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

One of the most intriguing aspects concerning the pathogenesis of AIDS is the long period of latency of the HIV in human cells, not causing any cytopatic effect in some and, on the other hand, causing cell destruction, at short periods, in others. The various agents and the mechanisms they adopt to reactivate the latente HIV, were described. Also the frequent epidemiological observation on the presence of both such agents and the HIV in AIDS patients allowed the authors to speculate on the probable important role of a cohort of co-factors which determine the destiny of such individuals. Special considerations were made in respect to the hepatitis B virus, cytomegalovirus, herpesviruses (HHV-1, e and 6), EB virus, HTLV-1 and 2 retroviruses, group B arbovirus Maguary, malaria and other endemic infectious diseases which victimize millions of Brazilians. Accepting the importance of such co-factors acting on the viral gens that regulate the HIV expression in the host cell, it was speculated on the possible role of vaccines, such as the hepatitis B vaccine, and some antiviral drugs which could be useful in the indirect prevention of AIDS-disease in both HIV-carriers and those practising AIDS-high-risk-activities.
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PMID:[Pathogenesis of AIDS: possible role of co-factors in HIV reactivation]. 269 96

Major causes of anaemia in pregnancy in tropical Africa are malaria, iron deficiency, folate deficiency and haemoglobinopathies: now there is added also the acquired immune deficiency syndrome (AIDS). Anaemia is often multifactorial, with the different causes interacting in a vicious cycle of depressed immunity, infection and malnutrition. Anaemia progresses through 3 stages: compensation, with breathlessness on exertion only; decompensation, with breathlessness at rest and haemoglobin (Hb) below about 70 g/litre; cardiac failure, with Hb below about 40 g/litre. Without treatment, over half of the women with haematocrit less than 0.13 and heart failure die. Maternal anaemia, malaria and deficiencies of iron and folate cause intrauterine growth retardation, premature delivery and, when severe, perinatal mortality. Surviving infants have low birthweights, immune deficiency and poor reserves of iron and folate. They have entered already the vicious cycle of infection, malnutrition and impaired immunity. Treatment with blood transfusions is even more hazardous since the advent of AIDS, and should be limited to saving the life of the mother. Treatment of malaria is complex as chloroquine-resistant strains are now common. Prevention remains relatively easy with proguanil and supplements of iron and folic acid and is highly cost-effective in the improvement of maternal and infant health; it is more important than ever as it avoids the unnecessary exposure of women and infants to HIV transmitted through blood transfusion.
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PMID:Tropical obstetrics and gynaecology. 1. Anaemia in pregnancy in tropical Africa. 269 76

17 Caucasian patients with aquired immunodeficiency syndrome (AIDS) contracted after long stays in Africa are reported. All 17 patients had previously been healthy; AIDS was diagnosed in them in France after July, 1983, except in 2 patients who were admitted to hospital before 1981. AIDS was diagnosed according to the Centers for Disease Control criteria--severe opportunistic infection or Kaposi's sarcoma. After 1983 every patient was given a questionnaire about where he or she had travelled in Africa, his or her profession, previous venereal disease or malaria, and sexual activity. It seems likely that these patients contracted HIV infection in Central Africa. The picture of the disease was similar to that in patients in other AIDS risk groups. Malaria was the only parasitic disease found in 2 of the patients, and there was no evidence of correlation between hepatitis B and AIDS in these patients. No patient was a hemophiliac or an intravenous-drug abuser, and only 1 patient had received a blood transfusion. Injections in Africa do not appear to be involved in the transmission of AIDS; in these patients, injections were carried out with sterile equipment. The study confirms that prostitutes constitute a reservoir of HIV, particularly in Central Africa, and suggest that the virus will continue to spread through heterosexual contacts. Public health programs are urgently needed to limit sexual contacts with people at risk of transmitting AIDS in Africa and to promote the use of condoms.
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PMID:Acquired immunodeficiency syndrome after travelling in Africa: an epidemiological study in seventeen Caucasian patients. 288 Nov 42

This study represented the 1st attempt to isolate human immunodeficiency virus (HIV) from African acquired immunodeficiency syndrome (AIDS) patients and controls. HIV was isolated from 27 (77%) of 35 Zairians with AIDS and from 5 (55%) of 9 patients with AIDS-related complex (ARC). In addition, 5 (19%) of 27 controls admitted to Zaire's Mama Yemo Hospital for causes unrelated to AIDS were found to be positive for antibodies to HIV. Next, an effort was made to isolate the virus from 42 AIDS or ARC patients on whom data were already available on the results of an enzyme-linked immunosorbent assay (ELISA). HIV was isolated from 30 (81%) of 37 patients with positive ELISA tests and from none of the 5 patients with a negative assay. Among controls, antibodies were found in a higher proportion of patients with abnormal helper: suppressor ratios or a low absolute T helper cell count. On the other hand, these abnormalities were not found in 3 of the 5 control patients from whom HIV was isolated, including 2 without HIV antibody. This suggests that neither of these criterion are good indicators of virus infection. The isolation of HIV infection from 5 hospital controls with no clinical signs of infection suggests that either the rate of asymptomatic HIV virus infection is high in Zaire or that common tropical diseases such as malaria or tuberculosis may be associated with HIV infection. The frequency of HIV isolation from AIDS and ARC patients in this study is higher than that in earlier reports from non-Africans, but is comparable to current statistics from the US.
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PMID:Isolation of human immune deficiency virus from African AIDS patients and from persons without AIDS or IgG antibody to human immune deficiency virus. 294 38

