AIDS related opportunistic infections, going but not gone

Samuel, Rafik; Bettiker, Robert L.; Suh, Byungse

doi:10.1007/bf02976619

Cited by 26 publications

(21 citation statements)

References 108 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This hypothesis is supported by two major aspects: 1) CD4 immunodeficiencies (for example AIDS) do not seem to correlate with a more frequent incidence of Whipple's disease, and 2) patients with Whipple's disease do not suffer more often from opportunistic infections known to be associated with impaired CD4 ϩ T cell activity like toxoplasmosis, Pneumocystis carinii, or nontuberculosis mycobacterial infections (29,30). Only giardiasis was found recently to be associated with Whipple's disease (25).…”

Section: Discussionmentioning

confidence: 99%

“…We studied CD4 ϩ T cell reactivity in 32 patients with different stages of Whipple's disease (13) (Table I, [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]; II, 27 elderly subjects, age-matched to Whipple's disease patients (16 M, 11 F, mean age, 54.9; range, 41-88); and III, 11 active triathletes, agematched to young subjects (11 M, mean age, 32.7; range, [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]. Triathletes practice swimming in the river Neckar in Heidelberg where T. whipplei was detected in sewage plants (5) and thus are supposed to have enhanced contact to environmental T. whipplei.…”

Section: Patients and Control Subjectsmentioning

confidence: 99%

See 1 more Smart Citation

Reduced Peripheral and MucosalTropheryma whipplei-Specific Th1 Response in Patients with Whipple’s Disease

Moos

Kunkel

Marth

et al. 2006

The Journal of Immunology

View full text Add to dashboard Cite

Whipple’s disease is a rare infectious disorder caused by Tropheryma whipplei. Major symptoms are arthropathy, weight loss, and diarrhea, but the CNS and other organs may be affected, too. The incidence of Whipple’s disease is very low despite the ubiquitous presence of T. whipplei in the environment. Therefore, it has been suggested that host factors indicated by immune deficiencies are responsible for the development of Whipple’s disease. However, T. whipplei-specific T cell responses could not be studied until now, because cultivation of the bacteria was established only recently. Thus, the availability of T. whipplei Twist-MarseilleT has enabled the first analysis of T. whipplei-specific reactivity of CD4+ T cells. A robust T. whipplei-specific CD4+ Th1 reactivity and activation (expression of CD154) was detected in peripheral and duodenal lymphocytes of all healthy (16 young, 27 age-matched, 11 triathletes) and disease controls (17 patients with tuberculosis) tested. However, 32 Whipple’s disease patients showed reduced or absent T. whipplei-specific Th1 responses, whereas their capacity to react to other common Ags like tetanus toxoid, tuberculin, actinomycetes, Giardia lamblia, or CMV was not reduced compared with controls. Hence, we conclude that an insufficient T. whipplei-specific Th1 response may be responsible for an impaired immunological clearance of T. whipplei in Whipple’s disease patients and may contribute to the fatal natural course of the disease.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Patients and Control Subjectsmentioning

confidence: 99%

Reduced Peripheral and MucosalTropheryma whipplei-Specific Th1 Response in Patients with Whipple’s Disease

Moos

Kunkel

Marth

et al. 2006

The Journal of Immunology

View full text Add to dashboard Cite

show abstract

“…Globally, TB continues to be one of the leading infectious causes of morbidity and mortality, accounting for an estimated 9 million cases and 2 million deaths per year [1][2][3][4]. The effect of the dual HIV and TB epidemics is felt most acutely in developing countries, with recent estimates of dual infection rising rapidly.…”

