Prakong Vithayasai

Clinical Manifestations of 174 AIDS Cases in Maharaj Nakorn Chiang Mai Hospital

The human immunodeficiency virus (HIV) has, since it was first reported in 1981, become a worldwide epidemic. The immunosuppressive nature of HIV results in opportunistic infections, neoplasms, and other pathological conditions. Clinical manifestations of these conditions are often the first indication that an individual is infected with HIV. This article reports and describes the clinical findings for 174 HIV-positive patients and is intended to educate Thai physicians concerning the rising HIV infection rate in Thailand. The opportunistic infectious agents included fungal, parasitic, viral, and bacterial organisms. Cryptococcosis, penicillosis, candidiasis, and histoplasmosis are fungal diseases which are discussed. Protozoal organisms and diseases covered are Pneumocystis carinii, toxoplasmosis, cryptosporidiosis, isosporiosis, and Demodex folliculorum. Bacterial infections addressed are tuberculosis, syphilis, and salmonellosis. The parasite causing nocardiosis is also discussed. Viral infections addressed are cytomegalovirus infection, herpes simplex, and hairy leukoplakia. Neoplasms or tumors discussed are Kaposis sarcoma and non-Hodgkins lymphoma. Other pathological conditions described are brain atrophy, HIV retinopathy, and HIV wasting syndrome. In most cases, a suggested therapy regime is given for the condition discussed.

Human Immunodeficiency Virus Type 1 Subtype E Envelope Recombinant Peptides Containing Naturally Immunogenic Epitopes

A series of recombinant peptides of the human immunodeficiency virus type 1 (HIV-1) subtype E envelope were used to address the question of whether immunogenic epitopes similar to those described for the subtype B envelope are also present in structurally analogous regions of another HIV-1 subtype with divergent sequences. Five recombinant peptides, covering the V2 and V3 domains of gp120, the cysteine-loop region of gp41, a gp41 region involved in oligomerization, and the cytoplasmic tail of gp41, were found to react with >50% of the serum samples analyzed. All but the V2 region in the HIV-1 subtype B envelope have been reported to contain continuous epitopes that are highly immunogenic during natural infection. This finding suggests that, despite the sequence divergence between subtype E and B envelopes, most of the continuous epitopes that are highly immunogenic during natural infection are located at structurally analogous regions of the envelope.