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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since 1981 there has been a constant rise in the incidence of squamous cell carcinoma of the oral cavity and the anorectum among homosexual men in the United States. In addition, lung cancer, testicular cancer, chronic lymphocytic leukemia, malignant melanoma, basal cell carcinoma, cervical cancer, and multiple myeloma have been recently reported in persons at risk for AIDS with HIV infection, with some peculiar clinicopathological features, including age, histological type, and clinical aggressiveness. Within the GICAT (Gruppo Italiano Cooperativo AIDS & Tumori) framework, we have identified four cases of testicular cancer, two cases of leukemia, and 1 case each of cervical cancer, carcinoma of the oral cavity, lung cancer, brain tumor, and multiple myeloma in persons at risk for AIDS, mainly i.v. drug abusers, with HIV infection, diagnosed in different Italian institutions. Work is in progress in order to collect histological and clinical data on these tumors. Although these data are preliminary and are not indicative of an actual increase in the incidence of malignancies other than malignant lymphomas and Kaposi's sarcoma in the AIDS setting, clinicians should be aware of the possible association of these tumors with HIV infection.
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PMID:Malignant tumors other than lymphoma and Kaposi's sarcoma in association with HIV infection. 318 Jan 32

Premature sexual activity among adolescents leads to such complications as unwanted pregnancy, abortion, and sexually transmitted diseases (STDs). The increasing adolescent sexual intercourse worldwide will likely result in increasing rates of adolescent pregnancy, although a recent study has shown that these rates will vary from country to country. Rates of pregnancy for girls younger than 14 are very low worldwide, and the cesarean rate is also lower than that found among older women. The most frequent complications of adolescent pregnancy are toxemia and anemia, both of which are exacerbated by incomplete follow-up in pregnant teenagers. Abortion rates are high in some European countries and lower in others, reflecting differences in legislation and attitudes. Increased incidence of STDs is due to inadequate sex education and poor hygiene. Human papillomavirus is becoming a common infection among adolescents, and rates of cervical cancer are greater among women who begin intercourse at an early age. Because there is no contraindication for the use of oral contraceptives in teenagers, the proper method of protection should be decided on an individual basis. Condom use should also be promoted to provide simultaneous protection from STDs/HIV and pregnancy. The creation of separate clinics where adolescents can receive medical and psychosocial support as well as counseling will help reduce the unwanted consequences of early sexual activity.
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PMID:Sequelae of premature sexual life. 756 6

HIV infection is known to increase the incidence of Kaposi's sarcoma and non-Hodgkin's lymphoma. Kaposi's sarcoma preferentially affects homosexual men and risk varies by geographic area, suggesting there is an environmental cofactor for Kaposi's sarcoma in addition to HIV. Despite intensive investigation, the responsible cofactor has not been conclusively identified. HIV-associated non-Hodgkin's lymphoma affects all HIV transmission groups, and non-Hodgkin's lymphoma risk increases with duration of HIV infection and age. Epstein-Barr virus has been implicated in the pathogenesis of this tumor, but the precise mechanisms have not been worked out. Cervical cancer and anal cancer have a less certain association with HIV infection and immunodeficiency, although epithelial dysplasia at these sites does seem to be HIV-related. Children with HIV infection are additionally affected by increased incidence of leiomyosarcoma and benign leiomyoma, whereas adults with HIV infection do not seem particularly susceptible to this tumor, perhaps because of hormonal or growth-promoting factors. Apart from these specific disease associations, HIV infection and related immunodeficiency do not result in a generalized tumor diathesis. Prevention and management of HIV-associated cancers are becoming increasingly important as the HIV epidemic continues to grow.
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PMID:Epidemiology of AIDS-related malignancies. 782 52

This review discusses recent insights into the roles of the p53 tumor-suppressor gene and growth factors in the development of ovarian cancer and describes the genes implicated in familial ovarian cancer syndromes related to the MSH2 (Lynch II) and BRCA1 (breast and ovarian cancer) genes. Evidence of the monoclonality of ovarian cancer, which contrasts with data supporting the polyclonal origin of primary peritoneal carcinoma, is presented. Finally, the roles of the human papillomavirus and the HIV virus in the etiology of cervical cancer are analyzed in view of the growing importance of this HIV-associated cancer and the poor outcome in these patients.
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PMID:Advances in the biology of gynecologic cancer. 782 56

