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

Oral manifestations in HIV positive children were observed in thirty-eight HIV infected children that have received care at the Special Care Dentistry Center (SCDC) of the School of Dentistry, University of Sao Paulo. Results have shown that 52.63% of the children presented at least one oral manifestation related with HIV/AIDS. Angular cheilitis occurred in 28.94%, parotid gland bilateral enlargement, pseudomembranous candidiasis and erythematous candidiasis in 18.42%, conventional gingivitis in 13.15%, herpes simplex in 5.26%, hairy leukoplakia, recurrent aphthous ulcer and condyloma acuminatum in 2.63%. Although enamel hypoplasia occurred in 23.68%, this could not be attributed specifically to HIV infection.
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PMID:Oral manifestations of HIV positive children. 1131 6

Presentation highlights are provided from the Nineteenth International Congress on Chemotherapy in Montreal. Some of the new data on anti-HIV therapeutics include phase I/II data on Agouron's protease inhibitor AG1343; information on the new protease inhibitor palinavir PRO2000 (a gp120/CD4 binding inhibitor); and liposomal (fat-enclosed) formulations of both foscarnet and exonuclease (a cellular enzyme that destroys viral DNA). Two additional studies from Brazil on the efficacy and safety of roxithromycin for cryptosporidiosis (the Food and Drug Administration (FDA) has not approved roxithromycin for sale in the U.S.) are discussed, as is the use of imiquimod treatment for genital warts.
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PMID:International Congress on Chemotherapy. 1136 4

Aside from the neoplasms that are clearly related to immunodeficiency, such as non-Hodgkin's lymphoma and Kaposi's sarcoma, numerous observations have also shown an association between HIV infection and the incidence of cervical and anal neoplasms. Human papillomavirus (HPV) is the etiologic factor in anogenital neoplasms, although the mechanisms of the association are not clearly understood. It is believed that several HPV genes are critical in the malignant cell transformation process. An etiologic similarity exists between cervical and anal neoplasms, and the risk factors for the former appear to be the same for the latter, such as history of anal or genital warts, history of sexually transmitted diseases (STDs), and certain sexual practices. In addition, a number of studies have shown a relation between HIV-induced immunodeficiency, HPV infection, and the development of anal neoplasms. In a study of 210 men, anal intraepithelial neoplasia was more common in HIV-infected patients than non-HIV-infected patients. Additional risk factors for abnormal cytology included CD4 count under 200, and a history of smoking. Patients who receive surgical treatment for anal carcinoma have been shown to have poor outcome and short survival. Standard treatments, including ablation, surgery plus radiotherapy for small localized lesions, and radiotherapy plus chemotherapy, are preferable for anal neoplasia. Due to the increasing incidence of HPV infection as a manifestation of HIV disease, strategies for screening and treating these patients must be refined.
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PMID:Anal neoplasia in persons with HIV infection. 1136 14

The Centers for Disease Control and Prevention (CDC) has updated its 1993 guidelines for STDs, adding new recommendations for treating primary and recurrent genital warts and for managing patients with asymptomatic HIV infection. The guidelines grew out of research into microbiologic cures, alleviating signs and symptoms, preventing sequelae, and preventing transmission. The guidelines recommend that people seeking treatment for STDs should be offered HIV testing and counseling. Results of a recent Alan Guttmacher Institute study of STD public health programs are included.
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PMID:New STD recommendations include HIV management. 1136 14

Cidofovir, produced by Gilead Sciences, is available in two forms: an intravenous injectable liquid used to treat cytomegalovirus (CMV) retinitis, which is a serious eye infection associated with HIV and low CD4 counts; and as a topical gel used to treat herpes simplex blisters. Additional applications proposed for the gel include treating genital warts and Kaposi's sarcoma lesions. In order to prevent kidney damage, cidofovir is administered with probenecid, and patients are advised to drink large amounts of water. One benefit of cidofovir, compared to other treatments for CMV retinitis, is that it requires patients to receive treatment less often. Physicians prescribing cidofovir with probenecid need to be aware of possible drugs that may interact with cidofovir or probenecid. Contact information is provided.
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PMID:Cidofovir. 1136 63

