Journal of Acquired Immune Deficiency Syndromes

Small, Catherine Butkus

doi: N/Apmid: N/A

To determine the compliance and tolerance with zidovudine (azi-dothymidine or AZT) therapy among poor, minority, and intravenous drug-using patients, data were collected on all AIDS and ARC patients followed for at least 4 weeks in a New York City Human Immunodeficiency Virus clinic. Ninety-nine patients received zidovudine, of whom 75% were males, 92% were minorities, and 59% had a history of intravenous drug use. Of the 99 patients, 72 had AIDS and 27 had ARC with T-helper (CD4) lymphocytes ≤ 500 mm

Skalka, Anna Marie

doi: N/Apmid: N/A

The termini of integrated retroviral DNAs are characterized by highly conserved dinucleotide sequences: 5'TG...//...CA3'. For the avian and murine C-type retroviruses, the dinucleotide sequences reside two deoxynu-cleotides (usually AA and TT) from the LTR ends of unintegrated viral DNA (5'AATG...//...CATT3'). The number and identity of terminal deoxynucle-otides in unintegrated HIV-1 linear DNA that extend beyond the conserved dinucleotides have not been determined. However, they had been presumed to consist of a single nucleotide (5'CTG...//...CAG3') on each end, based on inspection of the nucleotide sequence between the end of the supposed primer sites for retroviral DNA synthesis and the conserved proviral termini. We have utilized the polymerase chain reaction (PCR) to amplify segments representing the joined ends of linear DNA present in covalently closed circular HIV-1 DNA molecules isolated from infected T cells. These fragments were cloned and the nucleotide sequence of the LTR-LTR circle junction of several independent clones determined. Based upon the results, we predict that, like the avian and murine viruses, HIV-1 linear DNA contains two nucleotides beyond the conserved dinucleotides: 5'ACTG...//...CAGT3'. Models for the origin of these termini and other observed junction sequences are proposed.

doi: N/Apmid: N/A

Barnhart, J. Lowell

doi: N/Apmid: N/A

We used death certificate data for San Francisco residents from 1979 to 1986 to calculate the number of deaths and years of potential life lost before age 65 (YPLL) for leading causes of death. Acquired immune deficiency syndrome (AIDS)-related deaths were defined as including cytomegalovirus infection (ICD-9 078.5); cryptococcal infection (ICD-9 117.5);

Makuch, Robert W.

doi: N/Apmid: N/A

A double-blind, randomized, placebo-controlled trial comparing two daily doses of oral ribavirin and placebo was conducted at four medical centers. One hundred sixty-four adult men with lymphadenopathy were enrolled over a 2-month period and randomized to receive ribavirin 800 mg (53 subjects), ribavirin 600 mg (55 subjects), or placebo (56 subjects). Active treatment was administered for 24 weeks followed by a 4-week washout period. Nine subjects receiving placebo, four receiving ribavirin 600 mg, and none in the 800 mg group developed AIDS during the 24 weeks of active treatment. One patient randomized to the 800 mg group had Kaposi's sarcoma at study entry and was included in the intent-to-treat analysis. An overall significant difference in progression to AIDS was observed among the three treatment groups (

Hofnung, Maurice

doi: N/Apmid: N/A

The 177 N-terminal amino acids of CD4, the receptor of the human immunodeficiency virus (HIV), have been expressed in Escherichia coli as genetic fusions to the periplasmic maltose-binding protein (MalE) from this organism. A large fraction of the hybrid proteins can be released from the periplasm by osmotic shock and purified in one step on a cross-linked amylose column eluted with maltose under mild conditions. One hybrid protein binds HIV envelope protein gp 160 and neutralizes the virus in vitro. This provides the first example of the production and one-step purification of an active form of an eukaryotic protein by fusion to MalE. The use of this system for mass screening of CD4 mutants, high-scale production of the hybrid protein for structural studies on CD4, testing antiviral compounds, and therapeutic assays is discussed.

Klein, Robert S.

doi: N/Apmid: N/A

We investigated the relationship of human papillomavirus (HPV) infection of the female genital tract, cervical cytology, and human immunodeficiency virus (HIV) infection in 67 women. Forty-eight women had a history of intravenous drug use, 18 were heterosexual partners of HIV-infected intravenous drug users, and one was a transfusion recipient. Patients received a Pap smear, cervicovaginal lavage for HPV determination by Southern blot, HIV serum antibody by enzyme immunoassay with Western blot confirmation, and thorough screening for other sexually transmitted diseases. Seventeen of the 35 (49%) women seropositive for HIV had HPV infection, compared with 8 of 32 (25%) seronegative women (

Abrams, Donald I.

doi: N/Apmid: N/A

It is important in planning to meet resource needs and financing of care of people with acquired immune deficiency syndrome (AIDS) to determine the effect of the use of azidothymidine (AZT) on overall medical care costs. This study compares the medical care costs of people with AIDS (PWAs) who received AZT with those of PWAs not receiving it. Seven of the nine PWAs who were on the AZT arm of the phase II drug trial of AZT at San Francisco General Hospital (SFGH) in 1986 and a matched sample of PWAs at SFGH who were eligible for the trial but did not participate in it were included in the study and followed for 12 months. It was found that costs in the first 12 months and especially in the first 6 months were lower for persons using AZT, primarily because of significantly lower use of hospital services. However, costs began to rise in the second 6 months for those using AZT. The authors therefore doubt that the lifetime costs of PWAs are lowered by the use of AZT and conclude that they are likely to be the same as those of PWAs not using the drug. If this is indeed the case, the use of the drug is likely to be relatively cost-effective.

Cooper, David A.

doi: N/Apmid: N/A

A certain degree of controversy has surrounded the multicenter dose comparison clinical trial of oral ribavirin for patients with HIV-related lymphadenopathy since its inception in 1987. The

Skalka, Anna Marie

doi: N/Apmid: N/A

DNA integration appears to be an obligatory step for the efficient replication of retroviruses. Studies of the integration reaction for the avian and murine C-type retroviruses have defined the importance of: i) LTR terminal sequences, which are joined to host DNA, and ii) the activity of the retroviral integration protein (IN). The specific requirements for the integration of HIV DNA have not yet been defined. In this review, we survey studies pertinent to this reaction for HIV and extrapolate a mechanism for HIV DNA integration based upon knowledge of the integrative recombination reaction of the C-type retroviruses.