allopurinol and Acquired-Immunodeficiency-Syndrome

Topics: Acquired Immunodeficiency Syndrome; Adult; Allopurinol; Antifungal Agents; Antimetabolites; Bone Marrow; Drug Therapy, Combination; Enzyme Inhibitors; Female; Fluconazole; Humans; Immunocompromised Host; Kidney Transplantation; Leishmaniasis, Visceral; Male

We report on 11 patients with HIV infection and visceral leishmaniasis and who were treated with meglumine antimoniate plus allopurinol for 3 weeks (six patients) or 4 weeks (five patients). Clinical and parasitological cures were achieved in four of the five patients treated for 4 weeks and in one of the six patients treated for 3 weeks. Only one patient developed a severe maculopapular rash. Allopurinol plus meglumine antimoniate was found to be a safe combination of drugs for the treatment of visceral leishmaniasis in patients infected with HIV. The optimal length of this treatment is unknown but a course of at least 4 weeks' duration would appear to be necessary for obtaining parasitological cure in most cases.

Topics: Acquired Immunodeficiency Syndrome; Administration, Oral; Adult; AIDS-Related Opportunistic Infections; Allopurinol; Antiprotozoal Agents; Drug Therapy, Combination; Female; HIV Infections; Humans; Injections, Intramuscular; Leishmaniasis, Visceral; Male; Meglumine; Meglumine Antimoniate; Organometallic Compounds; Pilot Projects

Sera of patients with various inflammatory and autoimmune rheumatic diseases were screened for the presence of xanthine oxidase (XOD) and compared to sera from healthy donors and patients with nonrheumatic diseases including AIDS, internal diseases, and different carcinomas. Up to 50-fold higher levels of XOD were detected in rheumatic sera (P < 0.001). In addition, serum sulfhydryls (SH) were determined as sensitive markers of oxidative stress. The SH status in rheumatic patients was diminished by 45-75% (P < 0.001) and inversely correlated to the concentration of serum XOD (R = 0.73), suggesting a causal interrelation. The depletion of serum sulfhydryls by the oxyradical-producing XOD/acetaldehyde system was mimicked successfully ex vivo in human serum from healthy donors. Cortisone treatment of patients suffering from systemic lupus erythematosus and rheumatoid arthritis impressively normalized elevated XOD concentrations in rheumatic sera to those of healthy controls. The participation of xanthine oxidase in the depletion of serum antioxidants in rheumatic patients is discussed in the light of substrate availability and Km values.

Topics: Acetaldehyde; Acquired Immunodeficiency Syndrome; Autoimmune Diseases; Biomarkers; Cohort Studies; Cortisone; Female; Humans; Inflammation; Internal Medicine; Male; Metallothionein; Neoplasms; Organometallic Compounds; Oxidation-Reduction; Oxygen; Rheumatic Diseases; Schiff Bases; Singlet Oxygen; Stress, Physiological; Sulfhydryl Compounds; Xanthine Oxidase

The biochemical mechanisms underlying blood lymphoid cell genome destabilization in patients with HIV infection have been analyzed. Lymphocytes from HIV patients are characterized by increasing intensity of free radical oxidation together with activation of the xanthine oxidase D-form conversion into the O-form, enhanced activity of UV-endonuclease, and intensification of prooxidant-induced proteolysis. These changes increasing with the progress of the disease with a maximum at the AIDS stage form a metabolic basis for labilization of the lymph cell genome. The degree of biochemical manifestations of genome instability (levels of chromatin degradation products and intensity of formation of one-filament nicks of DNA) increase in the dynamics of HIV-infection. The data obtained are discussed in terms of the author's conception on the origin of AIDS from retroposons (retrotransposons?). A hypothesis is postulated on accumulation of autonomous genetic information on the basis of genome labilization under the influence of genotoxic factors. Clinico-biochemical data on the appearance of HIV proteins (p17, p24) in the blood of patients (previously negative for all HIV markers) in the presence of transfusions of HIV-negative blood and UV-irradiation of the autoblood are also discussed from this standpoint.

Topics: Acquired Immunodeficiency Syndrome; DNA Transposable Elements; Enzyme Activation; Free Radicals; Genome, Human; Humans; Hydrolysis; Lymphocytes; Oxidation-Reduction; Xanthine Oxidase

Topics: Acquired Immunodeficiency Syndrome; Adult; Humans; Male; Purine-Pyrimidine Metabolism, Inborn Errors; Xanthine; Xanthine Oxidase; Xanthines

Topics: Acquired Immunodeficiency Syndrome; Adult; Allopurinol; Antiprotozoal Agents; Humans; Leishmaniasis, Visceral; Male; Meglumine; Meglumine Antimoniate; Organometallic Compounds; Prognosis

Topics: Acquired Immunodeficiency Syndrome; Adult; Allopurinol; Humans; Leishmaniasis, Visceral; Male