Women with HIV who have certain gynecologic conditions, such as yeast infections or particular pre-cancerous lesions, may require higher doses of medicine to treat these conditions. Other disorders like gonorrhea, chlamydia, and pelvic inflammatory disease seem to require similar treatment responses for HIV-positive and HIV negative women. Studies validate that women with HIV, especially those with decreasing CD4+ counts, are more likely to have several human papillomavirus (HPV) infections, which can lead to the development of pre-cancerous abnormalities. It is unclear whether highly active antiretroviral therapy (HAART) has any beneficial effects in preventing HPV, however, it has been shown to reduce occurrences of Kaposi's sarcoma. Also, an observational study of 40 people was conducted to examine the effects of HAART on recurrence of genital warts. The findings suggest that relapse rates were directly related to viral load. Longer-term studies are needed to assess the rate of recurrences of cervical cancer in women with HIV. Women with HIV are also encouraged to get screened often for HPV with a pap smear or a colposcopy.
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PMID:Treatment of gynecological conditions in women. 1136 42

A study on women presented by L. Andieh at the 6th CROI evaluated the influence of highly active antiretroviral therapy (HAART) on infection with the human papillomavirus (HPV), which causes genital warts and is associated with genital cancers. When the study began, 82 percent of the 141 HIV positive women enrolled were taking HAART. The study had a high drop-out rate, with few women attending all scheduled physical exams, so only generalized findings were presented. Half of the women with normal Pap smears had detectable HPV levels, and about one-third of those with HPV had more than one type. Women tended to intensify their antiretroviral treatment during the study, which led to elevated CD4 counts and decreased viral load. Researchers hypothesize that the increased use of HAART may effect decreased HPV infection and cancer development.
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PMID:HAART and HPV infection. 1136 78

Two treatment briefs specific to HIV-positive women, from sessions at the 6th Conference on Retroviruses and Opportunistic Infections, are presented. The first brief involves menstrual irregularity which has long been associated with HIV infection. A study has found that otherwise healthy HIV-positive women with high CD4+ cell counts, without experiencing wasting or use or abuse of drugs, were unlikely to have menstrual irregularities. However, as HIV progresses, it seems to have an effect on hormones, which may contribute to the increased incidence of menstrual irregularity. The second brief presents Human Papilloma Virus (HPV) which is a sexually transmitted disease that causes anal and genital warts and cervical dysplasia, particularly in women with low CD4+ counts. Although HIV-related immune suppression is a co-factor in HPV development, other risk factors include smoking, age of first sexual intercourse, and hormonal levels. Recurrent cervical dysplasia requires aggressive treatment.
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PMID:Women and AIDS update. 1136 33

A presentation at the 39th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) noted that people with genital warts have significantly higher levels of semen viral load than those without warts. Genital warts are caused by the human papillomavirus (HPV) and are very common among the general population. Higher levels of HIV in semen may expose partners of HIV-positive men with genital warts to a greater risk of becoming infected. Another session presented statistics showing that rectal gonorrhea is increasing among gay men in New York and Paris, and cautioned that a corresponding increase in HIV rates could follow. Researchers are worried that the increase will include drug resistant strains of the virus.
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PMID:HIV transmission. 1136 61

Sexually transmitted diseases (STDs) are some of the most common causes of illness worldwide. Prevention and educational programs have helped to curb the rise of syphilis, gonorrhea, non-gonococcal urethritis, chancroid, granuloma inguinale and lymphogranuloma venereum within most of the United States. However, there are still "hot spots" in the southern U.S. and in non-Caucasian and urban populations, and these diseases continue to be prevalent in underdeveloped countries. Molluscum contagiosum and condyloma acuminata are increasing throughout the world. Herpes simplex is in the midst of an epidemic, having increased in the United States by 30% in the last 15 years. The failure of preventive programs to halt or reverse these epidemics stems from a combination of factors involving both patients and the medical profession. Patient and sexual partner ignorance, denial and deliberate deception play an important role. However, healthcare professional ignorance and failure to keep a high index of suspicion are also crucial. These issues are compounded by the quick-visit concept propagated by managed care, which dilutes most educational efforts. Teens particularly suffer from the lack of an unhurried discussion of sexual practices, and the sharp rise in STDs in this population reflects failure in the medical system. This paper will review the classical presentations of the various STDs, and will detail in what ways the coexistence of HIV disease alters clinical appearance and disease progress. Subtle variations in presentations that often lead to misdiagnosis are discussed. Diagnosis and treatment of STDs change rapidly as new developments occur, and the latest recommendations are examined. The ways in which these therapies differ in special need groups such as HIV and pregnancy are specifically detailed. The goal of this review is to arm the clinician with all of the necessary ingredients for timely and accurate diagnosis and treatment, as well as ways to assist the patient in dealing with these difficult topics. Patient education is highlighted, as it, along with practitioner expertise, is the key to disease eradication. We are the missing link in STD eradication.
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PMID:STD update: screening and therapeutic options. 1137 59


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