A set of new guidelines were formulated by an expert group meeting in Sweden organized by the pharmaceutical office during March 31-April 1, 1993. It contains various methods to avoid an undesired pregnancy and also advice about postcoital contraception. Among barrier methods, the condom is the only reversible method for men with a method failure of 2 and user failure of 10. It protects against gonorrhea, chlamydia, condyloma, herpes simplex, HIV, and hepatitis B. The diaphragm can be used with a spermicide and protects to a lesser degree against chlamydia, gonorrhea, and cervical cancer. The female condom is as effective as the condom. Among spermicides, nonoxynol-9 is not only effective against sperms but also against bacteria, viruses, and certain vaginal and cervical cells. The vaginal sponge is impregnated with nonoxynol-9 and is effective up to 24 hours. The copper IUD, with a method failure of less than 1, can cause profuse menstrual bleeding, dysmenorrhea, and endometritis-salpingitis. Hormonal methods include combination pills (2-phase and 3-phase pills) and gestagen methods (high dose with 150 mg of medroxyprogesterone acetate injection every 3 months and low-dose minipills with levonorgestrel, norethisterone, or lynestrol). Mechanisms of action concern combination pills, gestagen methods, minipills, Norplant, and Levonova. Drug cross reaction can reduce effectiveness. Side effects include bleeding and amenorrhea. Risk-benefit determination is based on health effects. Possible risks are associated with breast cancer, cervical cancer, blood pressure increase, venous thromboembolism, and heart infarction. Various phases of the reproductive age include young women, lactating women, and women in the later part of the reproductive age. Special groups include those who have experienced ectopic pregnancy, infections (candida, sexually transmitted diseases: chlamydia trachomatis, HIV infections), obesity, cardiovascular diseases, diabetes mellitus, tumors of the reproductive organs, liver diseases, migraine, epilepsy, surgery, and handicapped women. Postcoital contraception is used only in need, and methods for postcoital contraception include hormonal method and the copper IUD.
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PMID:[Contraception. Recommendations from a group of experts]. 790 65

HIV infections in women now account for 40% of all HIV infections worldwide, and the majority of new infections are due to heterosexual transmission. In the United States, 12% of AIDS cases occur in women and in certain high prevalence areas such as Brooklyn, New York, 25% of cases are in women. Both squamous cell neoplasia of the cervix and HIV infection are, in part, sexually transmitted diseases, with oncogenic types of human papillomavirus infection the implicated viral carcinogen associated with cervical cancer. Therefore, an association between cervical cancer and AIDS can be anticipated on the basis of common sexual behavioral risk factors. The author summarizes what we know about the diagnosis and management of women with these problems.
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PMID:Cervical neoplasia in women with HIV infection. 794 5

Worldwide, squamous cell cervical cancer and intraepithelial lesions (SIL) are a major source of morbidity and mortality. Compared to women in general, women with human immunodeficiency syndromes (HIV) are at higher risk of developing SIL. With the HIV epidemic escalating among women, prevalence, morbidity, and mortality related to SIL are likely to increase unless adequate prevention and detection programs are mounted. Consequently, this article provides background information for the design of such programs, focusing on selected biochemical risk factors and natural history of SIL in women infected with HIV (HIV+) and women in general (HIV-). Current screening policies are described, and implications for nursing research and policy are discussed.
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PMID:Squamous cell cervical lesions in women with and without AIDS. Biochemical risk factors, prevention, and policy. 795 77

