Polymerase chain reaction in the early diagnosis of HIV-1 infection in high risk subjects.

We investigated the presence of the HIV-1 infection using the polymerase chain reaction (PCR) test in seronegative sexual partners of HIV-infected subjects and in children born to seropositive mothers. By using PCR assay, no HIV-1 DNA was detected in 32 female partners of HIV positive patients including three pregnant women who were also studied during pregnancy and after delivery. HIV-1 DNA was found in 12 out of 38 children born to seropositive mothers; five of them also had detectable serum HIV-1 p24 Ag levels. On the whole, our data stress the importance of using a very sensitive technique, i.e. PCR, for the early diagnosis of HIV-1 infection.

Detection of serum HIV-Ag related to the major core protein (p24) in persons at risk for AIDS.

A commercial enzyme immunoassay was utilized for the detection of the human immunodeficiency virus antigen (p24) in serum samples from persons at risk for AIDS. The test demonstrated sensitivity to 20 pg/ml of serum antigen. The results obtained showed 14.63% of the subjects (Ss) with persistent generalized lymphadenopathy or asymptomatic Ss, and 69.23% of the Ss with AIDS related complex (ARC) or AIDS to be positive for HIV-Ag. In addition, there were no false-positives in the control serum samples collected from seronegative individual. The close correlation observed between HIV-Ag presence and advanced stages of the disease, stresses the diagnostic importance of this viral marker and its usefulness in the follow-up of Ss with HIV infection.

Heterosexual transmission of the human immunodeficiency virus: a seroepidemiological study.

The transmission of the human immunodeficiency virus (HIV) was studied in 647 subjects who presented no apparent risk factors for the infection other than having had promiscuous heterosexual relations, heterosexual relations with people with an elevated risk of infection, or heterosexual relations with people infected by human immunodeficiency virus. Thirty subjects were found to be seropositive for anti-human immunodeficiency virus antibodies. The elevated risk factors included being the habitual partner of a person at risk of infection or of a person who was infected by human immunodeficiency virus, or being the partner of a patient with acquired immunodeficiency syndrome. The transmission of the virus was verified in 13 of 284 subjects (4.57%) who had had heterosexual intercourse three or more times with persons at risk and in 16 of 101 subjects (15.84%) who had had heterosexual intercourse three or more times with persons who were seropositive for human immunodeficiency virus antibodies. No significant correlation between human immunodeficiency virus infection and a history of sexually transmitted infections, nor between human immunodeficiency virus infection and female subjects was found. These data suggest that the epidemic of acquired immunodeficiency syndrome can also spread through heterosexual relations, even if the possibility of becoming infected in this way seems at the moment limited to particular risk behaviors.

Amebic pleuro-pericarditis.

Author's report a case of visceral amebiasis in a 26 year old woman, clinically characterized by pericarditis, without any other symptoms related to organs usually interested in such disease. It was possible to reach an etiological diagnosis by indirect hemagglutination assay. The successful treatment with metronidazole confirmed the etiology "ex adjuvantibus".

HIV infection in children born to seropositive mothers: a laboratory and clinical follow-up study.

Several serological techniques may be used for the detection of HIV infection, however, in the case of infants, there are no methods that are effective prior to the loss of maternal antibodies. Thus, in such cases, a completed series of serological and virological assay of HIV antibodies should be performed in follow-up studies. Twenty children living in Modena (Italy) were studied since 1985. Seven of these children were of ages ranging from 3 to 10 years. Only one of them was found to be seropositive for HIV. The remaining 13 children were studied from birth. Six had lost maternal antibodies to HIV at a median age of 15.1 months. Four showed decreasing levels of the anti-body by Western blotting. HIV antigen was detected in serum samples from 2 children. The data reported stress the need for longitudinal studies that could lead to reliable methods of diagnosing HIV infections in newborns.

Isolation of mumps virus from vaginal secretions in association with oophoritis.

Mumps virus was isolated from the cervico-vaginal secretions of a 31-year-old woman presenting with mild signs of oophoritis accompanied by xantholeucorrhoea. The serological finding of mumps-specific IgM antibodies was further evidence confirming the casual link between mumps virus and ovarian pathology. Rarely, ovarian involvement may be the only manifestation of mumps infection. The importance of this diagnosis and its relationship to the possible development of secondary oligomenorrhoea and early menopause is discussed.

[Hepatic lesions induced by drugs. Report of 26 cases]. / Lesiones hepáticas por drogas. Presentación de 26 casos.

Two thousand six hundred and seventy one liver biopsies were reviewed from 1972 to 1985 at the Hospital A. Posadas. There were 26 patients with drug-induced liver injury; those who fulfilled the following criteria were included: contact with a drug known to produce hepatotoxicity; clinic, biologic and histologic picture corresponding to the drug studied, complete recovery after the drug was stopped and no other hepatic toxics. Fourteen patients showed estrogen-induced intrahepatic cholestasis, 5 had hepatitis-like lesions due to: alphamethyldopa (3), ketoconazole (1) and indomethacin (1). Carbon tetrachloride caused fatty degeneration in two patients and phenylbutazone a granulomatous hepatitis in one patient and cholestatic hepatitis in other. The last three cases were cholestatic lesions after the administration of chlorpromazine allopurinol and penicillin respectively. The evolution in 24 patients was excellent after the drug was withdrawn. Two patients died because of surgical complications since they were operated on with the wrong diagnosis of extrahepatic cholestasis.

Lesiones hepáticas por drogas. Presentación de 26 casos. / [Hepatic lesions induced by drugs. Report of 26 cases]

Two thousand six hundred and seventy one liver biopsies were reviewed from 1972 to 1985 at the Hospital A. Posadas. There were 26 patients with drug-induced liver injury; those who fulfilled the following criteria were included: contact with a drug known to produce hepatotoxicity; clinic, biologic and histologic picture corresponding to the drug studied, complete recovery after the drug was stopped and no other hepatic toxics. Fourteen patients showed estrogen-induced intrahepatic cholestasis, 5 had hepatitis-like lesions due to: alphamethyldopa (3), ketoconazole (1) and indomethacin (1). Carbon tetrachloride caused fatty degeneration in two patients and phenylbutazone a granulomatous hepatitis in one patient and cholestatic hepatitis in other. The last three cases were cholestatic lesions after the administration of chlorpromazine allopurinol and penicillin respectively. The evolution in 24 patients was excellent after the drug was withdrawn. Two patients died because of surgical complications since they were operated on with the wrong diagnosis of extrahepatic cholestasis.

Primary hepatic actinomycosis.

A case of primary hepatic actinomycosis is reported. Multiple liver abscesses were diagnosed in a febrile 60-year-old-man by means of non-invasive techniques such as ultrasonography, CT and radioisotope scans. The aetiology was confirmed by the unusual finding of Actinomyces israelii in anaerobic blood cultures. Other sites were not involved. Early penicillin therapy enabled surgery to be avoided.

[Tuberculous lymphadenitis. Apropos of a non-typical histological picture]. / Linfoadenite tubercolare. A proposito di un quadro istologico non tipico.

The case is presented of a young Somali with acute lymphadenitis. Whereas histological examination indicated abscessing granulomatous lymphadenitis, bacteriological studies revealed the presence of M. tuberculosis in the pus taken from the lymph node. Hence the aetiological diagnosis contradicted the morphological picture.

[On a case of autochthonous amebiasis]. / Su un caso di amebiasi autoctona.

Amoebiasis is usually acquired in countries where the disease is endemic. A case is presented of hepatic infection acquired indigenously. The Authors emphasized the importance of amoebic hepatic abscess as potential cause for delay in diagnosis.