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HHV8 associated Kaposi's sarcoma during triple immunosuppressive treatment with cyclosporin A, azathioprine, and prednisolone for ocular Behcet's disease and complete remission of both disorders with interferon α

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ANNALS OF THE RHEUMATIC DISEASES 2001年第1期60卷 83-86页

作者： Kötter, I Aepinus, C Graepler, F Gärtner, V Eckstein, AK Stübiger, N Kaskas, B Zierhut, M Bültmann, B Kandolf, R Kanz, L Univ Tubingen Hosp Dept Internal Med Haematol Oncol Immunol & Rheuma D-72076 Tubingen Germany Inst Pathol D-72076 Tubingen Germany Univ Tubingen Hosp Dept Internal Med Gastroenterol Infect Dis D-72076 Tubingen Germany Univ Tubingen Hosp Dept Ophthalmol D-72076 Tubingen Germany Univ Hosp Essen Dept Ophthalmol Essen Germany

Behcet's disease is a multisystem vasculitis with oral and genital aphthous ulcers, cutaneous vasculitis, uveitis, and arthritis as its main features.1 Ocular manifestations, especially panuveitis, have a poor prognosis, resulting in blindness in most patients after five years, irrespective of treatment. Recent reports have shown significant improvement of visual prognosis by early and aggressive immunosuppressive treatment.2 However, immunosuppressive treatment bears a risk of opportunistic infections, especially herpesvirus reactivation and increased incidence of malignancies.3 Kaposi's sarcoma is a rare malignant tumour (incidence 0.01%) of endothelia and vascular smooth muscle cells which has a markedly increased incidence in patients with AIDS (0.9%)4 and iatrogenic immunosuppression (0.52%).5 Recently, human herpesvirus 8 (HHV8) was identified as the causative agent.

关键词：抗病毒药/治疗应用贝赫切特综合征/药物疗法疱疹病毒8型人/分离和提纯免疫减弱宿主免疫抑制剂/副作用干扰素α/治疗应用机会致病菌感染/药物疗法机会致病菌感染/免疫学重组蛋白质类肉瘤卡波西/药物疗法肉瘤卡波西/免疫学成年人人类男(雄)性

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BIOLOGY AND THERAPY OF EPIDEMIC KAPOSIS-SARCOMA

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CANCER 1987年第3期59卷 633-637页

作者： GROOPMAN, JE HARVARD UNIV SCH MEDBOSTONMA 02115

Kaposi's sarcoma, once a rarely seen neoplasm in the West, now occurs in an epidemic fashion in association with acquired immune deficiency syndrome (AIDS). The pathogenesis of Kaposi's sarcoma is still unclear but it appears to be an endothelial neoplasm. Its clinical presentation may be quite subtle and varied. The natural history of Kaposi's sarcoma is still not fully defined, and its rate of progression may be either relatively indolent or aggressive. Therapies include local radiation, recombinant interferon alfa-2a, and cytotoxic chemotherapy. For a subset of patients with Kaposi's sarcoma who were treated with recombinant interferon alfa-2a, the disease is in complete remission, without opportunistic infection, and they appear to be culture-negative for the etiologic retrovirus that causes their immune deficiency. Interferon alfa-2a appears to have antineoplastic efficacy, (and may have antiretroviral efficacy as well) in this epidemic neoplasm.

关键词：抗肿瘤药/治疗应用抗病毒药/治疗应用生物学疾病暴发流行干扰素α-2b/治疗应用缓解诱导肉瘤卡波西/药物疗法肉瘤卡波西/病理生理学肉瘤卡波西/放射疗法人类

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GENITAL INFECTION WITH TYPE-2 HERPES-SIMPLEX VIRUS - COMMON VENEREAL-DISEASE

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POSTGRADUATE MEDICINE 1975年第2期58卷 66-70页

作者： CHOW, AW UNIV CALIF HARBOR GEN HOSPDIV INFECT DIS1000 W CARSON STTORRANCECA 90509 UNIV CALIF SCH MEDLOS ANGELESCA

Herpes genitalis has only recently been recognized as an important venereal disease. Like gonorrhea, it is frequently subclinical. Although generally self-limiting, the infection may pose a serious risk to the fetus when it occurs during pregnancy. Even more important is the potential risk of cervical cancer in women with genital herpes.

