No description available.

Thesis (M Med (Periodontics and Oral Medicine))--University of Limpopo, 2011. / Background: Kaposi sarcoma (KS) is the most common neoplasm diagnosed in HIV-seropositive subjects. HIV-associated KS (HIV-KS) may affect any body system and the disease may be slowly progressing or fulminant. Oral involvement is frequent and extensive oral HIV-KS is associated with poor prognosis. Methods: All cases of oral HIV-KS treated in the Department of Periodontology and Oral Medicine over a period of seven years were included in this retrospective study. A record was made regarding the clinical and laboratory features, and differences in these features between males and females were statistically tested. The differences between the percentages of the different clinical appearances of oral HIV-KS lesions; and between the features of oral HIV-KS in patients who contracted HIV infection before the diagnosis of oral KS and those who were diagnosed with HIV infection at the time of oral KS presentation were also tested. Results: Of the 37 patients included in the study, 54% were females and 46% were males and two patients (5%) were children. In 21 patients (57%) the initial presentation of HIV-KS was in the mouth. Seventeen patients (46%) were diagnosed with HIV infection and oral KS at the same time. At the time of oral HIV-KS diagnosis, 29 patients (78%) had multiple lesions affecting one or several sites. There were no statistically significant differences between males and females regarding the clinical and laboratory features of oral HIV-KS except for the size of the lesions. The percentage of lesions <10mm was significantly lower in females than males (chi-squared test: p=0.007), whereas the percentage of lesions ≥10mm≤50mm was significantly higher in females than in males (chi-squared test: p=0.0004). There were significantly more patients with multiple oral HIV-KS lesions than patients with single oral HIV-KS lesions (binomial distribution test: p=0.0003). At the time of oral HIV-KS diagnosis, the difference between ix the average CD4+ T cell counts of the patients who were concurrently diagnosed with HIV infection and oral KS (130cells/mm3), and those who contracted HIV infection before developing oral HIV-KS (90 cells/mm3) was not statistically different. Nine patients (24%) developed facial lymphoedema in association with multifocal exophytic oral HIV-KS lesions. The average CD4+ T cell counts of these patients at the time of oral HIV-KS diagnosis was 28 cells/mm3, and was statistically significantly lower (t-test: p= 0.01) than the average CD4+ T cell count (133 cells/mm3) of those who did not develop facial lymphoedema. All the patients with facial lymphoedema died, on average within two weeks from the occurrence of facial lymphoedema. One patient (2.7%) developed immune reconstitution inflammatory syndrome (IRIS) – associated oral HIV-KS, and his oral HIV-KS resolved following administration of highly active antiretroviral therapy (HAART) and systemic cytotoxic chemotherapy, and surgical excision. Out of the 28 patients who were not lost to follow-up, 21 (75%) died, on average within 13.6 weeks from the time of oral HIV-KS diagnosis and seven (25%) survived. At the time of oral HIV-KS diagnosis the difference in the average CD4+ T cell count of the patients who died (64 cells/mm3) and those who survived (166 cells cells/mm3) was statistically significant (t-test: p=0.016). The prognosis of the patients who received cytotoxic chemotherapy was better than the prognosis of those who received only HAART, or those who were HAART-naïve. Conclusions: Oral HIV-KS affects females more frequently than males (M:F = 1:1.2), and it is not uncommon in children. A lower CD4+ T cell count at the time of oral HIV-KS diagnosis is associated with a poor prognosis. Patients who develop facial lymphoedema during the course of HIV-KS disease, die soon thereafter. Oral HIV-KS can be successfully treated with systemic cytotoxic chemotherapy.

Thesis (doctoral)--Freie Universität Berlin, 1979.

Proefschrift Rijksuniversiteit Groningen. / Met lit.opg. - Met samenvatting in het Nederlands.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

Thesis (M.S.)--University of Michigan, 1939.

