Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:1.2.7.5 (AOR)
 1,763 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During mid-1987 to mid-1988 and mid-1990 to mid-1991, researchers conducted cross sectional serological surveys at the STD clinic in Port of Spain in Trinidad to examine trends in HIV-1 prevalence among 2019 and 1606 STD patients, respectively. They also conducted a case control study of risk factors for HIV-1 infection among heterosexual STD patients (131 cases and 173 age- and sex-matched controls) in 1992-1993. Between 1987-1988 and 1990-1991, HIV-1 seroprevalence increased markedly (3% to 13.6%). It increased more in women than in men (9- vs. 4-fold). During 1987-1988, men were more likely to be infected with HIV-1 (odds ratio [OR] = 3.1), but by 1990-1991, gender was no longer a significant risk factor (OR = 1.3). In 1990-1991, significant risk factors for HIV-1 infection were urban residence (OR = 2.2), HTLV-1 infection (OR = 3.1), and being at least 40 years old (OR = 1.8). None of these risk factors were significant in 1987-1988. HIV-1/HTLV-1 coinfection increased between the two surveys (0.05% to 1.5%). Significant independent HIV-1 risk factors in men identified in the case control study were: used crack cocaine in the past 6 months (adjusted OR [AOR] = 6.2; p = 0.0001); ever had anal sex (AOR = 7.2; p = 0.003); ever had syphilis (AOR = 3.2; p = 0.02); current genital ulcer disease (AOR = 5.2; p = 0.0001); and current genital warts (AOR = 3.9; p = 0.02). Significant independent HIV-1 risk factors in women were: less than 14 years old at first sex (OR = 4.8; p = 0.01); ever been a commercial sex worker (AOR = 5.7; p = 0.02); and ever had nongonococcal cervicitis (AOR = 4.1; p = 0.005). These findings suggest that sexual exposure to HIV-1 through ulcers for men and inflammatory STD and/or prostitution for women, all fueled by the crack cocaine epidemic, account for much of HIV-1 exploding in Trinidad. Public health interventions to prevent, detect, and treat STDs and crack cocaine addition may greatly reduce HIV-1 transmission.
AIDS 1995 Apr
PMID:HIV-1 prevalence and risk factors among sexually transmitted disease clinic attenders in Trinidad. 779 44

To measure participation in experimental drug trials among persons with acquired immunodeficiency syndrome (AIDS), we interviewed 4,604 persons at least 18 years of age who were reported to have AIDS to 11 state and city health departments in the United States. Ten percent reported that they were currently in a trial. Current enrollment differed significantly (p < 0.05) by race/ethnicity (blacks, 5%; whites, 14%; Hispanics, 15%), gender (women, 7%; men, 11%), exposure mode (injection drug use, 5%, men who have sex with men, 14%), annual household income (< $10,000, 8%, > or = $10,000, 14%), education (< 12 years, 6%; > or = 12 years, 12%), health care (no regular care, 1%, public care, 8%; private care, 17%), and time since AIDS diagnosis (< or = 6 months, 9%; > 6 months, 12%). Adjusting for all factors and time since AIDS diagnosis, blacks (adjusted odds ratio [AOR] = 0.35, 95% confidence interval [CI] 0.26, 0.47), persons with less than 12 years of education (AOR = 0.71, CI 0.53, 0.96), and those without regular health care (AOR = 0.24, CI 0.10, 0.61) remained less likely to be in a trial. Blacks, those with less than 12 years of education, and persons without regular health care were less likely than other persons with AIDS to be currently enrolled in AIDS trials. To increase enrollment of these persons, researchers must address barriers to participation for these groups.
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PMID:Differences in participation in experimental drug trials among persons with AIDS. 854 36

