Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We determined the histologic correlates of clinically identified mucopurulent cervicitis, culture-proven cervical infection with Chlamydia trachomatis, Neisseria gonorrhoeae, herpes simplex virus (HSV), and vaginal infection with Trichomonas vaginalis by examining cervical biopsies from 83 women. Clinical mucopurulent cervicitis and culture-documented infection with one or more of these pathogens correlated histologically with intraepithelial neutrophils, reactive endocervical cells, edema, luminal neutrophils, and with several deeper tissue changes such as extensive and dense subepithelial inflammation, granulation tissue, and necrotic ulceration. Focal loss of surface columnar cells and spongiosis were also correlated with culture-confirmed infection. Well-formed germinal centers were seen in biopsies from 14 of 21 patients (67%) with C trachomatis infection alone, but in none of 17 patients with infections other than C trachomatis (P less than 0.001). A predominantly plasmacytic infiltrate was also significantly associated with chlamydial infection. Necrotic ulcers overlying a predominantly lymphocytic infiltrate were seen in six of nine patients (67%) with HSV infection alone but in only two of 40 patients (5%) with other infections (P less than 0.001). Marked inflammatory changes were not seen in the patients infected with N gonorrhoeae. The organism T vaginalis was not associated with any endocervical pathology. If these results are confirmed by prospective studies, they suggest that pathologists should alert clinicians to the possibility of recent or current infection with C trachomatis or HSV when cervical biopsies show the above changes. The loss of surface columnar epithelium with HSV, chlamydial, and gonococcal infection offers a possible explanation for the reported association of these infections with increased risk of acquiring human immunodeficiency virus infection.
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PMID:Histopathology of endocervical infection caused by Chlamydia trachomatis, herpes simplex virus, Trichomonas vaginalis, and Neisseria gonorrhoeae. 238 74

In June 1989, a pilot study investigating the prevalence of sexually transmitted diseases (STDs) was conducted at Kamuzu Central Hospital, Lilongwe, Malawi. Among unselected outpatients, an STD prevalence of 4.4% was found. The patients were predominantly 20-35 years of age. The distribution of diagnoses was dominated by a relatively large proportion of ulcer diseases (syphilis, chancroid, and lymphogranuloma venereum), seen among 67% of the patients. Almost 2.3 of the patients were HIV-positive (62.4%). No significant difference was found in HIV infection prevalence when patients with ulcer diseases were compared to patients with discharges. Among the patients with gonorrhea, a prevalence of penicillinase-producing Neisseria gonorrhoea of 53% was found. It is concluded that a plan for the management of STDs is urgently needed as it is of paramount importance in combatting STDS in order to prevent the spread of HIV infection.
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PMID:The prevalence of symptomatic sexually transmitted diseases and human immunodeficiency virus infection in outpatients in Lilongwe, Malawi. 239 Nov 10

Longitudinal data on 2,125 participants in the Multicenter AIDS Cohort Study (MACS) with documented antibodies to the human immunodeficiency virus type 1 (HIV-1) were used to examine the incidence of acquired immune deficiency syndrome (AIDS)-related Kaposi's sarcoma (KS) over time and to determine if sexual practices and hematologic variables prior to diagnosis differed for participants who develop KS vs. non-KS AIDS (NKS). In the first 4 years of the study, 84 seropositive men were observed to develop KS and 307 presented with an AIDS diagnosis other than KS. A systematic trend in the incidence of KS over time was not apparent in this population. The number of anal-receptive intercourse partners prior to diagnosis declined in a similar fashion for both AIDS groups. Although the number of partners with whom the men performed rimming decreased prior to diagnosis for both AIDS groups, a greater proportion of the KS AIDS group had performed this activity with multiple partners than had the non-KS AIDS group. Furthermore, history of oral gonorrhea was significantly (p = 0.027) more prevalent in the KS group. In addition, the KS AIDS group had lower cytomegalovirus antibody levels prior to diagnosis and higher levels of total immunoglobulin G. The groups did not differ with respect to baseline hematological measures, temporal trends in helper and suppressor T cells, or hepatitis B surface antigen or antibody. Given this profile of factors associated with the occurrence of KS, an infectious agent, in addition to HIV-1, is plausible as a proposed cofactor in the development of KS.
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PMID:Incidence of Kaposi's sarcoma in a cohort of homosexual men infected with the human immunodeficiency virus type 1. The Multicenter AIDS Cohort Study Group. 239 82

