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Anonymous
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Vasculitis and HIV
      #201674 - 07/27/06 04:07 PM

Does anyone know about vasculitis and HIV?

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Bear60
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Reged: 12/21/05
Posts: 1390
Re: Vasculitis and HIV new
      #201740 - 07/28/06 07:51 AM

I have no idea what you are talking about. Hasn't this question been asked before?

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6 ft tall poz bear in Philadelphia

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Anonymous
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Re: Vasculitis and HIV new
      #201957 - 07/29/06 06:43 PM

Vasculitis and HIV Infection
Among the clinical manifestations of HIV infection are a number of rheumatic syndromes.[4,10] In a Spanish study, 2 rheumatic disorders were found in 63 (11%) of 556 HIV-infected patients (86% of the patients were intravenous drug users and 55% of the total had AIDS).
Forms of vasculitis reported in HIV-infected patients have included necrotizing, eosinophilic, leukocytoclastic, lymphomatoid, and isolated granulomatous angiitis of the central nervous system.[11] The association of necrotizing vasculitis and viral illness is a well-described phenomenon. The pathogenesis of PAN in HIV-infected patients is not well understood, and whether HIV or other agents are directly involved in the vascular injury remains to be established.

Two theories have been proposed to explain the virally associated vaculitis: The virus may directly attack the vessel wall, or cellular or humoral immune mechanisms may lead to the formation of in situ or systemic circulating immune complexes that subsequently result in the development of vasculitis.[4] The demonstration of vascular deposits of HIV antigens, immunoglobulins, and complement components suggests an immune complex deposition process.[1]

Gherardi and colleagues[12] reported the clinicopathologic findings of biopsy specimens obtained from 148 HIV-infected individuals with symptoms of autoimmune disease. Inflammatory vascular changes were documented in 34 of 148 patients. Among them, 4 of 34 were classified as PAN, 1 as Henoch-Schönlein purpura, 6 as drug-induced hypersensitivity-vasculitis, and 23 as "unspecified" vasculitis. The investigators suggested that in patients with HIV disease, the pathogenesis is multifactorial and may result from HIV-induced immunologic abnormalities and exposure to a variety of xenoantigens, including HIV, other infectious agents, and drugs.

The small number of HIV-infected patients who develop vasculitis and the presence of comorbid conditions make it difficult to evaluate the effectiveness of corticosteroids in the treatment of HIV-related vasculitis. Some reports have suggested that in PAN-like vasculitis, treatment with systemic corticosteroids may offer relief of the symptoms.[1,7] Intravenous gamma globulin may also be an effective alternative treatment.[1] Gisselbrecht and coworkers[13] have reported that 4 HIV-infected patients with PAN were successfully treated by combining plasma exchanges with an antiretroviral agent. Our patient has been in remission for over 24 months after treatment with corticosteroids in addition to combination antiretroviral therapy consisting of 2 non-nucleoside reverse transcriptase inhibitors and a protease inhibitor.

PAN-like disorders are associated with necrotizing vasculitic lesions in medium-sized vessels within muscle or epineurium. PAN has been reported among abusers of illicit drugs, especially amphetamines.[1] HIV RNA and p24 antigen have been reported within the vascular lesions,[4,12,14] and in some cases CMV inclusions were identified in vascular endothelial cells,[15] suggesting a direct or indirect role of other viruses in the development of vasculitis.[3]

Among 17 previously described cases of PAN-like disorders in HIV-infected patients,[1,13] only 3 had serologic evidence of hepatitis C; 2 of those 3 had trace mixed cryoglobulinemia, suggesting that hepatitis C may have contributed to vasculitis. In our patient's case, the clinical picture and the normal serum cryoglobulins suggested that vasculitis was probably not related to the hepatitis C infection.

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Rememeber, as with all other illnesses and conditions that may be found in people with HIV. You don't have to have HIV for these conditions to arise. If you are unsure of your status. Get tested.

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Anonymous
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Re: Vasculitis and HIV new
      #202078 - 07/31/06 11:32 AM

What other viral infections can be related to vasculitis and anto immune responses? I've visited too many doctors and all they say is that I have a viral infection but they have no idea what it is and after 10 months of this Im already getting desperate.

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