HIV Protease Inhibitors: Advances in Therapy and Adverse Reactions, Including Metabolic Complications

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90068/1/phco.19.4.281.30937.pd

Magnitude and Duration of Elevated Gastric pH in Patients Infected with Human Immunodeficiency Virus After Administration of Chewable, Dispersible, Buffered Didanosine Tablets

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90191/1/phco.24.16.1539.50959.pd

Mycobacterium avium complex immune reconstitution inflammatory syndrome: Long term outcomes

Abstract Background To describe long term outcomes of Mycobacterium avium complex (MAC) immune reconstitution inflammatory syndrome (IRIS). Methods Cases of MAC IRIS were retrospectively identified at four HIV clinics (Michigan, Maryland, Rhode Island, and Indiana) from 1996–2004. Patients were included if they were initially diagnosed with AIDS and found to have evidence of focal MAC infection documented by tissue culture or PCR after initiating HAART, and at least 6 months of follow up. Results Among the 20 patients included, the mean age was 40 years, mean CD4 cell count was 24/mm3 at pretreatment baseline and 100/mm3 at time of MAC IRIS diagnosis. Sites of disease included lymph nodes (15 patients [8 peripheral, 8 abdominal and 1 peripheral and abdominal]), gastrointestinal tract (7) and liver (3). Sixteen patients (80%) responded to treatment and were disease free after a mean of 17.4 months of therapy for MAC IRIS; IRIS therapy was withdrawn in 6 without relapse. Four patients (non-responder group) had persistent or relapsing disease despite 27 months of ongoing MAC IRIS treatment. At the time of resolution or last follow-up, the mean CD4 cell count and viral load was 143/mm3 and 7,000 c/mL for responders, and 65/mm3 and 17,000 c/mL for non-responders, respectively. Most patients with peripheral adenopathy were responders (7/8; 88%); many with abdominal adenopathy (4/8; 50%) were nonresponders. Conclusion The majority of patients with MAC IRIS eventually responded to treatment. Our sample size was not adequate to perform statistical analysis, but there was a tendency towards adequate CD4 response to HAART and peripheral rather than intraabdominal adenopathy among responders.http://deepblue.lib.umich.edu/bitstream/2027.42/112767/1/12967_2007_Article_210.pd

The Beginnings of Bacteriology in American Medicine: Activities of Frederick Novy 1888-1933.

Frederick Novy (1864-1957) was a leader among a new breed of full-time bacteriologists at American medical schools in the 1890s. Historians have not provided comprehensive accounts of these early bacteriology researchers. I describe Novy’s research and educational activities at the University of Michigan Medical School from 1891-1933, using them as a window to examine meanings of bacteriology in medicine, medical education and American society. In his medical school laboratory, Novy focused on designing innovative technology to visualize microbes and their behavior. Novy also used a makeshift bacteriology laboratory to define plague’s unusual behavior, although he could not find a biological basis for its aberrancy or convince citizens to adopt anti-plague actions. In addition, Novy developed the first full semester laboratory-based bacteriology course in America in 1889. Novy’s activities do not conform to traditional characterizations of early bacteriology in America as a merely practical application of European-derived theories. What can be learned from Novy’s composite activities at a time when laboratory science in medicine was new? His focus was on technical objectivity—devising novel instruments as a means of gaining an accurate understanding of microbes and their behavior. Through his scientific conduct, disinterested motives, and teachings, he embodied a code of ethics—a duty to search for objective truths above other commitments, whether they be practical application or personal gain. Novy intended to legitimate pure laboratory science, with disciplined hard work, search for truths, and moral code, by establishing noble “spirit” as a norm of behavior for all medical students, researchers and practitioners alike. Novy’s colleagues and students viewed his norm of “pure” science as adding legitimacy to a medical profession in need of certainty. Novy’s students saw his effort as uplifting the overall quality of medical education. The meanings of Novy’s science in American society can be viewed through the novel Arrowsmith, a representation of Novy’s activities as told by his student, Paul de Kruif. Sinclair Lewis, who collaborated with de Kruif to write Arrowsmith, offered laboratory science as having potential to provide a resonant truth and substance to an early 20th century American society portrayed as bereft of meaning.Ph.D.HistoryUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/91470/1/pkazanji_1.pd

Lack of good correlation of serum CC-chemokine levels with human immunodeficiency virus-1 disease stage and response to treatment

Three CC-chemokines—MIP-1(alpha) (CCL3), MIP-1(beta) (CCL4), and RANTES (CCL5)—are natural ligands for the human immunodeficiency virus–1 (HIV-1) coreceptor CCR5. To determine correlations between CC-chemokines and HIV-1 disease stage or response to treatment, we examined serum levels of MIP-1(alpha), MIP-1(beta), and RANTES in 60 infected patients during 18 months while they were taking highly active antiretroviral therapy (HAART). Our results demonstrate that serum levels of MIP-1(alpha) and RANTES were increased in HIV-1-infected individuals compared with those in healthy controls. We found no significant differences among 4 clinical stages of HIV-1 infection in the serum levels of three CC-chemokines. Longitudinal HAART analyses revealed a pronounced decline in serum MIP-1(alpha) levels over time. We found no difference in this decline between HAART responders and nonresponders. These findings indicate that production of MIP-1(alpha) and RANTES changes during HIV-1 infection and treatment; however, our results suggest that serum levels of CC- chemokines should not be used as biomarkers for HIV-1 disease stage or response to treatment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/83363/1/Ye.et-al.JLCM2004.pd

Meal Composition Effects on the Oral Bioavailability of Indinavir in HIV-Infected Patients

Purpose . To study the influence of large-volume high-calorie protein, fat, and carbohydrate meals and a non-caloric hydroxypropylmethyl cellulose (HPMC) viscous meal on the oral bioavailability of indinavir in HIV-infected subjects.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41479/1/11095_2004_Article_303570.pd

Abdominal CT demonstrating multiple abscessed intra-abdominal lymph nodes

<p><b>Copyright information:</b></p><p>Taken from "complex immune reconstitution inflammatory syndrome: Long term outcomes"</p><p>http://www.translational-medicine.com/content/5/1/50</p><p>Journal of Translational Medicine 2007;5():50-50.</p><p>Published online 15 Oct 2007</p><p>PMCID:PMC2213635.</p><p></p