Effect of oral beta-carotene supplementation on plasma human immunodeficiency virus (HIV) RNA levels and CD4+ cell counts in HIV-infected patients

We conducted a pilot, open-label study to assess the effect of short-term beta-carotene administration (180 mg/d with meals for 4 weeks) on the plasma human immunodeficiency virus (HIV) RNA levels and CD4+ lymphocyte counts in 21 HIV-infected patients. We found that plasma HIV RNA levels and CD4+ lymphocyte counts did not change following this short course of beta-carotene supplementation. Patients with lower serum concentrations of beta-carotene before supplementation were no more likely to have an increase in their CD4+ lymphocyte count or plasma HIV RNA copy number than were those with higher concentrations. No correlation was found between pre- or postsupplementation beta-carotene or vitamin A concentrations and pre- or postsupplementation CD4+ lymphocyte counts or plasma HIV RNA titers. This study provides no support for beta-carotene supplementation for HIV-infected subjects with normal baseline serum levels of beta-carotene and vitamin A.     

ABV方案化疗对艾滋病相关晚期卡波氏肉瘤外周血CD4淋巴细胞的影响

Objective: The combination of highly active antiretroviral therapy (HAART) and chemotherapy with ABV regimen (doxorubicin, bleomycln and vincristine) is a promising approach for the treatment of advanced HIV-related Kaposi's sarcoma (KS). Here we analyzed the relationship between the CD4 lymphocyte cell count and the clinical response to chemotherapy.Methods: The 176 HIV infected patients with advanced KS who failed to respond to prior HAART were selected. All these patients were then preceded to chemotherapy with ABV regimen which was administered at 3 weekly intervals for 6 cycles.For each patient CD4 cell count was done before starting chemotherapy and after finishing 6 cycles of chemotherapy. The difference of CD4 cell counts pre chemotherapy and post chemotherapy was compared with the clinical progress of the patients after 6 cycles of chemotherapy. Results: The overall clinical remission was shown in 93.7% patients. Progressive disease (PD) and no change in clinical condition (NC) was shown in 6.3% patients. The increase in CD4 cell count post chemotherapy was found in 89.8% patients and the decrease in CD4 cell count was seen in 10.2% patients. The difference of the mean CD4call counts for patients in group CR + PR (complete relief + partial relief) before and after chemotherapy was highly significant.The difference of the mean CD4 cell counts for patients in group NC + PD before and after chemotherapy was not significant.The difference in CD4 cell counts in CR + PR and NC + PD groups before and after chemotherapy was highly significant.Conclusion: The HIV related KS patients on HAART benefit from the chemotherapy as it increases the CD4 cell count and it has positive impact on clinical remission of KS.     

Assessments of plasma HIV RNA and CD4 cell counts after combined Pneumovax and tetanus toxoid vaccination: no detectable increase in HIV replication 6 weeks after immunization

AIM: To study the cardiovascular effect of total soyabeans saponins (TS) in brain and its relationship with monoamines. METHODS: After injection of TS (75 micrograms) into ventriculus lateralis cerebri (VLC) the changes of blood pressure (BP) and heart rate (HR) were observed and the contents of monoamines both in peripheral blood and brain (telencephalon, diencephalon, brainstem) were measured respectively by HPLC-ECD and fluorophotometry. RESULTS: After injection of TS into VLC, BP rise from 11.59 +/- 0.84 to 14.59 +/- 0.69 kPa; HR increased from 411 +/- 21 to 465 +/- 14 bpm; the contents of NE and E in peripheral blood increased from 6 +/- 3 to 64 +/- 44, from 6 +/- 2 to 38 +/- 34 nmol/L plasma, respectively, NE in brainstem increased from 14 +/- 0 to 18 +/- 3 nmol/g wet tissue respectively, but the contents of 5-HT in the 3 areas measured in the experiment decreased: in telecephalon from 9 +/- 1 to 5 +/- 1, in diencephalon from 14 +/- 2 to 7 +/- 2, in brainstem from 14 +/- 3 to 6 +/- 1 nmol/g wet tissue. CONCLUSIONS: The cardiovascular effects of TS in CNS were involved in the monoamine transmitters.     

