RESUMEN

Occlusal characteristics, fundamental to assess the presence of malocclusion, have been often unexplored in bioarchaeological analyses. This is largely due to the fragmented condition of the skeletal remains. By applying a method that considers dental and maxillary features useful to evaluate occlusion in ancient fragmentary material, the purpose of this work is to define the occlusal features and explore the causes of malocclusion in a mediaeval population from Mallorca. The findings of this study suggest that normocclusion was present in ca. 60% of the individuals (N=31), and that some characteristics, such as molar relationship, were slightly different from those of modern populations. The analysis of the occlusal features revealed for example that open-bite was absent in 85% of the sample, posterior open-bite was completely absent and overbite and overjet were normal in around 90% of the individuals. Statistically significant correlations between canine and molar relationships and between molar relationship and dental wear of the superior and inferior canines and incisors were observed. In addition, wear could affect the curve of Spee. All these findings strengthen the hypothesis that in ancient times malocclusion was not as generalized as in modern times. Although the factors that lead to malocclusion throughout centuries could have several causes, we suggest that in this population dental wear, which is strongly associated with the diet, was the fundamental causing factor.

Asunto(s)

Oclusión Dental , Maloclusión/historia , Restos Mortales/diagnóstico por imagen , Femenino , Fósiles/diagnóstico por imagen , Historia Medieval , Humanos , Masculino , Maloclusión/diagnóstico por imagen , Paleodontología , España

RESUMEN

Reference change values of six biochemical quantities (beta 2-microglobulin, neopterin, adenosine deaminase and immunoglobulins IgA, IgG and IgM) have been established in asymptomatic human immunodeficiency virus (HIV)-infected patients following the method described by Harris and Yasaka in 1983. Patients included in the evaluation were classified as A1, A2 or A3 according to the classification of the Centers for Disease Control (CDC) (January 1993). All patients were followed-up quarterly, with a minimum of four samples each available for statistical analysis. The main objective of this paper was to study whether differences found to be greater than calculated reference change values could predict clinical or immunological worsening in patients' status. Retrospective analysis was made in asymptomatic patients (n = 256) included in an HIV infection protocol carried out in our hospital. Of these patients, 179 showed clinical or immunological worsening during the study period and 77 maintained their clinical and immunological status. Changes in beta 2-microglobulin showed the greatest sensitivity to detect clinical or immunological worsening (43.0%), whereas changes in adenosine deaminase showed the lowest (21.8%). Clinical or immunological worsening in 169 of the 179 patients was detected by one of the six biochemical quantities evaluated. Ten patients showed clinical or immunological worsening, although differences between measurements were lower than the reference change values calculated. Of 77 patients whose clinical state did not deteriorate, there was a change in biochemical analytes greater than the reference value calculated in 29 patients (a period of 12 months had elapsed since detection). In 48 patients, no increases greater than calculated reference change values were detected. The sensitivity obtained using the six analytes was 94.4% and the specificity was 62.3%.

Asunto(s)

Adenosina Desaminasa/sangre , Infecciones por VIH/sangre , Inmunoglobulinas/sangre , Neopterin/sangre , Microglobulina beta-2/análisis , Análisis de Varianza , Biomarcadores/sangre , Progresión de la Enfermedad , Humanos , Sensibilidad y Especificidad

RESUMEN

OBJECTIVE: To evaluate the presence of thallium-201 brain uptake determined by thallium-201 brain SPECT (Tl-201 SPECT) in patients with progressive multifocal leukoencephalopathy (PML) and AIDS. MATERIAL AND METHODS: Six AIDS patients with stereotactic biopsy diagnosis of PML were prospectively evaluated with Tl-201 SPECT, Magnetic Resonance Imaging (MRI), and proton magnetic resonance spectroscopy (1H-MRS). Tl-201 SPECT results were compared with 2 patients with AIDS and biopsy proven primary CNS lymphoma. RESULTS: In all patients with PML, Tl-201 SPECT studies showed lack of uptake while MRI demonstrated subcortical white matter focal brain lesions and 1H-MRS disclosed metabolic abnormalities. Intense thallium uptake (uptake ratios of 3.2 and 5.6) was demonstrated in the 2 patients with primary CNS lymphoma. CONCLUSIONS: The present study shows that PML lesions are not detectable on Tl-201 SPECT while MRI and 1H-MRS demonstrate abnormalities, and intense thallium-201 uptake may be detected in primary CNS lymphoma. These results suggest that Tl-201 SPECT is a method which, combined with other non-invasive techniques such as MRI and 1H-MRS, may help in the diagnostic approach of PML and to differentiate PML from other high proliferative brain lesions characterized by positive thallium uptake.

