Markers for HIV-disease progression in untreated patients and patients receiving AZT: evaluation of viral activity, AZT resistance, serum cholesterol, beta 2-microglobulin, CD4+ cell counts, and HIV antigen

In order to find parameters which allow the assessment of the clinical state of HIV patients with or without antiviral therapy, viral cultures on lymphocytes and monocytes/macrophages, CD4-cell counts, HIV antigen, beta 2-microglobulin and serum cholesterol were evaluated for their predictive value. As had been shown previously for lymphocytes, the efficiency of viral isolation on macrophages also depends on the disease stage (CDC) of the patients and thus has a high predictive value. A multivariant discriminant analysis showed that the combination of beta 2-microglobulin, viral antigen, CD4+ cell count and HDL cholesterol predicted the outcome of viral cultures with 80% accuracy. While viral antigen, CD4+ cell counts and beta 2-microglobulin had been known, HDL cholesterol deserves further evaluation as prognostic parameter. The analysis of HIV derived from patients with AZT showed a 20-200-fold in vitro drug resistance after seven to 24 months of therapy. DNA sequence determination of such strains isolated from AZT patients over time showed only two of the amino acid exchanges described in the literature for resistant strains and an additional Val60-Ile transition after 32 months of therapy.

Perinatal listeriosis in Dresden 1981-1986: clinical and microbiological findings in 18 cases

Between 1981 and 1986 Listeria monocytogenes was isolated from blood cultures, CSF, meconium/stools or external swabs from 18 newborn infants of two neonatal intensive care units (ICU) in adjacent pediatric clinics of Dresden. The epidemiological and clinical data of infants and their mothers, as well as microbiological and laboratory, x-ray, EEG and ultrasonic findings, are presented. All infants had an early onset of their disease. Cases were classified as granulomatosis infantiseptica (three cases), sepsis (three cases), meningitis (eight cases) and listerial infection without distinct organ manifestations (four cases), respectively. As far as the predominant symptoms at admission were concerned, no typical clinical signs of neonatal listeriosis could be evaluated. Cases with manifest clinical infections had an overall mortality rate of 21% (3/14) despite the immediate initiation of antibiotic therapy; at discharge, a further five patients showed neurological residuals. Serotyping and phagetyping have proved to be methods for recognition or exclusion of epidemiological relationships.