Two-year safety and tolerability study of enfuvertide use in salvage therapy of Thai HIV-1 experienced cases.

Objective: To assess safety and tolerability of enfuvirtide, an antiretroviral, in Thai patients with advanced HIV-1 disease who have received antiretroviral treatment and failed on regimens that contain at least one of each antiretroviral (ARV) classes (PIs, NRTIs, and NNRTIs), or who have intolerance to previous antiretroviral regimens.

Material And Method: An open-label non-comparative study of enfuvirtide used in salvage regimens along with the backbone antiretroviral therapy of choice in Thai HIV-1 experienced cases that have been treated with at least one of each available ARV classes.

Results: Twenty-three patients were recruited from five participating centers.

Antiretroviral Drug-Associated Oral Lichenoid Reaction in HIV Patient: A Case Report.

Antiretroviral therapy has changed the course of HIV disease and improved quality of life in HIV patients. Incidence of an oral lichenoid drug reaction induced by zidovudine is not common. Once it occurs, it affects a patient's well being, in particular their oral functions.

Systematic review of clinical trials evaluating low doses of stavudine as part of antiretroviral treatment.

Stavudine is a nucleoside analogue used for the treatment of HIV-1 infection, as part of highly active antiretroviral treatment. In developing countries, stavudine is used widely, owing to low cost and inclusion in generic fixed-dose combinations. In developed countries, stavudine is now rarely used, although it is highly effective.

Factors associated with tuberculin skin test reactivity among HIV-infected people in Bangkok.

INH preventive therapy (IPT) has been shown in several randomized controlled trials to reduce the risk of developing active TB in tuberculin skin test (TST) or purified protein derivative (PPD) positive HIV infected individuals. Detection of latent tuberculosis by TST and determination of factors associated with the PPD positivity in HIV-infected persons are important for the targeting of chemoprophylaxis. Six hundred asymptomatic and early symptomatic HIV-infected subjects attending the AIDS Clinic of the Chulalongkorn University Hospital, Bangkok, Thailand were enrolled in two randomized clinical trials of chemoprophylaxis against TB from December 1994 to December 1996.

Magnetic resonance spectroscopy of the brain in neurologically asymptomatic HIV-infected patients.

The CNS involvement is frequently found in human immunodeficiency virus (HIV) infection. The purpose of our study was to determine whether proton magnetic resonance spectroscopy (MRS) could detect early brain involvement in neurologically asymptomatic HIV-infected patients with normal MR imagings and to find the correlation between MRS and the immune status. We performed MRS in 30 HIV seropositive neurologically asymptomatic patients with normal MRI and compared the MRS findings with 13 controls.

A comparison of two dosing regimens of zidovudine in Thai adults with early symptomatic HIV infection. Conducting clinical HIV trials in South-East Asia.

Aim: To compare the clinical and immunological efficacy, and tolerance of two dosage regimens of zidovudine (ZDV) in an adult Thai population with early symptomatic human immunodeficiency virus (HIV) disease and to identify important clinical issues associated with conducting HIV trials in South-East Asia.

Methods: HIV-infected Thai adults, with early symptomatic HIV disease and CD4 lymphocyte counts less than 400/mm3, who were managed in the infectious diseases clinics at two university teaching hospitals in Bangkok, Thailand, were enrolled in a randomised, open-label, dose-regimen comparison trial of ZDV. Two oral ZDV dosing regimens: regimen A, 100 mg tid+200 mg nocte (ZDV-A) vs regimen B, 250 mg bid (ZDV-B) were compared.

Diarrheal disease in patients infected with human immunodeficiency virus in Bangkok, Thailand.

Diarrheal disease and its associated morbidities occur frequently in patients infected with human immunodeficiency virus (HIV) and may be associated with a decreased quality of life. We studied the spectrum of symptoms, measures of nutritional status, and the enteric pathogens associated with diarrheal disease in a group of 24 patients infected with HIV in Bangkok, Thailand compared with a group of 19 patients infected with HIV without diarrhea cared for at the same clinic. Patients with diarrhea appeared to have more advanced disease by CD4 cell counts and complained more frequently of symptoms such as anorexia, gas, and bloating than patients without diarrhea.

Clinical and immunological features of human immunodeficiency virus infection in patients from Bangkok, Thailand.

Background: To assess the association between the CD4 count and clinical diseases in a cohort of Thai patients.

Methods: In all, 1902 patients who presented with human immunodeficiency virus (HIV) infection at the Chulalongkorn University Hospital in Bangkok were investigated.

