ABSTRACT
The temporal relationship of serum levels of human immunodeficiency virus (HIV) RNA and of immune activation products in 10 HIV-seropositive persons who showed an accelerated decline (inflection point) in CD4 T cell counts and went on to develop AIDS and in 10 matched controls without inflection point were examined. Cases and controls did not differ statistically at the baseline time point for this study. CD4 cell inflection points occurred 18-30 months before AIDS development. Serum levels of soluble tumor necrosis factor receptor II, soluble interleukin-2 receptor, beta2-microglobulin, and neopterin increased significantly > or = 6 months before the CD4 cell inflection point. In contrast, increases in mean HIV RNA levels occurred at the time of the CD4 cell inflection point. These data are consistent with the view that in vivo immune activation precedes the increases in virus load and is followed by an accelerated and rapid loss of CD4 lymphocytes.
Subject(s)
CD4-Positive T-Lymphocytes/immunology , HIV Seropositivity/immunology , HIV-1/immunology , Lymphocyte Activation/immunology , Viral Load , Acquired Immunodeficiency Syndrome/immunology , Acquired Immunodeficiency Syndrome/physiopathology , Acquired Immunodeficiency Syndrome/virology , CD3 Complex/immunology , CD4 Lymphocyte Count , CD8-Positive T-Lymphocytes/immunology , Case-Control Studies , Disease Progression , HIV Seropositivity/physiopathology , HIV Seropositivity/virology , Homosexuality, Male , Humans , Male , RNA, Viral/bloodSubject(s)
Nurses , Primary Health Care , Religious Missions , Costa Rica , Humans , United States/ethnologyABSTRACT
After a scraping injury to the skin a 47-year-old man developed a generalized Nocardia brasiliensis infection with cutaneous, pulmonary and cerebral dissemination. There was no predisposing underlying illness. High-dosage cotrimoxazol and short-term intrathecal and systemic gentamycin administration achieved extensive healing. This form of treatment would thus seem capable of reversing the otherwise poor prognosis of generalized N. brasiliensis infection.