Interrelationship between the duration of HIV infection, viral load and CD4 positive lymphocyte count

BACKGROUND: The decline in CD4+ lymphocytes occurs at different rates in patients with HIV infection. A longer duration of HIV infection and a higher level of viral replication, represented by the viral load, are associated with a lower CD4+ lymphocyte count. However, the interelationship between these variables is still not well known. PATIENTS AND METHODS: 107 HIV-infected patients for whom the date of infection was known, were included in a transversal study, in which the CD4+ lymphocyte count and the plasma viral load were analysed, the last using an isothermal amplification method (NASBA). Patients were not receiving antiretroviral drugs or suffered intercurrent infections at the time of the study. RESULTS: The mean duration of HIV infection was 8.6 +/- 2.9 years. The mean CD4+ lymphocyte count was 366 +/- 264 x 10(6)/l. The mean plasma viraemia was 4.3 +/- 0.9 logs. In a linear regression model, the CD4+ lymphocyte count was explained in 21.7% of cases by the duration of HIV infection, meanwhile the viral load justified up to 36.2 of CD4+ cell variability. When both parameters were combined, up to 58.4% of CD4+ lymphocyte values were explained. In this model, changes of 1 log in viral load had a 4-fold higher effect on the CD4+ cell count than each year of HIV infection. CONCLUSIONS: The duration of HIV infection and, particularly the viral load strongly influences the current CD4+ lymphocyte count, although other variables should exist (virus with syncytium-inducing phenotype, age of the patient and his immunegenetic repertoire) influencing the different decline seen in CD4+ T-cells.     

CD4+ T-lymphocyte variations in patients with advanced human immunodeficiency virus infection and counts below 100 cells per microliter

Especially in the inpatient treatment of adolescents the phase of termination is decisive, because important issues and developmental tasks are re-experienced by the young patient. Therefore a sufficient relief from symptoms cannot serve as the main criterium for termination. Instead the ego-development with all its aspects and the improvement of the capacity for emotional relationship is most important. The paper discusses some central dynamic factors of the termination phase. Most of these processes are also induced inside the therapeutic team thus leading also to a kind of separation crisis in the team.     

Neuropsychological performance and CD4 levels in HIV-1 asymptomatic infection

The performance of 68 HIV-1 seropositive asymptomatic (HIV+) subjects stratified on CD4 levels were compared with 82 HIV-1 seronegative (HIV-) subjects on a battery of neuropsychological, mood state, and perceived health status measures. The neuropsychological test battery included measures of attention, reaction time, memory, intellectual ability, psychomotor speed, frontal lobe or "executive" function, and decision time. None of the HIV+ subjects were taking antiviral agents. The groups did not differ for age, mood state, or WAIS-R Verbal and Performance IQ scores. Due to group differences for education and weekly ethanol consumption, both variables were used as covariates in multivariate analyses of variance. Relatively few differences were observed between subgroups of HIV+ patients or between these subgroups and control subjects. These data suggest that factors other than absolute levels of immunosuppression as expressed by CD4 levels alone, appear to be responsible for the deficits observed in HIV+ asymptomatic patients.     

The prognostic value of CD44 isoform expression in endometrial cancer

Elite sport requires high training volumes. However, little is known about the relationship between training volume and performance development. This relationship appears to have an inverted U-shape. Short-term overtraining or overreaching is probably associated with insufficient metabolic recovery, resulting in a decline in ATP levels. Systemic overtraining or staleness is attributed to failure of the hypothalamus to cope with the total amount of stress. Clinically, a parasympathetic and sympathetic form has been distinguished. It is assumed that these two forms express different stages of staleness. No specific, simple, and reliable parameters are known to diagnose overreaching and overtraining in the earliest stage.     

