Coronary artery lesions and human immunodeficiency virus infection.

The postmortem anatomopathological examination of eight heart-and-lung specimens obtained from eight HIV-seropositive patients was performed. Three patients were CDC stage II and five patients were CDC stage IV. The mean age was 27 (range: 23-32). Distal and proximal vascular lesions of the coronary arteries were observed. These impairments were marked by major excentric atherosclerosis (with 80-90% obstruction of the arterial lumen) or by fibrosis two-fold or six-fold the thickness of the tunica media. Sclero-hyalinosis of the smaller arteries and myocardial interstitial fibrosis lesions was also revealed. In view of the severity of the described lesions, the absence of any associated cardiovascular risk factors and the context of immunodepression, the role of a virus in the genesis of these lesions is suggested, in particular a virus of the herpes group.

Acute meningoradiculitis concomitant with seroconversion to human immunodeficiency virus type 1.

We report a case of acute regressive meningoradiculitis concomitant with HIV1 primoinfection. The clinical symptoms were mild and disappeared spontaneously. Electromyographic studies confirmed the regressive demyelinating-type process. The biological diagnosis of HIV1 infection was demonstrated by viral antigen detection, by the presence of the integrated proviral DNA after gene amplification by a polymerase chain reaction, and in particular, by the steady progression in the appearance of different HIV1-specific antibodies. This was shown using three different Western blot kits whose performances were compared.

[Effects of a postpituitary extract and lysine vasopressin on portal and systemic hemodynamics in the cirrhotic patient]. / Effets d'un extrait de post-hypophyse et de la lysine vasopressine sur l'hémodynamique portale et systémique chez le cirrhotique.

The purpose of this work was to study the hemodynamic effects of a pituitary extract (Post-Hypophyse, Choay, EPH) and of lysine vasopressin (Diapid, Sandoz, VP). Cardiac, pulmonary and liver hemodynamics were measured in 50 cirrhotic patients before and during intravenous infusion (0.45 IU/kg/h) of EPH (24 patients) or VP (26 patients). EPH and VP did not have identical consequences in cardiac output and systemic resistances. EPH significantly increased cardiac output and significantly decreased systemic resistances while VP significantly and increased systemic resistances. Both vasoactive drugs similarly decreased myocardial performances. EPH and VP had a moderate influence on WHV/IVC pressure gradient. This was variable from one patient to another. The decrease of WHV/IVC pressure gradient observed during EPH infusion was mainly related to an increase of IVC pressure. Since the effects of both drugs on WHV/IVC pressure gradient are slight and unpredictable and they exert an important effect on cardiopulmonary hemodynamics, caution should be taken in administering EPH or VP to cirrhotic patients. The clinical use of EPH or VP should be undertaken only when cardiac and liver hemodynamics monitoring are available.