV patients. Comparison of HIV infected with non-HIV infected referrals revealed differences in the reasons for psychiatric consultation and the diagnosis made after assessment, as well as in the number of follow-up consultations. The implications of the findings are discussed.

[Hepatitis in thalassemia minor: incidence and evolution]. / Epatite nella talassemia minor: incidenza ed evoluzione.

Incidence, clinical course and outcome of viral hepatitis was evaluated during a 42 mo. study in 118 Thalassaemia minor patients, compared with a paired group of 123 nonthalassaemic subjects, matched for age, sex and number of drug addicts. In the thalassaemics, which account for 13% of residents in our area, acute hepatitis showed to have an incidence of 1.3-1.7 higher than the control group. The acute course was milder and more protracted and the number of evolution into chronicity was more elevated: 19.7% vs. 11.3%, following hepatitis B, and 40.6% vs. 23.7% following NANB hepatitis. However data were statistically significant only as regard as differences between ALT (p less than or equal to 0.05, B-H; p less than or equal to 0.01, NANB-H) and IgM in the group of B hepatitis only (p less than or equal to 0.05) Differences between elongation of course were also significant in both types of hepatitis (p less than or equal to 0.01). Pathogenetic aspects such as depressed cellular immunity and hepatic disorders due to thalassaemia, which may explain the higher incidence of hepatitis and the tendency of evolution into chronicity, are discussed.

Cutaneous cryptococcosis in AIDS: successful treatment with itraconazole.

A case of cutaneous cryptococcosis in a HIV-positive 46-year-old farmer is presented. The situation could be cured by applying itraconazole 400 mg day-1 for 45 days.