Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.7.10.2 (focal adhesion kinase)
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The Centers for Disease Control and Prevention (CDC) are currently reviewing the guidelines for handling HIV-positive health care workers (HCWs). The Advisory Committee on HIV and STD Prevention and the Hospital Infection Control Practices Advisory Committee are working together to change these recommendations based on problems arising under the present regulations. Worker's lack of confidentiality in disclosing their HIV status to patients, and ambiguous terminology stating that HCWs should not perform procedures that are exposure-prone, are among the problems that need to be addressed. Current practices have shown that health care personnel with HIV and hepatitis B (HBV) should be dealt with separately, and disclosure of HIV status should not be mandated because the risk of transmission to patients is very low. The group suggests that self-disclosure is warranted in specific cases, and may be mitigated by a supervisor who could oversee the worker's health condition. Additional recommendations include concentrating efforts on preventing injury to health care workers, studying transmission risks for hepatitis C, and analyzing the methods for preventing transmission. Results from a look-back study conducted by the CDC suggest that there is no data to demonstrate transmission between 53 HIV-positive health care providers and their 22,759 patients. The working group also recognizes the need for review panels, but feels that they should be decentralized to fit the needs of individual health care providers.
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PMID:Pressure mounts for CDC to change guidelines for infected HCWs. Centers for Disease Control and Prevention. 1136 9

Chronic hepatitis B infection is frequently diagnosed within the genitourinary clinic setting with sexual transmission the commonest route of acquisition in the United Kingdom. Only 3--5% of adults who contract acute hepatitis B will progress to chronic infection, and these individuals can be identified by the presence of hepatitis B surface antigen (HBsAg) in the bloodstream 6 months after infection. Individuals at highest risk of long-term complications such as cirrhosis and hepatocellular carcinoma, carry HBeAg and have high levels of circulating hepatitis B virus (HBV) deoxyribonucleic acid (DNA). Therapy should be targeted towards this group of patients. Two forms of therapy are now licensed for use in chronic hepatitis B infection: interferon-alpha and lamivudine. Seroconversion occurs in 30--40% of patients treated with interferon and treatment is often limited by toxicity. Lamivudine is well tolerated with seroconversion rates of 15--20% at one year, rising with increasing duration of therapy. Long-term monotherapy is limited however by the development of resistance mutations and combination nucleoside therapy is likely to become the treatment of choice in the future. Patients with chronic hepatitis B should be counselled regarding transmission, partner vaccination and alcohol intake and co-infection with other hepatitis viruses should be excluded.
Int J STD AIDS 2001 Jun
PMID:The management of chronic hepatitis B infection. 1180 40

We assessed to what extent gay men are motivated to obtain vaccination against hepatitis B virus (HBV), as well as the social cognitive determinants of this motivation. A cross-sectional survey was conducted among homosexual men by means of a written questionnaire that contained assessments of intention, knowledge and social-cognitive determinants of intention (i.e. attitude, social norm and perceived behavioural control towards vaccination, perceived severity and perceived vulnerability regarding HBV infection). Four hundred and thirty-three homosexual men completed the questionnaire. We conducted a linear regression analysis to determine the contribution of social-cognitive variables in explaining intention to be vaccinated. Attitude, social norm and perceived vulnerability were significant predictors of intention. Usually, health education emphasizes the severity of a disease, but from this analysis we can conclude that gay men should be convinced of their personal vulnerability to HBV, the benefits of vaccination, and that important referents of the targeted person think positively about vaccination.
Int J STD AIDS 2002 Feb
PMID:Why do gay men want to be vaccinated against hepatitis B? An assessment of psychosocial determinants of vaccination intention. 1183 62