Human herpes virus type 8 (HHV-8) is strongly implicated as the etiological agent of Kaposi’s sarcoma (KS). The incidence of KS in South Africa is increasing in parallel with the HIV-1 epidemic. Molecular and serological prevalence of HHV-8 in HIV-1 infected individuals with and without KS was investigated. DNA fragments from ORF26 (capsid, 330BAM233) and ORF75 (tegument) regions were used to determine the prevalence of HHV-8 DNA in peripheral blood mononuclear cells (PBMC) from 429 HIV-1 infected individuals, 95 of whom had histologically confirmed KS. Of those without KS, 14 (4.2%) were PGR positive for HHV-8 DNA. In the individuals with KS, the proportion of HHV-8 DNA positive PBMC samples was 11 times higher (46/95,48%). Similarly, an immunofluorescence assay showed that 78% of KS patients had antibodies to HHV-8 compared to 16% of KS negative individuals. Among the KS group, 93% of PCRpositive samples were also HHV-8 antibody positive compared to only 66% of PCR negative samples indicating that viremia is associated with good antibody responses. Matched lymph node and PBMC samples were available for 8 patients. HHV-8 DNA was more frequently detected in the lymph node (3/8) than in the blood (1/8), suggesting that the lymph nodes are a reser / o r for HHV-8. These data confirm the association between HHV-8 and KS and suggest that there is a high background prevalence of HHV-8 infection in HIV-1 infected individuals in South Africa. The ORP 75 gene of 40 HHV-8 strains was sequenced and the phylogenetic relationships between South African and already published sequences were investigated. The majority (n=29) of strains overlapped with the published A and B subgroups and were termed A/B variants.Three strains were classified as subgroup C while 8 sequences did not cluster with any of the previously classified subgroups and were termed novel (N) group. The DNA distance of this novel group differed from the A, B and C subgroups by 4.7%, 3.8% and 4,5% respectively although within the N group there was only 0.4% variation. The addition of this group significantly increased the number of subgroup-specific polymorphisms from 17 to 47 over a 804 bp region. There was sufficient inter-subgroup genetic diversity that single strand conformational polymorphisms (SSCP) could be used to rapidly identify them. Thus, based on the analysis of the ORF75 gene, a unique HHV-8 sub-group is present in South Africa which accounts for 20% of circulating strains. Further studies are required to determine the extent of evolutionary phytogeny, distribution and pathogenic potential of this novel group.

Background Oral candidiasis is the most common infection of the oral mucosa of HIV-seropositive patients, although its frequency is rapidly decreasing with the advent of highly active antiretroviral therapy (HAART). Many questions regarding its complex pathogenesis remain unanswered. The diagnosis is usually established with non-invasive techniques such as mucosal smears. Oral lesions of HIV-associated Kaposi sarcoma (HIV-KS) are routinely biopsied and frequently show secondary infection with Candida albicans or other Candida species. Aims and objectives The aim of this investigation was to determine the frequency and histomorphology of secondary Candidal infection of the surface epithelium of oral HIV-associated KS lesions (HIV-KS), which are routinely biopsied in HIV infected patients. Materials and methods Haematoxylin and eosin (HE), and Periodic Acid-Schiff (PAS) stains of 133 cases of oral Kaposi sarcoma diagnosed between the period 2003 and 2007 within the Division of Oral Pathology were examined histologically for intensity and morphology of Candidal colonisation, depth of invasion, number of organisms, epithelial reactions and associated inflammatory response. The depth of Candidal invasion and severity of infection were correlated with the available CD4 T cell counts of HIV seropositive patients at the time of biopsy. Results Almost forty one percent (40.62%) of all oral HIV-KS cases were secondarily infected with Candida species. The intensity varied from an isolated single pseudohyphus to matted colonies of vegetative yeasts and psuedohyphae. Whilst in most cases the organisms did not invade beyond the parakeratin layer, pseudohyphae were noted extending into the stratum spinosum in 2 cases, and a single case showed a pseudohyphus within the lamina propria. A further 2 cases showed pseudohyphae growing in the pyogenic membrane. Neutrophilic permeation of the epithelium and Munro micro-abscess formation, features commonly associated with Candidal infection, were frequently present even in the absence of Candidal infection. Candidal organisms were often present in the absence of inflammation. Conclusion Oral lesions of HIV-KS are commonly secondarily infected with large numbers of Candidal organisms. The morphological characteristics of secondary Candidal infection within the surface epithelium of HIV-KS lesions suggest an altered pathogenetic pathway. Further studies are necessary in this regard.

Thesis (Ph. D.)--University of Queensland, 2002. / Includes bibliographical references.

Inaugural dissertation.--K. bayer. Julius-Maximilians-Universität Würzburg.