Cutting edge: novel RNA ligands able to bind CD4 antigen and inhibit CD4+ T lymphocyte function

The value of high affinity-specific reagents in immunology is exemplified by the use of mAbs. Recent in vitro selection methods suggested that oligonucleotides may provide a useful alternative, especially where Abs have been insufficient thus far. We used a systematic evolution of ligands by exponential enrichment (SELEX) procedure to derive high affinity oligonucleotide ligands (aptamers) recognizing CD4. These RNase-resistant aptamers bound with high affinity and specificity as demonstrated using BIAcore (Stevenage, U.K.) technology. They also bound native CD4 on rat lymphocytes and specifically interfered with labeling by high affinity mAbs. All aptamers recognized the same binding site in the CDR2-like region in domain 1 of CD4. The applicability of these aptamers for immunologic studies was clearly demonstrated by their ability to block a fully allogeneic MLR in a CD4-specific manner. The high affinity and stability of aptamers point to their value in the analysis and functional manipulation of the immune system.     

2-chlorodeoxyadenosine induces durable remissions and prolonged suppression of CD4+ lymphocyte counts in patients with hairy cell leukemia

A number of effective treatments are available for patients with hairy cell leukemia (HCL). 2-Chlorodeoxyadenosine (2-CdA) induces more than 80% complete responses, but is associated with profound suppression of CD4+ lymphocyte counts. However, the duration of each is uncertain. We have analyzed a previously reported cohort of 40 patients who had responded to 2-CdA. Eight patients (20%) have relapsed at a median of 16 months (range, 3 to 23 months). The remaining 32 patients were observed for a median of 30 months (range, 7 to 43 months). No patients have died. At 3 years, the actuarial disease-free survival rate is 77% (95% confidence interval, 70% to 84%). The median CD4+ lymphocyte count before therapy was 743/microL (range, 58 to 2,201/microL). The median CD4+ nadir after treatment was 139/microL (range, 25 to 580/microL). There was a single opportunistic infection and no second malignancies observed. Although there was evidence of some improvement in CD4+ lymphocyte counts on sequential testing, CD4+ counts remained significantly lower than baseline (P < .0001) at a median of 23 months after therapy (median, 237/microL; range, 25 to 514/microL), and were also lower than baseline (P < .002) in those patients with more than 1 year of follow-up (median, 27 months; range, 13 to 42 months). The median time to reach an absolute CD4+ lymphocyte count of 365/microL, the lower limit of the normal range, was 40 months. Although responses to 2-CdA are durable in the majority of patients with HCL, the uncertain long-term consequences of the observed CD4+ lymphocytopenia suggest caution in the broad application of this therapy.     

Increased plasma HIV type 1 RNA levels are associated with low levels of non-MHC class I-restricted cytotoxicity

2329 subjects (blood donors and patients) from various areas of the Sultanate of Oman were investigated for the presence of HTLV-I antibody by as enzyme immunoassay (EIA) method. 10 subjects (0.4%), including 9/1586 blood donors (0.6%) and 1/165 patients with sexually transmitted diseases (0.6%), were found to be EIA seropositive with a regional variation in seroprevalence of 0-14%. 6/9 EIA seropositive samples from blood donors yielded 'indeterminate' results on Western immunoblot analysis (WBA). A much larger survey with additional confirmatory assays such as a radioimmunoprecipitation assay (RIPA), should provide a more conclusive picture of the prevalence of this retroviral infection in the Sultanate.     

Correlates of apoptosis of CD4+ and CD8+ T cells in tonsillar tissue in HIV type 1 infection

