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[获得性免疫缺陷综合征(艾滋病)患者的巨细胞病毒感染:临床、病毒学及组织病理学相关性]

[Infection by cytomegalovirus in patients with acquired immunodeficiency syndrome (AIDS): clinical, virological, and histopathological correlations].

作者信息

Turchi M D, Pannuti C S, Sumita L M, Vilas Boas L S, Weinberg A, Stavale J N, Borges A F, Collarine D C, dos Santos H V, Kitadai S S

机构信息

Departamento de Doenças Infecto-parasitárias, Escola Paulista de Medicina (EPM), Bolsista da FAPESP, Brasil.

出版信息

Rev Inst Med Trop Sao Paulo. 1991 Jul-Aug;33(4):243-50.

PMID:1668973
Abstract

Between April 1986 and June 1987, 50 patients meeting the CDC criteria for AIDS were studied for serological and virological evidence of CMV infection. Attempts for virus isolation from peripheral blood, urine and saliva were performed in cell culture lines of human foreskin fibroblasts and CMV specific IgG and IgM were assayed by IFI and IgG by ELISA. A total of 121 blood, 119 urine and 96 saliva samples were collected. During the study period viremia was noted at least once in 12.5%, viruria in 23.2%, and excretion in saliva in 21.9%. When admitted in the study, 20% (10/50) of the patients had anti-CMV IgM antibodies and 100% (50/50) of them had IgG anti-CMV antibodies (IFI). Five of the 40 patients IgM negative at admission presented anti-CMV IgM antibodies during the study, suggesting CMV reactivation or reinfection. Active CMV infection based on virus isolation and/or IgM positivity was demonstrated in 60% of the patients. Histopathological studies were performed in 24 patients. CMV was found in 50% of the autopsies, mainly in the digestive system, lungs and adrenals. There was no correlation between clinical, virological (serology and isolation) and histopathological diagnosis.

摘要

1986年4月至1987年6月期间,对50名符合美国疾病控制与预防中心(CDC)艾滋病标准的患者进行了巨细胞病毒(CMV)感染的血清学和病毒学证据研究。尝试从外周血、尿液和唾液中分离病毒,采用人包皮成纤维细胞系进行细胞培养,并通过间接荧光免疫法(IFI)检测CMV特异性IgG和IgM,通过酶联免疫吸附测定法(ELISA)检测IgG。共采集了121份血液样本、119份尿液样本和96份唾液样本。在研究期间,12.5%的患者至少出现过一次病毒血症,23.2%出现过病毒尿症,21.9%出现过唾液排泄。研究纳入时,20%(10/50)的患者有抗CMV IgM抗体,100%(50/50)的患者有抗CMV IgG抗体(IFI)。40名入院时IgM阴性的患者中有5名在研究期间出现了抗CMV IgM抗体,提示CMV再激活或再次感染。60%的患者基于病毒分离和/或IgM阳性证明有活动性CMV感染。对24名患者进行了组织病理学研究。50%的尸检发现有CMV,主要存在于消化系统、肺部和肾上腺。临床、病毒学(血清学和分离)和组织病理学诊断之间无相关性。

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