In King County, Washington, penicillinase-producing Neisseria gonorrhoeae infections increased from 0.8% of reported cases of gonorrhea in 1986 to 6.8% of cases in the third quarter of 1987, then stabilized at 2.7% to 3.6% of cases. Of 268 penicillinase-producing N gonorrhoeae isolates tested, 159 (59%) belonged to a single clone, as evidenced by auxotyping, protein-I serotyping, plasmid analysis, and antimicrobial susceptibility testing. As this strain spread, the predominance of cases shifted from whites to blacks and from men to equal numbers of men and women. The proportion of cases associated with illicit drug use rose steadily from 19% in the first quarter of 1987 to 82% in the fourth quarter. Sixty percent of cases occurred in prostitutes or recent sexual contacts of prostitutes. These results suggest that core gonorrhea transmitters in King County are predominantly black illicit drug users, prostitutes, and their sexual partners. These are priority target populations for behavioral intervention and other measures to control the spread of all sexually transmitted diseases, including human immunodeficiency virus infection.
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PMID:Localized outbreak of penicillinase-producing Neisseria gonorrhoeae. Paradigm for introduction and spread of gonorrhea in a community. 249 72

We tested the hypothesis that strain-specific immunity occurs after gonococcal infection in a longitudinal study of 227 prostitutes resident in one small community who experienced frequent gonococcal infections. Women were examined and cultured for Neisseria gonorrhoeae at 2-wk intervals. Gonococcal isolates were typed according to protein 1 serovar, auxotype, and beta-lactamase plasmid type, and classified as to serovar and strain. The hypothesis was tested by comparing the predictions of the hypothesis with the observations of the study. Over the 14-mo period of the study, major changes in the prevalence of specific serovars were observed in the gonococcal population infecting these women. Women with HIV infection experienced a higher rate of gonococcal infection (0.56 +/- 0.03 vs. 0.46 +/- 0.04, P less than 0.05, t test) compared with HIV-negative women and were more likely to experience multiple infections with the same strain. The duration of prostitution was inversely related to the frequency of gonococcal infection. Women experiencing an infection with a specific gonococcal serovar were at a 2- to 10-fold reduced risk of reinfection with the same serovar, except for the 1B-1 serovar. The results of the study were consistent with all four predictions of the hypothesis. Infection with a specific gonococcal serovar results in specific but incomplete protection against subsequent infection with the homologous serovar. The mechanism of this protection remains to be determined.
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PMID:Epidemiologic evidence for the development of serovar-specific immunity after gonococcal infection. 249 42

Data from Edinburgh, Scotland, on the incidence of sexually transmitted diseases in homosexual men between 1980-1987 suggest that this high-risk population is effectively adopting "safer sex" practices. The incidence of early syphilis in homosexual men presenting to the department of genitourinary medicine at the Edinburgh Royal Infirmary peaked at 20 cases in 1984, and then began precipitous decline; no such cases were diagnosed in 1986 and 1987. The incidence of rectal gonorrhea reached a high of 58 cases in 1982, and has fallen steadily since then; there were 5 such cases diagnosed in 1987. Since unprotected anoreceptive intercourse is the main risk factor for human immunodeficiency virus (HIV) in homosexual men, trends in the incidence of rectal gonorrhea provide reliable information about the extent to which safe sex practices are being followed. Diagnoses of all types of gonorrhea peaked in 1982 at 120 cases, at which point they began a steady decline to 10 cases in 1987. Since this clinic does not have a policy of random anonymous testing for HIV infection, information on trends in the incidence of this infection are not available for this population. In general, these incidence trend date imply that the homosexual community in Edinburgh adopted sexual practices aimed at reducing the risk of sexually transmitted infection even before government health education campaigns were launched. While declines in the incidence of syphilis and gonorrhea were not recorded in the heterosexual population in Edinburgh until 1985, homosexual men began demonstrating this trend around 1982.
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PMID:Trends in sexual behaviour and HIV incidence in homosexual men. 249 5