关键词：抗病毒药/治疗应用诊断鉴别生殖器疱疹/并发症生殖器疱疹/诊断生殖器疱疹/治疗婴儿新生疾病/病因学光疗法妊娠并发症感染性宫颈肿瘤/病因学青少年成年人女(雌)性人类婴儿新生男(雄)性妊娠

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Severe exacerbation of asthma:: A new side effect of interferon-α in patients with asthma and chronic hepatitis C

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MAYO CLINIC PROCEEDINGS 1999年第4期74卷 367-370页

作者： Bini, EJ Weinshel, EH Dept Vet Affairs Med Ctr Div Gastroenterol 111D New York NY 10010 USA NYU Med Ctr Bellevue Hosp Div Gastroenterol New York NY 10016 USA

Interferon-alpha is used by physicians to treat numerous common medical disorders;however, therapy is often limited by side effects, Pulmonary complications, such as interstitial pneumonitis and bronchiolitis obliterans organizing pneumonia, have been described in patients receiving interferon-alpha therapy. Exacerbation of asthma induced by subcutaneous administration of interferon-alpha has not been previously reported, We describe two patients with mild asthma in whom treatment with interferon-alpha for chronic hepatitis C resulted in exacerbation of the underlying asthma, The severe asthmatic symptoms resolved promptly after use of interferon-alpha was discontinued and corticosteroid therapy was initiated, Repeated treatment with interferon-alpha several months later resulted in a rapid, more severe exacerbation of asthma in both patients. Patients undergoing therapy with interferon-alpha, especially those with chronic asthma, should be monitored closely for pulmonary symptoms, If these symptoms develop, patients should be instructed to discontinue use of interferon-alpha and seek medical attention immediately.

关键词：急性病抗病毒药/副作用抗病毒药/治疗应用哮喘/化学诱导哮喘/并发症丙型肝炎慢性/并发症丙型肝炎慢性/药物疗法干扰素α/副作用干扰素α/治疗应用复发成年人人类男(雄)性中年人

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Effect of potent antiretroviral therapy on recurrent cytomegalovirus retinitis treated with the ganciclovir implant

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AMERICAN JOURNAL OF OPHTHALMOLOGY 1999年第3期127卷 283-287页

作者： Davis, JL Tabandeh, H Feuer, WJ Kumbhat, S Roth, DB Chaudhry, NA Univ Miami Sch Med Bascom Palmer Eye Inst Miami FL 33101 USA

(PURPOSE)-P-.: To determine the effect of highly active antiretroviral therapy on cytomegalovirus (CMV) retinitis treated with ganciclovir implants, (METHODS)-M-.: A retrospective cohort study was performed of 15 patients with recurrent CMV retinitis treated with the ganciclovir implant and highly active antiretroviral therapy (cases) and 38 patients with recurrent retinitis treated with ganciclovir implants before availability of improved antiretroviral therapy (controls), Progression was defined as occurrence of new lesions in the treated eye or advancement of the retinitis border by more than 750 Esm (RESULTS)-R-.: Cases and controls were statistically similar in age, ethnicity, and duration of acquired immunodeficiency syndrome (AIDS), Controls had received intravenous ganciclovir for 9.5 +/- 9.5 months vs 3.5 +/- 4.6 months in cases (P = .003), The mean (+/- SE) time to progression of retinitis after implantation of the device was 26.7 +/- 2.4 months (95% confidence interval, 22.1 to 31.3) in the cases receiving highly active antiretroviral therapy vs 6.2 +/- 0.9 months (95% confidence interval, 4.5 to 7.9) in the controls (P =.001), Multivariate analysis, adjusted for preoperative variables, confirmed a significantly prolonged time to progression in patients receiving highly active antiretroviral therapy (P=.0003), The odds ratio for progression in the cases vs controls was 0.034 (95% confidence interval, 0.003 to 0.350), Cases had higher CD4(+) T-lymphocyte counts (P =.004) and longer survival (P <.001) than controls, (CONCLUSION)-C-.: Highly active antiretroviral therapy is associated with improved outcomes in patients with AIDS and recurrent CMV retinitis treated with the ganciclovir implant, (C) 1999 by Elsevier Science Inc. All rights reserved.

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Prolonged interferon α treatment in children with chronic hepatitis B

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ANNALS OF TROPICAL PAEDIATRICS 2001年第1期21卷 77-80页

作者： Yüce, A Koçak, N Özen, H Gürakan, F Univ Hacettepe Fac Med Dept Pediat Div Gastroenterol TR-06100 Ankara Turkey

Interferon alpha has been used widely to treat hepatitis B virus infection in children. However, the overall initial response rates have been treatment in children who did not respond to a previous course of interfer... 详细信息

Interferon alpha has been used widely to treat hepatitis B virus infection in children. However, the overall initial response rates have been <50% and several strategies have been attempted to improve this. The aim of this study was to evaluate the safety and efficacy of prolonged interferon treatment in children who did not respond to a previous course of interferon alpha treatment. Twenty-seven children with chronic hepatitis B who had not responded to a 6-month course of interferon alpha 2a (5 MU/m(2) body surface) thrice weekly subcutaneously continued to receive interferon aat the same dosage for another 6 months without a rest phase. The children were followed for 6 months after completing 12 months of therapy. All of them had HBsAg, HBV-DNA and HBeAg tested on completion of the first course. Six of the 27 (22.2%) cleared both HBV-DNA and HBeAg after completion of therapy and all six had a sustained response. Pre-treatment predictive factors were not significantly associated with treatment response. No adverse effect of interferon was seen during follow-up. We conclude that prolonged interferon treatment is well tolerated and leads to additional benefit.

