Hepatitis C virus genetic variability in 52 human immunodeficiency virus-coinfected patients.

The aim of this study was to examine whether hepatitis C virus (HCV) pretreatment quasispecies complexity was linked to virological response or other clinical and biological parameters, in human immunodeficiency virus (HIV)-coinfected patients undergoing anti-HCV treatment. In addition, HCV quasispecies composition is described longitudinally in these patients before, during, and after treatment. The 52 HIV-coinfected patients were included in a randomized therapeutic trial.

CD4 T lymphocyte proliferative responses to hepatitis C virus (HCV) antigens in patients coinfected with HCV and human immunodeficiency virus who responded to anti-HCV treatment.

CD4 T lymphocyte proliferative responses to hepatitis C virus (HCV) antigens were evaluated before and during an anti-HCV regimen (interferon-alpha2a and ribavirin) in 36 patients coinfected with HCV and human immunodeficiency virus (HIV), to determine whether immune responses against HCV antigens are present in such patients, whether these responses are modified by anti-HCV treatment, and whether they are correlated with treatment efficacy. The CD4 responses against HCV antigens (primarily core antigens) detected at study entry in one-half of the patients did not correlate with anti-HCV treatment efficacy. Of 36 patients, 8 had patterns of persistent immune response to infection by genotypes 3 or 4 that were significantly correlated with sustained virologic response.

Acquired immunodeficiency syndrome-associated Kaposi's sarcoma and human herpesvirus 8 DNA detection in serial peripheral blood mononuclear cell samples.

Human herpesvirus 8 (HHV8) DNA was amplified from peripheral blood mononuclear cells (PBMCs) using PCR in 120 HIV-seropositive in- and outpatients who were enrolled in a cohort study between January 1994 and June 1995. Risk factors for HIV infection were homosexuality/bisexuality alone in 64 cases (30 with Kaposi's sarcoma (KS) and 34 without KS, 4 of whom had KS lesions that appeared during follow-up in the cohort), heterosexual contact alone in 32 cases (among whom 1 woman with KS who was the spouse of a bisexual with KS), and transfusion of blood or blood products alone in 24 cases. Three blood samples at 3-4-month intervals were scheduled for each patient.

Acute painful diabetic neuropathy: two patients with recent insulin-dependent diabetes mellitus.

Two young men developed an acute painful peripheral neuropathy a few weeks after being diagnosed to suffer from an insulin-dependent diabetes mellitus. In both cases, peripheral nerve biopsy exhibited a few features of acute axonal degeneration. Additionally, in the first case there was a lymphocytic infiltrate around an endoneurial capillary, and in the second case there were several mast cells in the endoneurium of every fascicle examined.

Evaluation of serological response to Bartonella henselae, Bartonella quintana and Afipia felis antigens in 64 patients with suspected cat-scratch disease.

The serological response to Bartonella henselae, B. quintana, and Afipia felis was assessed by an indirect fluorescence antibody test (IFAT) in 64 patients with suspected cat-scratch disease (CSD) recruited from the Bordeaux area in France. Blood samples were collected from 57 patients with chronic lymphadenopathy who underwent lymph-node biopsy with suggestive histopathologic features of CSD, and from an additional 7 patients with suspected CSD who underwent surgical incision and drainage because of lymph-node tenderness.

Detection of Toxoplasma gondii by PCR and tissue culture in cerebrospinal fluid and blood of human immunodeficiency virus-seropositive patients.

To investigate whether both tissue culture and PCR on a sequence from the repetitive rDNA could contribute to the diagnosis of toxoplasmosis, blood samples and, if they were available, cerebrospinal fluid (CSF) and aqueous humor samples from 72 human immunodeficiency virus-seropositive patients with suspected toxoplasmosis were prospectively tested. For 10 patients with fever of unknown origin but without confirmed toxoplasmosis, no Toxoplasma gondii was detected. For two patients with confirmed toxoplasmic uveitis, only PCR of aqueous humor samples was positive.

[Evaluation of antibiotherapy in dental surgery].

Objectives: Debate on antibiotic prophylaxis in patients with infectious endocarditis has emphasized the need for reliable data on the effectiveness of antibiotic therapy in dentistry patients.

Methods: We randomly sampled 583 antibiotic prescriptions delivered by dentists working in out-patient clinics in the French department of Gironde in 1992. Two-hundred fifty-seven prescriptions were analyzed in detail after telephone contact with the prescribing practicians in coordination with infectiology experts from university hospitals.

Spontaneous splenic rupture: an uncommon complication of cytomegalovirus infection.

A previously healthy 25-year-old man developed a spontaneous rupture of the spleen during a cytomegalovirus (CMV) infection. The only other clinical feature was a well tolerated fever of 37.5 degrees C to 39 degrees C during the month before.

[Septicemia in patients with human immunodeficiency virus infection (excluding Mycobacteria). Apropos of 58 cases].

We reviewed the characteristics of 58 episodes of septicemia which occurred in 53 HIV infected adults over a 30-month period. This cases represented 10.1% of HIV infected hospitalized patients.

Scrub typhus: an imported Rickettsial disease.

A case of scrub typhus due to Rickettsia tsutsugamushi is reported. This imported rickettsial disease was contracted by a 30-year-old woman while traveling in Thailand, and was transmitted by an infected mite's bite. Diagnosis was confirmed by specific serology and resolution was obtained by tetracycline therapy.

Decreased incidence of infection after renal transplantation with the use of cyclosporine.

The incidence of infection within six months of cadaveric kidney transplantation was reviewed in 183 consecutive patients. Prior to June, 1985, 91 patients received azathioprine 2 mg/kg/day and prednisone 0.5 mg/kg/day; 63 patients (group A1) also received antilymphocyte globulin 15 mg/kg/day for the first ten days, whereas for the 28 other patients (group A2) antilymphocyte globulin had to be withdrawn before 72 hours because of general intolerance.

[Cardiac lesions in AIDS].

The frequency of cardiac lesions in AIDS patients is diversely evaluated. At post-mortem examination macroscopic lesions are said to have been found in 20 percent of the patients, and microscopic lesions in 50 percent. In some clinical studies, up to 55 percent of the patients had echocardiographic abnormalities.

[Malaria and retinal hemorrhages].

A 24-year-old woman presented with retinal hemorrhages, back from a travel in Cameroon. She took a chloroquine chemoprophylaxis. We diagnosed a malaria due to Plasmodium falciparum with anemia, splenomegaly and low parasitemia.