Between February 1990 and March 1993, 759 female commercial sex workers who attended sexually transmitted disease (STD) clinics in Dakar, Thies, and Mbour, Senegal, were interviewed and underwent a general physical and detailed gynecologic examination so researchers could ascertain the influence of HIV-1 and HIV-2 infection on the prevalence of cervical human papillomavirus (HPV) and squamous intraepithelial lesions (SIL) in this high-risk population. Most lesions were low-grade SIL. 619 had neither HIV-1 nor HIV-2 infection. 9%, 8%, and 2% had HIV-1, HIV-2, and concurrent HIV-1 and HIV-2 infection, respectively. Polymerase chain reaction revealed that 43% had HPV infection, while Southern transfer hybridization found only 7%. HIV-1 infected women faced a significant increased risk for HPV (adjusted odds ratio [AOR] = 2.9) as also did HIV-2 infected women (AOR = 1.7). Both these groups also faced an increased risk for SIL (AOR = 1.8 and 2.9, respectively), but the increased risk was not significant. Similarly, women infected with both HIV-1 and HIV-2 faced an increased risk of HPV and SIL (AOR = 4.9 and 5.2, respectively). Among women with HIV infection, women with HPV had a lower CD4 count and CD4/CD8 ratio (854 vs. 1033 million/l, p = 0.08, and 0.88 vs. 1.17, p = 0.05, respectively) than women with no detectable HPV. HIV-positive women with SIL had a lower CD4/CD8 ratio than HIV-positive women without SIL (0.65 vs. 1.03; p = 0.003). HIV-2 women exhibited lower immunosuppression than HIV-1 women. These findings show that both HIV-1 and HIV-2 infection were associated with HPV and SIL. The researchers expressed interest in longitudinal studies designed to examine the risk of high-grade SIL, the direct precursor of invasive cervical cancer, among HIV-infected women.
AIDS 1996 Apr
PMID:HIV-1, HIV-2, human papillomavirus infection and cervical neoplasia in high-risk African women. 872 46

Thrombocytopenia in persons infected with HIV is prevalent and has numerous causes. To study the occurrence, associations, and effect on survival of thrombocytopenia in HIV-infected persons, we used surveillance data from a longitudinal survey of the medical records of 30,214 HIV-infected patients who received medical care from January 1990 through August 1996 in more than 100 medical clinics in 10 U.S. cities. Thrombocytopenia was defined as a physician diagnosis of thrombocytopenia or a platelet count of < 50,000 platelets/ microliter. Analysis of associations of thrombocytopenia was conducted using logistic regression. In HIV+ patients, the 1-year incidence [corrected] of thrombocytopenia was 8.7% in persons with one or more AIDS-defining opportunistic illnesses (clinical AIDS), 3.1% in patients with a CD4 count < 200 cells/mm3 but not clinical AIDS (immunologic AIDS), and 1.7% in persons without clinical or immunologic AIDS. The incidence of thrombocytopenia was associated with clinical AIDS (adjusted odds ratio [AOR] 2.2; 99% confidence interval [CI] 1.7-3.0), immunologic AIDS (AOR 1.5, CI 1.0-2.1), history of injecting drug use (AOR 1.4, CI 1.0-1.9), anemia (AOR 5.0, CI 3.8-6.7), lymphoma (AOR 3.7, CI 1.3-10.6), and black race (AOR 0.7, CI 0.5-0.9). After controlling for anemia, clinical AIDS, CD4 count, neutropenia, antiretroviral therapy, and Pneumocystis carinii pneumonia prophylaxis, thrombocytopenia was significantly associated with decreased survival (risk ratio 1.7; 95% CI, 1.6-1.8). Thrombocytopenia in HIV-infected persons is an important clinical condition associated with shorter survival.
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PMID:Surveillance for thrombocytopenia in persons infected with HIV: results from the multistate Adult and Adolescent Spectrum of Disease Project. 911 81

A survey was carried out in 2 drug use treatment centres (TCs) in Rio de Janeiro, Brazil, to assess risk behaviours, HIV infection and other sexually transmitted infections/blood-borne infections (STIs/BBIs). Two hundred and twenty-five drug users (195 males and 30 females) were interviewed and clinically examined, and their blood and urine were tested for STIs/BBIs. Prevalences (%) for these infections were as follows--HIV: 0.9, hepatitis B virus (HBV): 14.7, hepatitis C virus (HCV): 5.8, syphilis: 5.3, gonorrhoea/chlamydia (CT/NG): 4.7. In bivariate analyses CT/NG infection was associated with younger age (P=0.003); current genitourinary symptoms (odds ratio [OR]=6.2) and a mainly illegal source of income (OR=9.1). Hepatitis C infection was associated with a history of ever having injected any drug (OR=19.6), and with each one of the injected drugs. After multiple logistic regression, lower educational level (adjusted odds ratio [AOR]=3.70) and 'ever having injected drugs' (AOR=3.69) remained as independent risk factors for hepatitis B infection. In conclusion, TCs must implement programmes directed towards the prevention of STIs/BBIs.
Int J STD AIDS 2000 Jun
PMID:Sexual behaviour and infection rates for HIV, blood-borne and sexually transmitted infections among patients attending drug treatment centres in Rio de Janeiro, Brazil. 1087 12