This paper evaluates the effectiveness of a bar-based, peer-led community-level intervention to promote sexual health amongst gay men. The intervention consisted of peer education within bars, gay specific genitourinary medicine (GUM) services and a free-phone hotline. Data were collected at baseline (1996) and at follow-up (1999) in gay bars in Glasgow (intervention city) and Edinburgh (control city). During the intervention peer educators interacted with 1484 men and new clients increased at the gay specific GUM service. However, the hotline was under-utilized and abused. The outcome measures were: reported hepatitis B vaccination; HIV testing; unprotected anal intercourse (UAI) with casual partners; negotiated safety; and amongst men reporting UAI with a regular partner, the proportion who knew their own and their partner's HIV status. Significant differences in sexual health behaviours were observed across locations and across time, but the only significant intervention effects were amongst men who had direct contact with the intervention, with higher uptake of hepatitis B vaccination and HIV testing. The intervention did not produce community-wide changes in sexual health behaviours. These results question the replication and transferability of peer-led, community-level sexual health promotion for gay men outwith the USA and across time.
Int J STD AIDS 2002 Feb
PMID:Does bar-based, peer-led sexual health promotion have a community-level effect amongst gay men in Scotland? 1183 64

In the former West Germany, in specific venereal diseases legislation passed in 1953, only syphilis, gonorrhoea, ulcus molle, and lymphogranuloma venereum were defined as venereal diseases and subject to mandatory notification. The proportion of unreported cases was as high as 75% for syphilis and up to 90% for gonorrhoea. Epidemiological data for the past 10 years exist only on selected populations from research studies and are summarized in this article. In the former East Germany reporting of sexually transmitted infections (STIs) was mandatory and, due to the centralized organization, underreporting was considered to be low, although no specific studies have examined this. After the unification in 1990 of the two German states the West German laws were adopted in East Germany. Since 1982 - when the first AIDS case was reported in Germany - information on AIDS cases has voluntarily been collected at the national register at the AIDS Centre of the Robert Koch Institute in Berlin. The law governing the reporting of infectious diseases has recently been revised. Under the new Protection against Infection Act, which became effective on 1 January 2001, clinical diagnoses of STIs (with the exception of hepatitis B) are no longer notifiable diseases. Laboratory reporting of positive test results for Treponema pallidum has been introduced. With T. pallidum and HIV notifications, additional disaggregated data are collected. Since T. pallidum and HIV remain the only notifiable STIs, all other STIs have to be monitored through sentinel surveillance systems. These surveillance systems are currently being established. Under the new legislation, local health authorities have to provide adequate counselling and testing services for STIs, which may be provided free of charge if necessary.
Int J STD AIDS 2002 Apr
PMID:Sexually transmitted diseases in Germany. 1188 9

The outcomes of hepatitis B immunization programme at the genitourinary medicine (GUM) department in Middlesbrough during a period of five years were examined. The majority of those immunized were male homosexuals who had earlier requested an HIV test. All participants had preimmunization hepatitis B serology, and were negative. The default rate was high at 20/42 (47.6%). However, among those who completed all the processes, seroconversion rate was high at 21/22 (95.5%). The only non-responder was a man who was HIV-positive. The type of vaccine and immunization regimen are discussed.
Int J STD AIDS 2002 Apr
PMID:Audit of hepatitis B immunization at the genitourinary medicine department in Middlesbrough, UK. 1266 96

In order to plan a health education programme in high schools in Southern Latium, a survey on knowledge, attitude and behaviour about Sexually Transmitted Diseases and AIDS was carried out among students of three high schools in Cassino. An anonymous, self-administered questionnaire was submitted to all students of the last two years in those schools. The results show a good knowledge of Cassino's students about HIV transmission, in similar or higher proportion respect to analogous surveys conducted in Italy or abroad. We found a good knowledge only about AIDS, Herpes genitalis and Syphilis, while knowledge about Hepatitis B, Condyloma acuminatum and Gonorrhoea is not satisfactory. Considering that 38% of male and 17% of female students declared to have already had their first sexual intercourse, the results suggest that there is a strong need to implement an educational intervention on sexuality and STD.
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PMID:[Knowledge, attitudes, and practices regarding sexually transmitted diseases among students in 3 high schools in Cassino]. 1216 21