关键词：丙氨酸转氨酶/血液抗病毒药/治疗应用 DNA 病毒/血液用药计划表随访研究肝炎表面抗原乙型/分析肝炎e抗原乙型/分析肝炎病毒乙型/遗传学肝炎乙型慢性/药物疗法肝炎乙型慢性/免疫学干扰素α-2a/治疗应用治疗结果土耳其儿童儿童学龄前女(雌)性人类婴儿男(雄)性

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Unsuccessful treatment with cidofovir and cytarabine in progressive multifocal leukoencephalopathy associated with dermatomyositis

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JOURNAL OF THE ROYAL SOCIETY OF MEDICINE 2000年第7期93卷 374-375页

作者： Tubridy, N Wells, C Lewis, D Schon, F Atkinson Morleys Hosp Dept Neurol London SW20 0NE England St George Hosp Clin Infect Unit London England

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Additive antiviral effects of lamivudine and α-interferon in chronic hepatitis B infection

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ANTIVIRAL THERAPY 2000年第4期5卷 273-277页

作者： Mutimer, D Dowling, D Cane, P Ratcliffe, D Tang, H O'Donnell, K Shaw, J Elias, E Pillay, D Queen Elizabeth Hosp Liver & Hepatobiliary Unit Birmingham W Midlands England Univ Birmingham Sch Med Div Immun & Infect PHLS Antiviraql Susceptibil Reference Unit Birmingham B15 2TT W Midlands England Univ Birmingham Sch Med Dept Med Birmingham B15 2TT W Midlands England

alpha -Interferon has limited efficacy against chronic hepatitis B virus (HBV) infection. Nucleoside analogues may confer greater benefits, however, it is likely that combination therapies will be required for effective control of this infection. We investigated the antiviral effect of lamivudine and interferon therapy in eight patients with high HBV-DNA levels. Six patients received lamivudine/interferon combination therapy followed, after a 6-month drug-free period, with lamivudine monotherapy. Mean HBV viral load (copies/ml) reduction was significantly greater after 4 months of combination therapy (4.3x10(3)) compared to an equivalent period of lamivudine monotherapy (2.9x10(2)) (P=0.03). Two patients were given 6 months of lamivudine/interferon combination therapy followed immediately by lamivudine monotherapy. Cessation of interferon in these patients led to a rapid 1-2 log(10) increase in HBV viral load. These findings suggest that alpha -interferon has a direct antiviral effect on chronic HBV infection, which may be additive to, or synergistic with lamivudine.

关键词：抗病毒药/治疗应用 DNA 病毒/血液药物协同作用药物疗法联合肝炎病毒乙型/生理学肝炎乙型慢性/药物疗法肝炎乙型慢性/病毒学干扰素α/治疗应用拉米夫定/治疗应用治疗结果病毒载量人类

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Resolution of recalcitrant hand warts in an HIV-infected patient treated with potent antiretroviral therapy

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JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY 1999年第5期40卷 818-821页

作者： Spach, DH Colven, R Univ Washington Dept Med Div Internal Dis Seattle WA USA Univ Washington Dept Med Div Dermatol Seattle WA USA

Human papilloma virus (HPV)-related cutaneous manifestations occur with increased frequency and severity among HIV-infected persons. In this report, we describe an HIV-infected man with persistent, severe cutaneous hand warts that did not respond to multiple therapies, including liquid nitrogen cryotherapy, topical dinitrochlorobenzene, topical podophyllin, and intralesional interferon-alfa injections. Approximately 1 year after starting a potent protease inhibitor-containing antiretroviral regimen, the patient's recalcitrant cutaneous warts markedly diminished in size, even though the patient did not receive any specific therapy for the warts after starting aggressive antiretroviral therapy. The patient continued on a potent protease inhibitor-containing antiretroviral regimen and, approximately 2 years later, the warts completely resolved. Our patient's dramatic clinical improvement of cutaneous HPV infection that followed protease inhibitor-containing antiretroviral therapy provides a clear-cut example that protease inhibitor-containing combination antiretroviral therapy can produce significant clinical benefit.

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Fomivirsen for the treatment of cytomegalovirus retinitis

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2002年第4期133卷 552-556页

作者： Jabs, DA Griffiths, PD Johns Hopkins Univ Sch Med Dept Ophthalmol & Med Baltimore MD USA Johns Hopkins Univ Bloomberg Sch Publ Hlth Dept Epidemiol Baltimore MD USA Royal Free Hosp Dept Virol London NW3 2QG England UCL Sch Med London W1N 8AA England

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