The objective was to evaluate the association between antiretroviral therapy and AIDS mortality in New York City (NYC). Design was a population-based case-control study. We randomly selected 150 case patients and 150 control patients whose AIDS diagnosis was made during 1994 to 1996 (male:female, 2:1) from among 19,238 persons reported to the NYC Health Department HIV/AIDS Reporting System (HARS). Case patients had died of AIDS-related causes in 1996. Control patients, category matched with case patients on gender, were not known to have died by the end of 1996. Analysis was performed on 279 patients (142 cases and 137 controls). Cases and controls were similar in age, gender, race, HIV transmission category, and health insurance coverage. The median baseline CD4 count was 30 cells/microL for those who died and 103 cells/microL for survivors (p < 0.001). The prescription of HAART (antiretroviral combination that includes at least one protease inhibitor) in 1996 was strongly associated with survival in univariate analysis (OR = 5.1, 95%CI = 2.5-10.2). This association remained in a logistic regression analysis after adjusting for sex, age, race, health insurance status, HIV transmission categories, year of AIDS diagnosis, baseline CD4 count, and other antiretroviral therapy (AOR = 8.6, 95%CI = 3.5-20.7). Prescription of combination therapy other than HAART in 1996 and baseline CD4 count were also associated with survival, but less strongly so. The survival benefit of HAART extends beyond the confines of a few highly selected patients into the "real world," reducing AIDS deaths at the population level. This population-based study supports the likelihood that the introduction of HAART in 1996 played a primary role in the decline in NYC AIDS mortality.
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PMID:Antiretroviral therapy and declining AIDS mortality in New York City. 1097 20

This study provides population-based estimates of the incidence of constituent symptoms associated with HIV-related lipodystrophy syndrome. Possible predictors of symptomatology based on analysis of accrued cases are provided after adjustment for a broad range of personal, clinical, and treatment characteristics. Patients enrolled in a province-wide HIV/AIDS treatment program reported annually on the occurrence of lipoatrophy, lipohypertrophy, and elevated triglyceride and cholesterol levels. Of 1261 individuals who provided baseline data, 745 were available at follow-up, among whom incidence was 27% for lipoatrophy, 21% for lipohypertrophy, and 10% and 16% for increased triglyceride and cholesterol levels, respectively. In logistic multivariate modeling, incident lipoatrophy was associated with duration of stavudine (per quarter) (adjusted odds ratio [AOR] 1.18; 95% confidence interval [CI] 1.09-1.27) and having been diagnosed with AIDS (AOR 2.07; 95% CI 1.20-3.56). Lipohypertrophy risk increased with use of protease inhibitor (AOR 3.53; 95% CI 1.81-6.86) and stavudine (AOR 3.67; 95% CI 1.61-8.38). Incident cholesterol or triglyceride abnormalities were associated with protease inhibitor use (AOR 7.17; 95% CI 2.46-20.96) and duration of ritonavir (per quarter) (AOR 1.12; 95% CI 1.04-1.21). Our findings suggest high annual rates of incidence and a role of first line antiretroviral therapies in symptom development. These outcomes, in conjunction with the findings of others have important implications for evolving treatment patterns.
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PMID:Antiretroviral treatment patterns and incident HIV-associated morphologic and lipid abnormalities in a population-based chort. 1213 51