Section: Introductionmentioning

confidence: 99%

Spinal Tuberculosis Evaluated by Means of 18F-FDG PET/CT: Pilot Study

Zinn¹,

Vorster²,

Sathekge³

2014

TONMEDJ

View full text Add to dashboard Cite

Abstract:Introduction: Spinal tuberculosis is a serious health care problem and diagnosis is often difficult because many diseases may have similar imaging findings. Hence the need to describe findings of spinal tuberculosis with 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) when compared to CT. Materials and Methods:Sixteen consecutive patients who underwent 18F-FDG PET/CT and known to have or subsequently were proven to have spinal tuberculosis were analyzed. All patients included underwent whole-body 18F-FDG PET imaging; none of the patients were on tuberculostatics at the time of the PET investigation. We evaluated 18F-FDG uptake visually and semiquantitatively using standardized uptake values (SUVmax) and the ratio of lesion to normal liver (S/L ratio), respectively. The presence of spinal and extraspinal lesions was evaluated histopathologically and by the radiologic findings noted on diagnostic CT. Diagnostic Computed Tomographic (CT) findings were reviewed and compared to 18F-FDG PET/CT.Results: Only 4 patients had one spinal lesion, while 12 (75%) patients had 2 or more lesions. Those patients that had three or more lesions demonstrated intense FDG uptake with a median of 11.34 (3.8-20.9). Ten (62%) of the patients had both spinal and extraspinal lesions. In most of the cases (75%), the lumbar spine was involved as opposed to the thoracic vertebrae. 18F-FDG PET detected all 39/39 (100%) clinically (sites of disease that resulted in symptoms or signs such as pain, swelling, neurological fallout etc.) and histologically (as reported by the laboratory) observed spinal sites. The median of the SUVmax for spinal lesions was 6.06 (ranging from 2.63 to 16.78). Diagnostic CT reported corresponding morphological changes in only 27 (69%) of the spinal sites identified on 18F-FDG PET/CT. 18F-FDG PET/CT detected 60 of 60 (100%) clinically observed extraspinal sites including pulmonary TB, nodal disease and other musculoskeletal sites versus the 43 of 60 (71%) detected by diagnostic CT only. The median of the SUVmax was 3.61 for nodal sites (ranging from 1.71 to 10.79) and 3.38 for pulmonary sites (ranging from 1.23 to 5.93). Conclusion:The results suggest that 18F-FDG PET/CT is more effective compared to diagnostic CT only in the identification of sites of active disease and contributes to a better evaluation of extraspinal involvement in TB patients. It also appears to be a very promising imaging modality for the identification of the most appropriate biopsy site, staging disease, predicting multi-drug resistance and monitoring response to therapy.

show abstract

“…Impaired immunity related to HIV infection leads to increased susceptibility to infection by pathogens such as cytomegalovirus, cryptococcus neoformans, and tuberculosis [28]. In addition there is increased vulnerability to developing malignancies such as lymphoma, Kaposi's sarcoma, and anogenital cancers [29], related to impaired host immune surveillance, increased infection with oncogenic viruses, and facilitation of tumour angiogenesis and KSHV transmission by HIV-1 encoded proteins [30].…”

Section: Scan Changes Related To Secondary Pathologymentioning

confidence: 99%

PET/CT scanning with a high HIV/AIDS prevalence

Warwick

Sathekge

2011

Transfusion and Apheresis Science

View full text Add to dashboard Cite

a r t i c l e i n f oArticle history: Available online xxxx a b s t r a c t Positron emission tomography (PET) with [F-18]-fluoro-deoxy-glucose (FDG) has a well established and growing role in the management of most lymphomas. The interpretation of FDG PET scans in HIV positive patients is however challenging. This is largely due to scan changes giving a higher likelihood of false positive studies from both the direct effects of HIV and its treatment, and related to secondary HIV-related pathology. There is currently a need for further clinical research to evaluate to contribution of FDG PET in the management of HIV positive patients with lymphoma. In this paper existing studies related to FDG PET scanning in HIV positive patients will be reviewed, and potential pitfalls will be identified. These pitfalls can be avoided to some extent by the interpreter having a good clinical knowledge of the individual patients' condition, and an awareness of known scintigraphic patterns that can occur in these patients. PET remains a sensitive tool for the localisation of pathology, however when the exact nature of lesions has a direct bearing on patient management lesions need to be biopsied where possible. FDG PET can be particularly useful for the characterisation of brain lesions suspected to be related to primary central nervous system lymphoma.

show abstract

AIDS related opportunistic infections, going but not gone

Cited by 26 publications

References 108 publications

Reduced Peripheral and MucosalTropheryma whipplei-Specific Th1 Response in Patients with Whipple’s Disease

Reduced Peripheral and MucosalTropheryma whipplei-Specific Th1 Response in Patients with Whipple’s Disease

Spinal Tuberculosis Evaluated by Means of 18F-FDG PET/CT: Pilot Study

PET/CT scanning with a high HIV/AIDS prevalence

Contact Info

Product

Resources

About