Barrier methods keep sperm from entering the cervical canal. Spermicides, most of which are nonoxynol based, are used with diaphragms and caps and in the lubrication of some male condoms. One dose of spermicide for each act of intercourse suffices. The efficacy rate of barrier methods is good when used before any genital contact and used correctly. Nurses should discuss with potential users of barrier methods the possibility of failure and inform them about postcoital contraception. Nurses or family planning-trained physicians must do an accurate fitting of diaphragms and caps. They need to also do a good job of teaching clients how to use them. The failure rate of diaphragms and caps is 4-18%, depending on the degree of consistent and correct use. Diaphragms and caps protect against some sexually transmitted diseases (STDs) (but not HIV) and may protect against cervical cancer and pelvic inflammatory disease (PID). Diaphragms lie across the cervix. Suction holds the cap over the cervix. The type and size of cap depends on the shape of the cervix. Contraindications to the diaphragm or cap range from allergy to rubber or spermicides to current vaginal, cervical, or pelvic infection. Diaphragms and caps must be left in position for 6 hours after intercourse but no longer than 24 hours. They can be inserted 3 hours before intercourse and, if it is longer than 3 hours, an extra dose of spermicide should be inserted. The UK has had the single-use female condom since 1992. It comes in 1 size. It protects against STDs, including HIV; cervical cancer; and PID. Acceptability of the female condom is rather low, however. Spermicides protect against some STDs. The contraceptive sponge is a carrier for the spermicide and is not a barrier method. Its efficacy is relatively low (75-90%). Male condom efficacy varies from 85-98%. Male condoms protect against STDs and HIV. Nurses should advise both male and female clients about correct use of male condoms.
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PMID:Contraception. Risk cover. 804 44

Studies in various regions of the world have shown that women infected with HIV-1 are at increased risk for cervical human papillomavirus (HPV) infection as well as for cervical cancer precursor lesions. HIV infection and cervical cancer are both widespread in West Africa, but little is known about the relationship between HPV and HIV-2, the predominant type of HIV in the general population of many West African countries. The authors report findings from their collection of cervical samples for cytology and HPV analysis from 93 women presenting to the University of Dakar Infectious Disease Service; 18 women infected with HIV-1, 17 with HIV-2, and 58 HIV seronegative controls. Compared to those without HIV infection, HIV seropositive women were 13.1 and 11.0 times more likely to have HPV detected using Southern transfer hybridization and the polymerase chain reaction, respectively. The detection of high and intermediate risk HPV types was significantly associated with HIV-1 and HIV-2 infection. Among HPV-positive women, those infected with HIV were more likely to harbor high-risk HPV types. HIV-1 and HIV-2 seropositive women were 23.3 and 9.3 times more likely to have a cytological diagnosis of dysplasia, respectively, than were HIV-seronegative women. Biopsy-proven cervical intraepithelial neoplasia (CIN) 3 was found in one woman with HIV-1 and invasive cancer was found in one woman with HIV-2. It remains unclear, however, whether HIV-1 and HIV-2 confer similar risks of developing CIN 2-3 and the potential of invasive cervical cancer.
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PMID:Cervical intraepithelial neoplasia and human papillomavirus infection among Senegalese women seropositive for HIV-1 or HIV-2 or seronegative for HIV. 806 Oct 90

The Center for Disease Control (CDC) recently added invasive cervical cancer to its list of surveillance case-defining diseases, and also included cervical dysplasia, carcinoma in situ, and pelvic inflammatory disease (PID) in the classification system. There are several reported cases of cervical cancer in AIDS patients that behaved in an unusually aggressive fashion and responded poorly to therapy. In light of the above-reported cases, it may be expected that cervical cancer may manifest itself in unusual ways in HIV-positive women. A case of aggressive cervical cancer in an AIDS patient with PID is reported. She was admitted with PID and newly diagnosed cervical cancer with recurrent fever spikes despite adequate antibiotic coverage. An aspiration of a presumed psoas abscess revealed metastatic squamous cell carcinoma. These data suggest that not only are HIV-infected women at risk for aggressive and unusual presentations of cervical cancer, but also that coexistent pelvic infection may contribute to development and spread of the disease. Immunosuppression from the virus may increase the incidence and severity of neoplasia. Data suggest that cervical cancer in HIV-infected women is often of advanced stage and responds poorly to treatment. Unique treatment approaches may need to be developed as conventional strategies do not seem to be adequate. More research is required to determine what these strategies should be. Lastly, universal HIV screening of women with either PID or cervical cancer seems prudent.
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PMID:Metastatic cervical cancer and pelvic inflammatory disease in an AIDS patient. 808 16


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