Dental practitioners were surveyed, using a self-completed postal questionnaire, to assess their attitudes to managing patients with blood-borne viruses (BBV) and to identify dental services available for such patients in North Nottinghamshire. Questionnaires were completed by 79 (65.3%) of the 121 practitioners from 43 (82.7%) of the 52 study practices. Previous BBV experience was reported by 44 (55.7%), 31 (39.2%), 20 (25.3%) respondents for hepatitis B (HBV), hepatitis C (HCV), HIV, respectively. Over two-thirds would maintain existing patients with subsequently diagnosed BBV on their lists, approximately one-third would accept new BBV patients. Risk factors for BBV of homo/bisexuality and injecting drug use were not asked by 71 (89.9%) and 49 (62.0%) practitioners, respectively. Universal precautions were employed by 67 (84.8%) practitioners regardless of the patient's status and by seven practitioners for known BBV patients. The advice of the General Dental Council, British Dental Association, and the use of universal precautions are discussed.
Int J STD AIDS 2002 Aug
PMID:Availability of dental services for patients with blood-borne viruses. 1219 36

Screening for HIV in China began in 1984, with the first AIDS case appearing in 1985. 305,280 sera were tested as of 1992, of which 379 were seropositive for antibodies to HIV. Of these 379 individuals, there were 4 hemophiliacs identified in 1985, 1 homosexual male, 4 individuals returning from Africa, 365 drug addicts and 2 spouses. 68 foreigners and 1 Chinese hemophiliac from Hong Kong also tested seropositive. Concern is expressed over the psychosomatic trials of infected women who feel unable to discuss their HIV status with family members for fear of influencing their role as primary caregivers and sex partners. Without access to medical therapy and support groups, these women no doubt feel isolated. Non-directive counseling is recommended for seropositive women during pregnancy. AIDS patients have reduced natural killer cell cytotoxicity. Seminal plasma also suppresses several immune responses. The pathogenicity of HIV, however, has yet to be determined. Fatty acid metabolism and Beta-endorphin are discussed in the context of therapeutic approaches. HIV/STD interactions are finally considered with individual attention given to bacterial vaginosis, hepatitis B, Chlamydia trachomatis, Herpes Simplex virus, microbiological contaminants of the vagina bacterial vaginosis, syphilis, mycoplasmas/epididymitis, bacterial prostatitis, and IVF culture media infections.
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PMID:HIV / STD interactions immunosuppression and future research development. 1228 86

Wisconsin Pharmacal's Female Health Company stated plans for the launch of the Reality female condom at a press conference in New York. The disposable polyurethane barrier contraceptive is a soft sheath that is open on one end and closed at the other. Reality began to appear on retail shelves in the US in August 1994, and it is available over the counter in all major drug store chains, many supermarket chains, independent pharmacies, and grocery stores. The company hopes to ultimately obtain about 2% of sexually active women as regular users, or about one million regular users on an annual basis. In 1993, male condom sales exceeded 700 million units. In late August 1994, the Female Health Company sent letters to 65,000 pharmacies and 50,000 physicians announcing the availability of Reality in retail outlets. A professional sales force of more than 60 people began presenting Reality to more than 10,000 selected high-potential U.S. physicians and other health care professionals. Before FDA approval, a six-month contraceptive study found that when used consistently and correctly, Reality's pregnancy failure rate was 2.6%; the typical failure rate was 12.4%. Laboratory studies have demonstrated that Reality's polyurethane sheath is an effective barrier to HIV and to a viral particle smaller than hepatitis B. One limited STD clinical study found that the reinfection rate of trichomoniasis was 0% when the female condom was used consistently and 14.7% when it was not used with every sex act. One study will measure Reality's effectiveness as a barrier to gonorrhea, chlamydia, and syphilis, and another study will explore what method of protection women will use when given a choice. An ongoing study at the University of Alabama at Birmingham's School of Public Health is looking at Reality's efficacy at preventing gonorrhea, chlamydia, and herpes simplex-2, compared with the male condom.
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PMID:Condom campaign heralds arrival of weapon against AIDS. 1228 15


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