CLUBBING IN HUMAN IMMUNODEFICIENCY VIRUS INFECTION

We describe two patients who developed clubbing shortly afterHIV seroconversion. None of them had the full syndroine of hypertropicosteoarthropathy. Other causes of clubbing are unlikely. Wesuggest that clubbing may belong to the spectrum of arthropathiesassociated with HIV infection. KEY WORDS: Clubbing, Hypertrophic osteoarthropathy, HIV, AIDS     

THE NEUROLOGICAL FEATURES OF EARLY AND 'LATENT' HUMAN IMMUNODEFICIENCY VIRUS INFECTION

Neurological manifestations of unknown cause occurring in patients who become or are HIV antibody positive with presumed normal immune function have been described recently. This report adds a further six cases, all of whom had normal CD4 + cell counts either throughout the period of observation or after the episode of seroconyersion. Three had an acute presentation, two in the context of documented seroconversion consisting of one of the following: an encephalitis, an ataxia, and confusion with neuralgic amyotrophy. Three had a subacute disorder occurring at a later phase of HIV infection but before opportunistic infections or neoplasms, and marked by a static mild cognitive deficit. This report extends the range of abnormalities that may be seen at seroconversion and documents the presence of a non-progressive cognitive deficit occurring in the latent phase of HIV infection.     

POLYARTERITIS NODOSA IN HUMAN IMMUNODEFICIENCY VIRUS INFECTION: REPORT OF FOUR CASES AND REVIEW OF THE LITERATURE

Four patients with HIV infection were diagnosed as having panarteritisnodosa type vasculitis in muscle samples taken by biopsy. Fever,weight loss and neuromuscular symptoms were the major complaints.All but one were successfully treated with a low dose of prednisone.The other patient refused treatment, but her muscular complaintsdid not worsen during 9 months of follow-up. Previously reportedcases in the literature are reviewed KEY WORDS: AIDS, HIV, Necrotizing arteritis, Rheumatic manifestations, Vasculitis, Panarteritis nodosa, Prednisone, Neuromuscular symptoms, Muscle biopsy, Muscle atrophy     

SALMONELLA PYOMYOSITIS IN PATIENTS WITH THE HUMAN IMMUNODEFICIENCY VIRUS

Pyomyositis is a common disease in the tropics, mostly due toStaphylococcus aureus. We report two patients infected withthe human immunodeficiency virus (HIV) who presented with feverand unilateral limb swelling and in whom pyomyositis was diagnosedin quadriceps and gluteus major, respectively. Salmonella enteritidiswas isolated in both, with recurrent episodes of muscle involvementand secondary osteomyelitis in one case. Non-typhi Salmonellapyomyositis may occur in HIV + patients with a relapsing andaggressive clinical course in some cases. KEY WORDS: Human immunodeficiency virus infection, Pyomyositis, Salmonellosis     

PNEUMOCYSTIS CARINII PNEUMONIA IN A PATIENT WITH RHEUMATOID ARTHRITIS, NOT ON IMMUNOSUPPRESSIVE THERAPY AND IN THE ABSENCE OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION

We report a case of Pneumocystis carinii pneumonia in a patientwith rheumatoid arthritis, not on immunosuppressive therapy,and in the absence of human immunodeficiency virus infection;investigation revealed a CD4+ T-lymphopenia. KEY WORDS: Pneumocystis carinii, Rheumatoid arthritis, Lymphopenia     

SEPTIC BONE, JOINT AND MUSCLE LESIONS ASSOCIATED WITH HUMAN IMMUNODEFICIENCY VIRUS INFECTION

Ten episodes of musculoskeletal sepsis have been seen in ninepatients with HIV infection. Seven patients had AIDS, circulatingCD4-positive lymphocyte counts being less than 0.1 x 10⁹/l insix. Septic arthritis recurred in seven patients, osteomyelitisin three and pyomyositis and bursitis each occurred in one patient.Staphylococcus aureus was isolated from four patients, atypicalmicro-organisms being found in three. Presentation of musculoskeletalinfection in this patient group may be atypical but rapid diagnosisis important as early antimicrobial therapy is often successful. KEY WORDS: HIV infection, Musculoskeletal sepsis, Septic arthritis, Osteomyelitis     