Injection drug users who continue to use drugs may not respond to highly active antiretroviral therapy (HAART) as well as other HIV-infected individuals, even after adjusting for a reliable measure of adherence. We therefore compared the virologic response among participants in a population-based HIV/AIDS Drug Treatment Program in British Columbia, Canada, by injection drug use activity. Participants who were HIV infected and naive to antiretroviral therapy and who were prescribed antiretroviral treatment between August 1996 and December 2000 were eligible for this study. They were classified as current, former, or non-injection drug users. The main outcome was having two consecutive HIV-1 RNA levels less than 500 copies/mL. We used logistic regression to adjust for baseline HIV-1 RNA, type of antiretroviral regimen (2 nucleosides + nonnucleoside reverse transcriptase inhibitor versus 2 nucleosides + protease inhibitor), duration of therapy (months), adherence (derived from refill compliance data), and age. A total of 578 participants were first prescribed HAART during the study period. Among them, 78 (13%) were current injection drug users, 96 (17%) were former injection drug users, and 404 (70%) never injected drugs. In the multivariable logistic regression, relative to non-drug users, current injection drug users were significantly less likely to suppress their HIV-1 RNA (adjusted OR [AOR] = 0.30, 95% CI: 0.13-0.67), and former injection drug users were not significantly different from non-drug users (AOR = 0.56, 95% CI: 0.24-1.34). There was a significant interaction between drug use and adherence. In the analyses stratified by drug use, the adherence of former and non-drug users was positively associated with HIV-1 RNA suppression (AOR = 1.33, 95% CI: 1.14-1.55), whereas for current drug users, it was not (AOR = 1.07, 95% CI: 0.87-1.33). Current injection drug users were less likely to achieve HIV-1 RNA suppression compared with non-drug users. Adherence as measured by pharmacy refill compliance was not a reliable measure in this subpopulation.
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PMID:Impaired virologic response to highly active antiretroviral therapy associated with ongoing injection drug use. 1267 4

To describe prevalence of fatigue and its correlates among persons with HIV infection, we abstracted medical records of 13,768 persons in care for HIV in >100 US clinics. The prevalence of fatigue (defined as fatigue, malaise, or weakness that was the primary reason for a medical visit, was persistent, or was severe enough to preclude work) was 37%. Fatigue was more common among persons with clinical AIDS (adjusted odds ratio [AOR] 1.3, CI 1.1-1.5); depression (AOR 2.4, CI 2.1-2.7); and hemoglobin concentrations <8, 8-10, and 10-12 g/dL (AORs 3.3 [CI 2.4-4.6], 2.7 [CI 2.2-3.2], and 1.5 [CI 1.3-1.7], respectively). Fatigue was not associated with viral load or CD4 cell count <200/microl. Fatigue cannot be viewed solely as a constitutional symptom of progressive HIV disease. Physicians should seek underlying, treatable causes for fatigue such as depression and anemia and treat these conditions when they are found.
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PMID:Prevalence and correlates of fatigue among persons with HIV infection. 1269 84

To identify the frequency of and factors associated with early detection of HIV infection in Los Angeles County, data were evaluated from interviews of a population-based sample of adult persons with AIDS. Early detection was defined as greater than 5 years between the first reported positive HIV test and an AIDS diagnosis. The associations between early detection and sociodemographic and behavioral factors were assessed for the period January 1997 through June 2002. Over the study period, only 20% (253/1268) of persons interviewed met the criterion for early detection. Early HIV detection was less likely for women (adjusted odds ratio [AOR] = 0.6, 95% confidence interval [CI]: 0.4, 0.9), blacks (AOR = 0.5, 95% CI: 0.4, 0.8), foreign-born Latinos (AOR = 0.2, 95% CI: 0.1, 0.3), U.S.-born Latinos (AOR = 0.3, 95% CI: 0.2, 0.6, and heterosexuals (AOR = 0.5, 95% CI: 0.3, 0.7). Trends of increasing early detection with older age groups (p < 0.001) and higher educational levels (p < 0.001) were also observed. Our findings indicate an overall low level of early HIV detection and suggest that major sociodemographic and risk group disparities exist in the likelihood of early detection among HIV-infected persons in Los Angeles. These differences have important implications for reducing the level of community HIV transmission and for improving individual health outcomes among people with HIV. Aggressive efforts are needed to expand HIV testing and early detection for women, minorities, heterosexuals, younger age groups, and persons of lower education. Links to treatment and behavioral intervention programs should accompany such expanded testing efforts.
AIDS Patient Care STDS 2003 Jun
PMID:Frequent failed early HIV detection in a high prevalence area: implications for prevention. 1288 Apr 91


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