A sample of 329 prostitutes from the eastern area of Santiago, Chile, who attended the Dermatology Service of the Salvador Hospital in January-February 1988 were studied to determine the current incidence of sexually transmitted disease among prostitutes. Approximately 600 prostitutes attend the service for required monthly health examinations. The 329 women worked in established locales such as saunas, massage parlors, and nightclubs. None were uncontrolled street prostitutes. The average age was 24.3 years. 68% were single, 17% were separated, and 15% were married. Only 14% had no more than primary education, and half had high school or college educations. The average parity was 1.52. 83% used contraception. 31% used oral contraceptives (OCs), 21% used injectables, 24% used IUDs, and 7% used other methods. The average number of sexual contacts per day was 2.87. 54% always used condoms, 36% occasionally did so, and 10% never did so. The estimated number of monthly sexual contracts/woman was 65. 22% of the women had some sort of genital pathology. No cases of HIV infection were seen. 9.7% were diagnosed with trichomonas, 4.6% with unspecified vulvovaginitis, 3.3% with candidiasis, 1.8% with syphilis, 1.5% with gonorrhea, .9% with condyloma acuminata, and .3% with active herpes. The frequency of vaginitis did no appear to be associated with the number of sexual contacts, but other pathologies were more common in women with more partners. Women who always used condoms were only half as likely to have genital pathologies or vaginitis as women who never used condoms.
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PMID:[Prostitutes of the east sector of Santiago: characteristics and pathology of sexual transmission]. 251 76

Registered Prostitutes are seen weekly for medical examination in the STD-Clinic of the Public Health Office Vienna. 1987 no syphilis was seen in this special riskgroup. The incidence of both gonorrhoe and chlamydial infection was. Chlamydias were found 1.6 times more, as gonococcal infections. There was no evidence of HIV infection. Screening for cervical neoplasia was started in reduced. 1988 and yielded a tenfold incidence of abnormal findings, requiring conisation often than compared to preventive checkups amoung the general female population.
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PMID:[The current examination protocol for prostitutes at a venereal disease counseling clinic, Vienna Public Health Service]. 252 78

During a three-week period in March/April 1987, the authors examined 253 consecutive patients referred to a rural hospital in northwestern Tanzania. Sera were tested for antibodies to human immunodeficiency virus type 1 (HIV-1), human immunodeficiency virus type 2 (HIV-2), and human T-lymphotropic virus type I (HTLV-I), as well as for various parasites, hepatitis B virus, and Treponema pallidum. Neopterin (urinary and serum) was chosen as the immunologic parameter. In eight of the 253 patients (3.2%), a clinical diagnosis of acquired immunodeficiency syndrome (AIDS) was established. Three of the AIDS patients had HIV-1 antibodies, two had HIV-1 antigen, one had both HIV-1 and HIV-2 antibodies, and in one patient, only HIV-2 antibodies were found. The total HIV-1 and HIV-2 seroprevalence (antibodies plus antigen) was 4.3%; HTLV-I seroprevalence was 9.9%. No correlation could be found between HIV (or HTLV-I) seropositivity and raised levels of antibody to the above pathogens. There was, however, a significantly positive correlation between HIV seropositivity and history of gonorrhea, whereas a history of operations, injections, vaccinations, blood transfusions, or scarification did not influence the level of HIV seropositivity. The most frequently noted epidemiologic association with HIV seropositivity was traveling to or coming from Uganda or Rwanda. Two thirds of the studied Tanzanians had elevated neopterin levels, and all seven HIV-seropositive patients with clinical signs of AIDS had extremely high serum and urinary neopterin levels compared with HIV-seropositive patients without signs of AIDS. Increased neopterin levels reflect a stimulation of the T-cell/macrophage system.
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PMID:Retroviral infections (HIV-1, HIV-2, and HTLV-I) in rural northwestern Tanzania. Clinical findings, epidemiology, and association with infections common in Africa. 254 23

This study provides the background recommendations of the US Preventive Services Task Force for interventions by primary care physicians to prevent sexually transmitted diseases. Rationale for and data supporting use of barrier methods, epidemiologic treatment, contact tracing, patient education, prophylactic antibiotics, and disease reporting are discussed. Specific recommendations include those for gonorrhea, syphilis, human immunodeficiency virus infection, enteric infections, human papillomavirus infection, herpes simplex virus infection, and Chlamydia trachomatis infection.
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PMID:Preventive strategies in sexually transmitted diseases for the primary care physician. US Preventive Services Task Force. 303 85


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