Asunto(s)

Complejo SIDA Demencia/diagnóstico por imagen , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico por imagen , Leucoencefalopatía Multifocal Progresiva/diagnóstico por imagen , Tomografía Computarizada de Emisión de Fotón Único , Adulto , Encéfalo/diagnóstico por imagen , Neoplasias Encefálicas/diagnóstico por imagen , Diagnóstico Diferencial , Metabolismo Energético/fisiología , Femenino , Humanos , Linfoma Relacionado con SIDA/diagnóstico por imagen , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Masculino , Persona de Mediana Edad , Examen Neurológico , Radioisótopos de Talio

Asunto(s)

Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Esofagitis/virología , Miocarditis/virología , Polimiositis/virología , Adulto , Humanos , Masculino

RESUMEN

The objective was to determine whether the use of intermediate echo times (135 ms) in proton magnetic resonance spectroscopy (1H-MRS) detects a homogenous pattern in progressive multifocal leukoencephalopathy (PML) in HIV-1 infected people, and to confirm the results of previous studies. Six patients infected with HIV-1, with PML established by biopsy, and six healthy age and sex matched volunteers were evaluated to define their spectroscopic pattern. 1H-MRS spectra performed at 1.5 T were obtained with the STEAM sequence: TE/TM/TR, 20 ms/13.7 ms/2000 ms; 2500 Hz, size 2048 points, 256 acquisitions (STEAM-20) and with the PRESS sequence; TE/TR, 135 ms/2000 ms; 2500 Hz, size 2048 points, 256 acquisitions (PRESS-135). A single voxel was placed on the lesions and on the parieto-occipital white matter of controls. The peaks of N-acetylaspartate (NAA), choline (Cho), myoinositol (mI), lactate, and lipids were considered, and the results were expressed using creatine as reference. Spectra of PML lesions were characterised by significantly reduced NAA, lactate presence, and by significantly increased Cho and lipids compared with control group values. These results indicate that 1H-MRS detects a homogenous pattern in PML lesions. Recent studies, together with this, suggest that 1H-MRS may help in the diagnostic approach to patients with suspected PML lesions associated with AIDS.

Asunto(s)

Complejo SIDA Demencia/diagnóstico , Leucoencefalopatía Multifocal Progresiva/diagnóstico , Espectroscopía de Resonancia Magnética/métodos , Complejo SIDA Demencia/metabolismo , Síndrome de Inmunodeficiencia Adquirida/diagnóstico , Adulto , Astrocitos/patología , Biopsia , Núcleo Celular/patología , Femenino , VIH-1/aislamiento & purificación , Humanos , Leucoencefalopatía Multifocal Progresiva/metabolismo , Masculino , Persona de Mediana Edad , Oligodendroglía/patología

RESUMEN

Serum vitamin B12 levels are often low in human immunodeficiency virus (HIV)-infected patients. However, only a few patients appear to have actual vitamin B12 deficiency. A low red cell folate level accompanying the low vitamin B12 level makes the presence of vitamin B12 deficiency more likely. Our experience suggests that a low red cell folate level always indicates deficiency, but does not differentiate between vitamin B12 and folate deficiency. The deoxyuridine suppression test and the assay of serum or plasma total homocysteine and/or of methylmalonic acid levels can also be useful in the identification of patients with true vitamin B12 deficiency. HIV-positive patients frequently have absorption disorders, including vitamin B12 malabsorption. However, the correlation between vitamin B12 malabsorption and serum vitamin B12 and plasma homocysteine levels is poor. Abnormalities in vitamin B12-binding proteins, which are often found in HIV-positive patients, may explain many cases of low vitamin B12 levels. Current evidence suggests that low vitamin B12 levels are more common as the HIV disease progresses. The results of vitamin B12 treatment have been disappointing thus far, including the prevention of toxicity induced by azidothymidine. The possible role of vitamin B12 treatment in the long-term survival of HIV-infected patients is at present unknown. However, it is important to identify those patients who have real vitamin B12 deficiency to treat or prevent their hematologic and/or neurological symptoms.