Results: At the time of presentation 295 (15.

Managing HIV with limited medical resources.

Only a small minority of people in the world infected with HIV will receive the benefits of the current advances in medical treatment. Planning is required to ensure that each country provides the best possible care allowed by its health resources. Relatively small amounts of money, if well spent, can go a long way towards reducing suffering and assisting death with dignity.

Clinical correlation of the immunological markers of HIV infection in individuals from Thailand.

Objective: To evaluate the usefulness of T-cell subsets, beta-microglobulin (B2M), p24 antigen and anti-p24 antibodies as differentiating and prognostic markers in HIV-infected Thai patients.

Design: Sixty-one HIV-infected patients in various stages of disease (six AIDS, three AIDS-related complex, 34 persistent generalized lymphadenopathy and 18 HIV-asymptomatic) were followed prospectively for 2 years. Patients were examined and immunological markers assessed every 6 months at least.

Acquired immunodeficiency syndrome associated with cerebral astrocytoma.

A 32-year-old homosexual man presented with headache and progressive right hemiparesis. CT scan revealed a heterogeneous ring-enhancing mass in the left parietooccipital lobe which proved to be astrocytoma. Clinicians should be aware of this new and unusual association of a cerebral glioma and acquired immune deficiency syndrome.

Effect of a selective restriction policy on antibiotic expenditure and use: an institutional model.

Strictly enforced antibiotic formulary restriction in combination with formulation of agreed guidelines for antibiotic use in common infection problems such as septicemia, febrile neutropenia, urinary tract infection, biliary sepsis, liver abscess, peritonitis, nosocomial pneumonia, soft tissue infection and purulent meningitis, generated a combined savings of 307,748.5 bahts or 13.5 per cent cost reduction over a 6 month period, and improved quality of use, appropriate 54.

Detection of Plasmodia in acridine orange stained capillary tubes (the QBC system).

The sensitivity, specificity and convenience of carrying out malaria diagnosis in acridine orange stained capillary tubes using a fluorescent microscope (the QBC system) was compared to screening for Plasmodia on conventional Giemsa stained thick smears. A dilution study revealed that the QBC is able to detect Plasmodia in as low a dilution as 5 organisms per ul. The QBC system was evaluated at a district hospital in Thailand.

Limiting dilution assay for human B cells based on their activation by mutant EL4 thymoma cells: total and antimalaria responder B cell frequencies.

The analysis of human B cell responses at the clonal level (limiting dilution assay) is still technically difficult. In the present study we report on a culture system that leads to activation, proliferation and differentiation into antibody-secreting cells (ASC) of about 90% of B cells from peripheral blood or spleen. In this system, B cells are cultured in the presence of a mutant subclone of the mouse thymoma EL4 for B cell activation and human T cell plus macrophage supernatant as source of proliferation and differentiation factors.

Complement changes in falciparum malaria infection.

Complement profiles were sequentially studied in 183 Thai adults infected with Plasmodium falciparum. On the first day of admission, CH50, C1q, C4 and C3 were low in 65%, 8%, 19% and 62% of cases, respectively. All patients with low C1q or C4 also had low C3 and CH50.

Stool desorbing activity: a possible cause of false-positive reactions in competitive enzyme immunoassays.

We have developed a competitive enzyme immunoassay for the measurement of purified toxin A of Clostridium difficile. However, when we applied this assay to the detection of C. difficile toxin in stool specimens, we noted a high rate of nonspecific activity in fecal specimens which did not contain toxin.

Hemolytic uremic syndrome in leptospirosis bataviae.

Hemolytic uremic syndrome was observed in a 46-year-old man who had leptospirosis. Renal failure was severe with a prolonged clinical course. Despite clinical recovery there was residual renal damage indicated by mildly elevated serum creatinine.

Improved enzyme immunoassays for the detection of antigens in fecal specimens. Investigation and correction of interfering factors.

Solid phase enzyme immunoassays (EIA) are widely used for the detection of infectious agents in body fluids such as stool specimens. However, we found that stool specimens contained substances which desorb from 50% to 68% of the immunoreactant from solid phase surfaces. This desorbing activity decreased the sensitivity of EIA systems for toxin A of C.

Autoantibodies in falciparum malaria: a sequential study in 183 Thai patients.

Various autoantibodies were sequentially studied in 183 consecutive Thai adults infected with Plasmodium falciparum. On the first day of admission, 31.1% of the patients had positive fluorescent anti-nuclear antibodies (FANA) and 16.