Transforming growth factor beta-1 and interferon-alpha in the AIDS dementia complex (ADC): possible relationship with cerebral viral load?

Mechanisms involved in the pathogenesis of the AIDS-dementia complex are still unclear. The dichotomy between a small number of HIV-infected cells in the brain and their marked dysfunction could be related to a cellular amplification and/or activation of cerebral viral load by several cytokines. This link between cytokines and viral load could play a role in the generation of the clinical dementia syndrome. We have studied cerebral levels of transforming growth factor-beta1 and interferon-alpha, both in the mild and severe AIDS-dementia complex and also compared these cytokines with HIV RNA load in patients with different degrees of dementia. Our data indicate that production of different cytokines characterized the expression of clinical dementia. In the mild AIDS-dementia complex, there was a significant inverse correlation between interferon-alpha and transforming growth factor-beta1 (r = - 0.743; p < 0.001), and HIV-RNA was present in inverse proportion to transforming growth factor beta1 (r = - 0.751; p < 0.001). In patients with severe AIDS-dementia, transforming growth factor-beta1 was undetectable, while interferon-alpha level were higher than in mild AIDS dementia and correlated positively to cerebral HIV-RNA. No significant difference was evident between these cytokines in the serum of ADC patients and in the control samples. Our study suggests that a relationship is possible between productive HIV infection in the cerebral nervous system and a heterogenous and different expression of the immune response via a complex interaction of cytokines with a differential modulation of the dementia phenotype.

Hepatitis C virus among health care workers.

The purpose of our study was to describe the results of a seroprevalence survey for HCV antibody among health care workers at our center. 961 specimens were consecutively obtained under code and screened for anti-HCV by the second generation immunoblot assay (RIBA 2) and hepatitis B core antibody by CORAB test. After serum samples were tested, we reviewed demographic data and categorized four groups: intravenous drug abusers (IVDAs), blood recipients, health care workers and apparently healthy subjects. 51/97 (52.6%) IVDAs, 8/77 (10.4%) transfusion recipients, 12/472 (2.5%) health care workers and 8/285 (2.8%) apparently healthy subjects were anti-HCV positive. Furthermore dividing health care personnel by type of profession we found that surgeons have a higher seroprevalence (4.3%) compared to other professions. Therefore severe preventive standards are required for health care workers.

Hepatitis C virus infection in family members of chronic carriers.

To determine the transmission of hepatitis C in family members of chronic carriers we study the results of a HCV seroprevalence among spouses and children living together with patients affected by HCV related chronic liver disease. Seroprevalence of HCV antibodies and mean cohabitation time was determined among 54 index patients, their 54 spouses and 99 children. Twelve spouses (22.2%) and no children were anti-HCV positive, with an overall seroprevalence of 7.8%. Couples with both anti-HCV positive partners had a mean cohabitation time (31.8 +/- 10.4 years) higher compared to couples with only one anti-HCV positive partner (24.6 +/- 9.9 years) and children (19.1 +/- 10.2 years). Sexual transmission of HCV infection cannot be excluded and its prevalence is strongly associated to the length of cohabitation time.

Hepatitis C virus in prisoners.

The purpose of this study was to assess the epidemiology of hepatitis C virus (HCV) in prisoners and outpatients attending our center. 2205 specimens were consecutively obtained under code and screened for anti-HCV by the second generation RIBA test and Hepatitis B core antibody (HBcAb) by CORAB test. After serum samples were tested, we reviewed demographic data and categorized four groups: Intravenous drug abusers (IVDAs), prisoners and apparently healthy subjects and warders. Anti-HCV prevalence was 59.4% in 613 IVDAs, 15.5% in 756 prisoners, 2.6% in 454 healthy subjects and 2.8% in 145 warders. These findings suggest that prisoners may be considered a group at increased risk for HCV infection.

Cerebrospinal fluid cytokines in AIDS dementia complex.