Asunto(s)

Síndrome de Inmunodeficiencia Adquirida/complicaciones , Deficiencia de Vitamina B 12/complicaciones , Eritrocitos/metabolismo , Ácido Fólico/sangre , Homocisteína/sangre , Humanos , Síndromes de Malabsorción/complicaciones , Enfermedades del Sistema Nervioso/complicaciones , Pronóstico , Deficiencia de Vitamina B 12/epidemiología

Asunto(s)

Síndrome de Inmunodeficiencia Adquirida/complicaciones , Leucoencefalopatía Multifocal Progresiva/complicaciones , Trastornos de la Visión/etiología , Femenino , Humanos , Leucoencefalopatía Multifocal Progresiva/diagnóstico , Imagen por Resonancia Magnética , Persona de Mediana Edad , Síndrome

Asunto(s)

Síndrome de Inmunodeficiencia Adquirida/sangre , Venas Cerebrales , Embolia y Trombosis Intracraneal/sangre , Deficiencia de Proteína S/sangre , Trombosis de los Senos Intracraneales/sangre , Síndrome de Inmunodeficiencia Adquirida/diagnóstico , Adulto , Angiografía Cerebral , Venas Cerebrales/patología , Senos Craneales/patología , Femenino , Humanos , Embolia y Trombosis Intracraneal/diagnóstico , Imagen por Resonancia Magnética , Proteína S/análisis , Deficiencia de Proteína S/diagnóstico , Trombosis de los Senos Intracraneales/diagnóstico

Asunto(s)

Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Diarrea/etiología , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Adulto , Animales , Antiprotozoarios/uso terapéutico , Antituberculosos/uso terapéutico , Antivirales/uso terapéutico , Criptosporidiosis/complicaciones , Criptosporidiosis/tratamiento farmacológico , Infecciones por Citomegalovirus/complicaciones , Infecciones por Citomegalovirus/tratamiento farmacológico , Diarrea/microbiología , Diarrea/parasitología , Heces/microbiología , Heces/parasitología , Femenino , Humanos , Masculino , Microsporida , Microsporidiosis/complicaciones , Microsporidiosis/tratamiento farmacológico , Infecciones por Mycobacterium no Tuberculosas/complicaciones , Infecciones por Mycobacterium no Tuberculosas/tratamiento farmacológico , Factores de Riesgo

RESUMEN

The deoxyuridine suppression test (dUST) was used to evaluate human immunodeficiency virus type 1 positive (HIV-1) patients with low serum levels of vitamin B12 and/or low red cell folate and to assess any possible interferences of azydothymidine (AZT) in this test. The dUST was studied in 29 HIV-1 positive patients, 18 without low serum vitamin B12 or low red cell folate and 11 with low serum vitamin B12 (6 patients), low red cell folate (4 patients) and 1 case with both. The role of AZT was studied using different concentrations (0.2, 2.5 and 10 microM/ml) in 2 groups: 1 group of 5 patients with vitamin B12 and/or folate deficiency and another group consisting of 13 healthy subjects. Methotrexate (MTX)(50 micrograms/ml) was added to induce a folate megaloblastic pattern in the latter group. Results of the dUST in the HIV-1 group without low levels of serum vitamin B12 fell within the health-related reference interval values. A vitamin B12 deficiency was only detected in 1 case in the HIV-1 group with low serum vitamin B12, although a folate deficiency pattern was observed in the 4 patients with low red cell folate. In the healthy subjects AZT induced a dose-dependent decrease of the MTX-induced folate megaloblastic pattern. The pattern was also observed in the group of patients with vitamin B12 or folate deficiency, although AZT did not entirely interfere with the dUST. The effect of AZT on the dUST was attributed to a decrease in the incorporation of the isotope in the absence of deoxyuridine. The dUST is useful in differentiating vitamin B12 deficient patients from HIV-1 infected patients with low levels of serum vitamin B12.

