Influenza in Patients with Human Immunodeficiency Virus Infection: Discussion (Part 3)

In: Influenza

25 Nov 2012

Influenza in Patients with Human Immunodeficiency Virus Infection: Discussion (Part 3)Prolonged respiratory illness was present in four of six HIV-infected patients in this series, despite the rarity of advanced HIV infection in the sample. No serial virologic assessment of respiratory tract shedding was performed, yet previous studies have demonstrated a close correlation of the duration of fever with length of viral shedding. In this series, persistence of fever for a median of 7.5 days seems prolonged when compared with those findings of previous reports. In addition, a recent report of shedding of parainfluenza 3 virus for greater than two months from the respiratory tract of two children with AIDS lends further support to the possibility of prolonged viral shedding in HIV-infected patients. buy antibiotics online
Although the pathogenesis of influenza virus infection is incompletely understood, humoral, T-cell, and interferon responses are each important in determining the course of illness. The presence of serum antibody against the influenza hemagglutinin protects against acquisition of influenza A infection in mice and in humans and may prevent severe pulmonary parenchymal disease if infection does occur. Studies in chickens suggest that clearance of influenza A virus may be facilitated by antibody to the neuraminidase. Old BALB/c mice have delayed development of cytotoxic T-cell lymphocyte activity and prolonged viral shedding when compared with young mice, and regeneration of respiratory tract epithelium following influenza is delayed in nude as opposed to immunocompetent mice. Rising titers of interferon correlate closely with decreasing virus titer in mice and with resolution of clinical symptoms in influenza-infected men.


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