THE DETECTION OF HUMAN IMMUNODEFICIENCY VIRUS DNA IN DENDRITIC CELLS FROM THE JOINTS OF PATIENTS WITH ASEPTIC ARTHRITIS

Three patients with inflammatory arthritis were found to beseropositive for human immunodeficiency virus (HIV). Two ofthese individuals developed synovitis following an episode ofyersinia bowel infection. We have studied joint material fromall three in an attempt to define the role that HIV may be playingin the aetiology or maintenance of arthritis Cell-associated HIV DNA was detected within joint fluid by insitu hybridization and the phenotypes of infected cells wereestablished using a double-labelling immunocytochemical technique.Viral DNA was detected in dendritic cells (4-25%) isolated fromboth the peripheral blood and synovial fluid and in occasionallymphocytes from peripheral blood (<0·1%). No infectedmacrophages were seen Functional studies using the mixed leucocyte reaction showedthat the dendritic cells from synovial fluid were poor stimulatorsof allogenic peripheral blood lymphocytes whilst being effectiveat stimulating autologous lymphocytes. In addition, synovialfluid lymphocytes responded poorly to normal control dendriticcells. Infection of these cells with HIV could be contributingto this low stimulatory activity of antigen-presenting cellsand to the unresponsiveness of lymphocytes KEY WORDS: HIV, Antigen-presenting cells, Lymphocytes, Synovial fluid     

肾移植受者并发Kaposi肉瘤的诊治和预防

目的：探讨同种异体肾移植受者并发Ｋａｐｏｓｉ肉瘤的诊治和预防。方法：回顾分析我院７７３例肾移植受者中４例Ｋａｐｏｓｉ肉瘤的诊治经过。结果：肾移植术后Ｋａｐｏｓｉ肉瘤发生率为０．５２％,占同期所发生的各类肿瘤的３６．４％,发生时间分别为术后３、７、１４、２１个月,首发症状为咽喉痛、咽部异物感染伴吞咽困难者２例,均经病理检查确诊。治愈２例。结论：应提高对肾移植受者并发Ｋａｐｏｓｉ肉瘤的认识,强调尽早行     

在大肠杆菌中高效表达人Ⅰ型免疫缺陷病毒p24蛋白

为深入研究人Ⅰ型免疫缺陷病毒（ＨＩＶ—１）衣壳蛋白ｐ２４的结构与功能,制备抗Ｐ２４单克隆抗体及其诊断抗原,将编码ＨＩＶ－１ｐ２４蛋白的ｐ２４ｇａｇ基因片段,克隆到原核表达载体ｐＥＴ－１７ｂ的Ｔ７噬菌体启动子下游,构建成了重组表达质粒ｐＥＴ２４,并使ｐ２４ｇａｇ基因片段在大肠杆菌ＢＬ２１（ＤＥ３）中高效表达,其产物为３０ｋＤａ的ｓ１０－ｐ２４融合蛋白,表达量占菌体总蛋白的３８．４％。重组Ｐ２４蛋白均抗ｐ２４单克隆抗体及ＨＩＶ—１阳性血清发生特异性反应,具有较好的抗原性,对研究开发ＡＩＤＳ诊断试剂和基因工程疫苗具有重要意义。     

在大肠杆菌中高效表达人Ⅰ型免疫缺陷病毒p24蛋白

In order to study the capsid protein (p24) of human immunodeficiency virus type 1(HIV-1),a plasmid vector pET24,containing the p24^gaq gene fragment encoding the p24 protein under the control of the bacteriophage T7 promoter ,was constructed.The pET24 plasmid-highly expressed a 30kDa protein of s10-p24 spanning 284 amino acid residues.The total amount of the fusion protein was approximately 38.4% of the total celluar protein in Escherchia coli BL21(DE3).Westein blotting and,immunodot blotting indicated that the recombinain protein could be relognized by anti-p24 monoclonal antibody and HIV-1 positive sera respectively.It is significance for preparing specific antibody,and diagnostic usage.