Asunto(s)

Desoxiuridina , Infecciones por VIH/complicaciones , Deficiencia de Vitamina B 12/etiología , Vitamina B 12/sangre , Zidovudina/efectos adversos , Anemia Megaloblástica/etiología , Médula Ósea/efectos de los fármacos , Médula Ósea/patología , Células Cultivadas , Ácido Fólico/sangre , Infecciones por VIH/sangre , Infecciones por VIH/tratamiento farmacológico , VIH-1 , Humanos , Absorción Intestinal , Metotrexato/farmacología , Vitamina B 12/farmacocinética , Zidovudina/farmacocinética , Zidovudina/uso terapéutico

RESUMEN

We describe the clinical characteristics, causes and response to treatment in 6 patients with AIDS who presented with abnormal movement disorders between January 1987 and July 1993 in our hospital, 3 with hemiballismus-hemichorea, 1 with athetosis, 1 myoclonia and 1 with "rubric" tremor. Brain imaging showed lesions in the corpus striatum in all the patients. Suspected diagnoses were cerebral toxoplasmosis in 4, cerebral lymphoma in 1 and progressive multifocal leukoencephalopathy in 1. The toxoplasmosis patients showed improvement (2 cases) or disappearance (2 cases) of movements with antiparasitic therapy. Treatment provided no benefit to the patients with leukoencephalopathy and lymphoma. Hemiballismus-hemichorea was the most common movement disorder in AIDS patients. The underlying cause is usually lesions in the basal ganglia arising from toxoplasmosis. If the lesions are so caused, movements may improve with antiparasitic therapy.

Asunto(s)

Síndrome de Inmunodeficiencia Adquirida/complicaciones , Atetosis/etiología , Corea/etiología , Mioclonía/etiología , Temblor/etiología , Síndrome de Inmunodeficiencia Adquirida/diagnóstico , Síndrome de Inmunodeficiencia Adquirida/fisiopatología , Adulto , Antiparasitarios/uso terapéutico , Atetosis/fisiopatología , Ganglios Basales/fisiopatología , Encéfalo/patología , Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/patología , Corea/fisiopatología , Cuerpo Estriado/fisiopatología , Femenino , Humanos , Leucoencefalopatía Multifocal Progresiva/complicaciones , Linfoma/complicaciones , Linfoma/patología , Imagen por Resonancia Magnética , Masculino , Mioclonía/fisiopatología , Toxoplasmosis/complicaciones , Toxoplasmosis/tratamiento farmacológico , Toxoplasmosis/parasitología , Temblor/fisiopatología

RESUMEN

We have retrospectively reviewed 63 cases of encephalic toxoplasmosis (ET) in HIV-infected patients in order to determine clinical and radiological characteristics, the diagnostic value of serologic determinations, and the response to antioxoplasmic therapy. ET was the AIDS-defining condition in 44% of the patients. Eighty of the patients had a CD4 cell count < 100/microliters when ET was diagnosed. Only 4.8% of the patients had been taking anti-Pneumocytis carinii prophylaxis with cotrimoxazol. The most frequent clinical presentation was focal neurologic signs in 80.9% of the patients, with headache and fever in 53.3% and 42.4%, respectively. The most frequent cerebral CT finding was hipodense lesions (92%) with ring enhancement (68.9%). They were most frequently had a hemisferic location. Seroconversion was detected in two patients (6%), whereas 55 patients had serologic evidence of latent infection by Toxoplasma gondii (87.3%). Ninety eight percent of the patients were treated with sulphadiazine plus pyrimethamine. However, such therapy should be discontinued in 22% of them and switched to clindamycin plus pyrimethamine. The overall mortality rate during the acute phase of the disease was 7.9%, but 41.4% of the survivors exhibited neurologic sequelae. Relapsing ET was detected in 33.3% of the patients, and it was usually due to discontinuation of treatment. The mean survival time after the diagnosis of ET was 11.5 months. ET is the most common opportunistic infection of the central nervous system among our AIDS patients. Primary prophylaxis for toxoplasmic infection seems advisable in our epidemiologic environment, when CD4 cell count is less than 200/microliters and there is serologic evidence of latent infection. Acute ET usually has a good response to therapy, and the acute mortality rate is low. However, most of the survivors will remain with neurologic sequelae. The high frequency of adverse effects to sulphamide therapy with clindamycin make the need of alternative treatment strategies urgent.