We evaluated cerebrospinal fluid (CSF) and serum concentrations of interleukin-1-alpha (IL-1-alpha), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-alpha) in 30 patients with AIDS dementia complex (ADC), and in 20 HIV-seronegative subjects with other neurological diseases (OND). CSF TNF-alpha, IL-1-alpha and IL-6 were more frequently detectable in ADC patients than in OND subjects. These cytokines were also detectable in CSF of ADC patients with minimal symptoms. In contrast, the majority of both ADC and OND patients did not contain detectable serum levels of cytokines. Our data support the notion of intrathecal synthesis of cytokines in ADC patients and raise the possibility that activated macrophages may play a significant role in the pathogenesis of ADC.

Cerebrospinal fluid interleukin-6 and IgE in bacterial and viral meningitis.

The aim of the present study was to assess the significance of IgE and interleukin-6 (IL-6) in paired CSF and serum of patients with viral and bacterial infections of the central nervous system. The results suggest that the detection of IL-6 and IgE in CSF is an useful marker for monitoring course and prognosis of these patients.

Hepatitis C virus-related acute and chronic hepatitis in hemodialysis patients.

The incidence of HCV antibodies has been evaluated in 123 chronic hemodialysis (HD) patients (Group A; 55 M and 68 F) and in 37 consecutive HD patients (group B) admitted to our hospitals for acute hepatitis. In group A, HCV antibodies were present in 27% of the patients. 20 of 36 (55%) had previously received blood transfusions. 21 patients (58%) were also positive for HBV Ab. In 8 patients, ALT were significantly increased. In group B, the diagnosis of HCV-related acute hepatitis was made in 11 patients. 8 of them had previously received blood transfusions. Seroconversion occurred 2-3 months after onset of the disease.

[Levels of interleukin-4 (IL-4) in lymphocyte cultures of subjects with HIV-1 infection]. / Levels of interleukin-4 (IL-4) in lymphocyte cultures of subjects with HIV-1 infection.

The authors report IL-4 levels in peripheral blood mononuclear cells (PBMC), stimulated with MoAb anti-CD3, in subjects with HIV-1 infection, classified according to the criteria of Centers for Disease Control (CDC) in various stages. The results "in vitro" have indicate that PBMC IL-4 levels were in normal range also in advanced stages of retroviral infection, and were correlated to low levels of CD4+ lymphocytes and, sometimes, to high levels of IgE immunoglobulins. The normality of IL-4 levels in advanced stages or in presence of decreased CD4+ cells, suggests that the production of this cytokine is also present in other subsets of mononuclear cells not involved in this infection. Moreover the presence of significant correlation between high levels of Ig E and IL-4 suggests a possible pathogenetic role of IL-4 in the determination of isotypic switch of this immunoglobulin.

[HCV and HBV infection in 3 communities in the Neapolitan area]. / Infezione da HCV ed HBV in tre comunita' dell' area napoletana.

Using the antibody to HCV and HBc (anti-HCV, anti-HBc), we studied the prevalence of Hepatitis C and B virus in three groups: intravenous drug abusers, subjects lodging in huts and elderly clergymen. Statistical analysis was carried out by chi-square and Fisher's exact tests. Our results show statistical significance for anti-HCV seroprevalence among the three groups, while anti-HBc doesn't differ. These preliminary data seem to show that the two viruses have different ways of transmission.

Seroprevalence of HBV and HCV markers among intravenous drug abusers and subjects affected by chronic active hepatitis.

In order to investigate the seroprevalence of HBV and HCV in neapolitan area, we studied blood specimens of 180 IVDAs, 115 CAH patients and 72 healthy subjects using hepatitis B core (anti-HBs) and hepatitis C antibody (anti-HCV). High frequency of anti-HBs (80.9%) and strong association with an unexpected seroprevalence of anti-HCV (67%) was found in CAH patients. Our study does not explain these results, but suggest either a possible inference between both viruses or that serum from CAH subjects contains a component that gives false positivity.

[Alveolo dental injuries in children]. / I traumi alveolo dentari in età pediatrica.

The frequency of alveolo-dental traumas in children necessitates a thorough study of their etiopathogenesis, diagnosis and therapy. The paper describes the authors' personal experience.