The immunopathogenesis of human immunodeficiency virus type 1 (HIV-1) infection has been associated with increased death by apoptosis of T cell subsets. In the present study, we have examined correlates of apoptosis of CD4+, CD8S+CD28+, and CD8+CD28- T cells in tonsillar lymphoid tissue in persons with HIV-1. Single-cell suspensions of tonsillar lymphocytes were analyzed by flow cytometry to determine the fraction of cells showing typical characteristics of apoptosis as well as the expression of activation markers within the live and the apoptotic cell populations. The proportion of cells carrying infectious provirus was quantified by limiting dilution analysis. Compared with uninfected controls, apoptosis of both CD4+ and CD8+ T cells was enhanced in HIV-1 infection and was higher among CD8+ than among CD4+ T cells. Apoptosis of CD28-cells was more prevalent than apoptosis of CD28+ cells for both CD4+ and CD8+ T cells. Occurrence of apoptosis of CD4+ T cells correlated with provirus levels and proportional expression of the activation marker HLA-DR. Apoptosis of CD8+CD28+ cells correlated with expression of the activation markers CD69 and HLA-DR while apoptosis within CD8+CD28- cells did not correlate with any of the studied parameters. Although apoptosis was much more prevalent among CD8+ than CD4+ T cells, CD8+ T cells still accumulated in tonsillar lymphoid tissue in persons with HIV-1. Our data may be interpreted to suggest that apoptosis of CD4+, CD8+CD28+, and CD8+CD28- cells in tonsillar tissue is regulated by different mechanisms and the results are of importance to our understanding of the immunopathogenesis of HIV-1 infection.     

Abnormalities of CD45 isoform expression in HIV infection

Systemic chemotherapy with 5-fluorouracil (5-FU) has been the mainstay of treatment for patients with metastatic colorectal carcinoma. Administering the drug in a continuous low-dose schedule has produced better result than bolus therapy. Resistance to short-pulse treatment can also be overcome by prolonged exposure. Recent studies suggest the feasibility of biomodulation of 5-FU with recombinant interferon (rIFN alpha-2a) with improved response. Sixteen patients were treated with continuous 5-FU 250 mg/m2 and rIFN alpha-2a 10 x 10(6) u thrice weekly for a maximum of 24 weeks. Five of them had received bolus 5-FU previously. Nine (82%) of the chemonaive group and 1 (20%) previously treated patient had partial response. The median duration of response was 7 months. Grade II to III mucositis were seen in 44% of the patients and 2 patients developed neurological complications. Although the overall response appeared encouraging, the incidence of toxicity was high. In the absence of further phase III studies, rIFN alpha-2a biomodulation of 5-FU cannot be regarded as standard treatment for patients with metastatic colorectal carcinoma.     

CD4 and CD8 counts are associated with interactions of gender and psychosocial stress

OBJECTIVE: This study examined relationships of gender, psychosocial stress/distress (caregiving, hassles, depressed mood), and the relative percentage and absolute cell counts of CD4 and CD8 cells in two samples of older adults (mean age = 69.4)--spouse caregivers of persons with Alzheimer's disease (N = 78) and age- and gender-matched spouses of nondemented controls (N = 72). METHODS: Counts and percentages of CD4 and CD8 cells and psychosocial variables were assessed twice (Time 1, Time 2) over a 15- to 18-month period. Several covariates were examined in the analyses, including body mass index (BMI), medication use, alcohol use, exercise, and illness history. RESULTS: Caregiver men had fewer CD4 cell counts at Times 1 and 2 than did control men (p < .05). At Times 1 and 2, both CD8 cell counts and percentages were positively associated with hassles in men (p < .05), but not in women. Although interactions of hassles and gender were present for CD8 percentages at both times, interactions and main effects were not present for CD4 percentages at either time. When the ratio of CD4 to CD8 levels was analyzed, hassles by gender interactions were present at both Times 1 and 2-hassles were negatively associated with the CD4/CD8 ratio in men (p < .05), but unrelated in women. From Time 1 to Time 2, change analyses showed that increases in hassles scores were associated with decreases in CD4 counts (p < .05), whereas increases in Hamilton Depression Scores were related to increases in both CD8 counts and percentages (p < .05). CONCLUSION: Caregiver status, hassles, and depressed mood had cross-sectional and/or longitudinal associations with CD4 and CD8 counts, but such relationships occurred primarily in men. Moreover, absolute cell counts were more related to psychosocial factors than were percentages.