Asunto(s)

Infecciones por VIH/complicaciones , Toxoplasmosis Cerebral/diagnóstico , Toxoplasmosis Cerebral/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Adulto , Anciano , Antibacterianos/uso terapéutico , Antiinfecciosos/uso terapéutico , Clindamicina/uso terapéutico , Coccidiostáticos/uso terapéutico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pirimetamina/uso terapéutico , Radiografía , Estudios Retrospectivos , Sulfadiazina/uso terapéutico , Toxoplasmosis Cerebral/diagnóstico por imagen

RESUMEN

We report a high prevalence of elevated serum and red cell ferritin (SF and RCF) levels in 168 patients with HIV infection. SF levels increase with clinical worsening of infection and with decreasing CD4+ lymphocyte counts (ANOVA, p < 0.001) while RCF is significantly higher in asymptomatic AIDS patients (ANOVA, p < 0.001) and in those treated with zidovudine (AZT) (ANOVA, p < 0.001). It is suggested that, although inflammatory processes may explain high SF levels, if we also take in account RCF levels a possible association between iron overload and HIV infection might exist, and this may be worsened by AZT treatment. The significance of these high ferritin levels and their effects on immune system suppression and susceptibility to infectious and neoplastic complications in these patients merits further investigation.

Asunto(s)

Eritrocitos/metabolismo , Ferritinas/sangre , Infecciones por VIH/sangre , Análisis de Varianza , Biomarcadores/sangre , Humanos

RESUMEN

BACKGROUND: Low vitamin B12 levels (B12) are often observed in patients infected with human immunodeficiency virus type 1 (HIV-1). The causes underlying this finding are thought to be intestinal malabsorption and/or abnormalities in the vitamin plasma binding proteins (BP). MATERIAL AND METHODS: Serum levels of B12 and BP were studied in eighty HIV-1-positive patients, 55 of whom met the diagnostic criteria for AIDS. Subjects were divided into various subgroups: non-AIDS HIV-1 positive versus AIDS; low serum B12 levels (DB12, < 150 pmol/L) versus normal serum B12 levels (NB12); and the results obtained were compared both between groups and with respect to a reference population (RF) of normal volunteers. RESULTS: Low levels of serum B12 were found in 14 patients (17.5%), without differences between the AIDS and non-AIDS subgroups. The levels of holohaptocorrin (holoHP) were lower in the DB12 group than in the NB12 and RF groups (p < 0.01), and no differences were found between the AIDS and non-AIDS groups. The levels of apotranscobalamin (apoTC) were higher in the AIDS group than in the non-AIDs and RF subjects (p < 0.01), but no differences were found between the DB12 and NB12 groups. Likewise, no differences were noted in the levels of holoTC between the DB12 and NB12 groups. A positive correlation between neutrophil counts and free serum haptocorrin levels (apoHP) (rs = 0.36; p = 0.002), and a negative one between the former and the levels of apoTC (rs = -0.3; p = 0.009) were observed. Furthermore, a positive correlation was detected between the erythrocyte sedimentation rate and the levels of apoHP and TC. CONCLUSIONS: Low serum levels of HP in HIV-1 positive patients could lead to the low levels of serum vitamin B12 frequently observed in this patient population, while the high levels of TC could merely represent a non-specific marker of inflammation (acute phase, reactant).

Asunto(s)

Síndrome de Inmunodeficiencia Adquirida/sangre , Apoproteínas/sangre , Infecciones por VIH/sangre , Transcobalaminas/análisis , Deficiencia de Vitamina B 12/complicaciones , Vitamina B 12/sangre , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Reacción de Fase Aguda , Adulto , Femenino , VIH-1 , Humanos , Incidencia , Pacientes Internos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Neutropenia/sangre , Neutropenia/complicaciones , Pacientes Ambulatorios , Transcobalaminas/deficiencia , Deficiencia de Vitamina B 12/sangre , Deficiencia de Vitamina B 12/epidemiología

Asunto(s)

Infecciones Oportunistas Relacionadas con el SIDA/sangre , Síndrome de Inmunodeficiencia Adquirida/sangre , Biopterinas/análogos & derivados , Adenosina Desaminasa/sangre , Biomarcadores , Biopterinas/análisis , Humanos , Neopterin , Pronóstico , Estudios Prospectivos , Microglobulina beta-2/análisis

Asunto(s)

Adenosina Desaminasa/líquido cefalorraquídeo , Pruebas Enzimáticas Clínicas , Meningitis Criptocócica/enzimología , Infecciones por VIH/complicaciones , Humanos

Asunto(s)

Infecciones por VIH/sangre , VIH-1 , Abuso de Sustancias por Vía Intravenosa/complicaciones , Microglobulina beta-2/análisis , Bisexualidad , Transfusión Sanguínea , Femenino , Infecciones por VIH/etiología , Homosexualidad , Humanos , Masculino , Pronóstico , Estudios Prospectivos

Asunto(s)

Infecciones por Bacteroides/etiología , Rinorrea de Líquido Cefalorraquídeo/complicaciones , Meningitis Bacterianas/etiología , Sinusitis del Esfenoides/complicaciones , Infecciones Estreptocócicas/etiología , Adolescente , Rinorrea de Líquido Cefalorraquídeo/etiología , Rinorrea de Líquido Cefalorraquídeo/cirugía , Femenino , Humanos

RESUMEN

To detect potential cardiac abnormalities induced by intravenous heroin use, 68 persons without a previous episode of infective endocarditis were studied by Doppler echocardiography. A control group of 41 normal subjects was studied for comparison. The following measurements were considered: (1) diameter of heart chambers, (2) systolic left ventricular function, (3) morphologic valvular abnormalities, (4) presence of valve regurgitations, (5) Doppler indexes of diastolic function, and (6) estimation of pulmonary arterial resistances. Results showed no significant differences regarding the size of the heart chambers or systolic left ventricular function. A significantly higher incidence of valvular abnormalities (focal thickening or valve prolapse) was found in drug addicts (p = 0.0009) at the mitral and tricuspid valves, as was valvular regurgitation detected by Doppler (p = 0.04). Also, a significantly prolonged deceleration time of mitral and tricuspid early diastolic Doppler flow was found in the study group (p = 0.0001 and 0.027, respectively) although a different hemodynamic condition in the study group (pharmacologically reduced preload) precluded these findings to be attributable to an actual diastolic dysfunction. No differences were observed in pulmonary arterial resistances. It is concluded that mitral and tricuspid valve abnormalities can be detected by echocardiography in asymptomatic intravenous heroin users, whereas no apparent effects are observed in morphologic or functional parameters of cardiac structures other than the valves.

Asunto(s)

Ecocardiografía Doppler , Enfermedades de las Válvulas Cardíacas/patología , Dependencia de Heroína/patología , Abuso de Sustancias por Vía Intravenosa/patología , Función Ventricular Izquierda , Adolescente , Adulto , Distribución de Chi-Cuadrado , Femenino , Enfermedades de las Válvulas Cardíacas/fisiopatología , Dependencia de Heroína/fisiopatología , Humanos , Masculino , Válvula Mitral/patología , Miocardio/patología , Estudios Prospectivos , Abuso de Sustancias por Vía Intravenosa/fisiopatología , Válvula Tricúspide/patología

RESUMEN

A prospective study of 60 consecutively admitted patients with HIV infection was performed to document the prevalence, etiology and manifestations of low serum vitamin B-12 in such patients. Low serum B-12 levels were found in 10 patients (16.7%). In 6, vitamin B-12 absorption was impaired and hog intrinsic factor addition did not improve it. Patients with low vitamin B-12 levels showed lower hemoglobin, leukocytes, lymphocytes, CD4 lymphocytes and CD4/CD8 lymphocyte ratio than HIV patients with physiological serum vitamin B-12 levels. However, bone marrow megaloblastosis was found in only 3 low vitamin B-12 patients and the deoxyuridine suppression test was pathological in only 1 case. In 7 patients, parenteral treatment was begun with variable response despite serum vitamin B-12 correction. In conclusion, low serum vitamin B-12 is often found in HIV-infected patients and it could be related to malabsorption, but clear megaloblastic abnormalities and treatment response could not be demonstrated. A decreased concentration of the serum binders due to disturbances in the leukocytes and related immunocompetent cell may play an additional role.

Asunto(s)

Infecciones por VIH/sangre , Vitamina B 12/sangre , Adulto , Anemia/sangre , Anemia/complicaciones , Femenino , Ácido Gástrico/metabolismo , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Humanos , Hidroxocobalamina/uso terapéutico , Factor Intrinseco/metabolismo , Recuento de Leucocitos , Masculino , Estudios Prospectivos