Seroprevalence to human immunodeficiency virus (HIV) was determined among 368 children 2 to 14 years of age who were admitted to the pediatric service at Mama Yemo Hospital in Kinshasa, Zaire. Forty (11%) of these patients and only one (1%) of 92 healthy siblings of these patients were HIV seropositive (chi 2 = 8.68, P less than .01). Seropositivity was associated with previous hospitalization, receipt of a blood transfusion prior to the current hospitalization (odds ratio 3.1; 95% confidence interval, 1.5 to 6.4), receipt of medical injections during the past year, and smaller household size. Clinically, HIV seropositivity was associated with the diagnoses of malnutrition and pneumonia. A higher proportion of seropositive children died during the current hospitalization (4/40 v 10/328); when patients with malaria were excluded, the in-hospital mortality of seropositive children was more than eight times higher than that of seronegative children (Fisher exact test, P = .006). Clarification of clinical, immunologic, and epidemiologic features of childhood HIV infection is urgently required because HIV appears to account for or complicate a substantial proportion of pediatric hospitalizations in Kinshasa.
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PMID:Human immunodeficiency virus seroprevalence in pediatric patients 2 to 14 years of age at Mama Yemo Hospital, Kinshasa, Zaire. 302 Apr 92

A study was conducted at the Ndola Central Hospital, Zambia, in 1987 to determine whether human immunodeficiency virus (HIV) infection increases the risk or severity of infection with falciparum malaria in patients aged 12 years and over. The 170 patients examined all presented with symptoms suggestive of malaria, including fever, chills, rigors, headaches, joint pains, myalgia, acute diarrhea, and vomiting. 67 (39%) were diagnosed as having falciparum malaria and 28 (17%) were positive for the HIV antibody. The prevalence of malarial parasitemia in patients with HIV antibodies was lower than that in patients without such antibodies (29% versus 42%, respectively), and differences in densities of parasites also failed to provide evidence of increased susceptibility to malaria in patients infected in HIV. There were no significant differences in antibody titers to P falciparum in patients who were positive for HIV antibody and in those who were negative, whether or not they had parasitemia. The earlier finding of a significant association between malaria and HIV infection is now believed attributable to false positive results with the 1st enzyme linked immunosorbent assays and to interpretation difficulties with the Western blot test. Of interest is the fact that 20 patients in this study had symptoms suggestive of malaria, but had negative results for parasites and positive results for HIV antibody. This indicates that many patients with HIV infection may be presenting with an illness clinically similar to malaria before acquired immunodeficiency syndrome (AIDS)-related complex or AIDS is recognizable.
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PMID:Relation between falciparum malaria and HIV seropositivity in Ndola, Zambia. 304 86

Numerous infectious diseases are transmissible by blood, with AIDS and hepatitis being the predominant concerns today. Less in the limelight, but nonetheless blood transmissible, are cytomegalovirus infection, malaria, babesiosis, and hepatitis B. A major controversy with respect to non-A non-B hepatitis relates to the use of 'surrogate' testing of donors for ALT and hepatitis B core antibody. Transfusion-associated AIDS has been markedly reduced as a risk, due to blood donor antibody screening implemented in March 1985. However, other retroviruses such as HTLV-1, HTLV-II and HIV-II pose additional concerns regarding the safety of the blood supply, and decisions will be forthcoming regarding testing of donated blood for antibody to these viruses.
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PMID:Infectious complications of blood transfusion. 305 66

The epidemiologic and social aspects of AIDS are different in developed and developing countries. In Africa, where there are several tens of thousands of cases, the ratio of female to male cases is 1:1. The highest incidence in men is at age 37.4 and in women 30 years. In Haiti the female to male ratio is 1:1.8. In Rwanda and Zambia the incidence is higher among educated people. In most of Africa AIDS is predominantly urban. Also, in Africa the time between diagnosis and death is shorter. Seroprevalence rates in Africa and the Caribbean are between .5 and 18% for the population at large. In Zaire seroprevalence peaks between ages 16-20 and at under 1 year. Both in the US and in Africa the epidemic appears to have begun around 1980. In West Africa a related virus, HIV-2, has been identified. Progression rates from seropositivity to AIDS or AIDS-related complex in Africa are similar to those in the US. However, in Africa, and recently in Haiti, transmission has been heterosexual. In Africa female prostitutes have the highest incidence of HIV seropositivity, and there is much female to male transmission via this route. Genital ulcers, especially chancroid, increase the risk of AIDS, and condom use may protect women from infection. The 2nd most important route of AIDS transmission in Africa and Haiti is blood transfusion. Blood transfusion are common in treatment of children with anemia from malaria and with sickle cell anemia, and many children have been infected via this route in Africa. Medical injections, scarification and circumcision also account for HIV transmission. Perinatal transmission from seropositive mothers is also common in Africa. Among patrilineal African societies premarital or extramarital sex is rare among girls, but young men and husbands of nursing mothers often visit prostitutes. In the cities there are varying degrees of promiscuity. In couples where the husband is seropositive, he usually has a history of sex with prostitutes, but in couples where the wife is seropositive, she usually has a history of blood transfusion.
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PMID:Epidemiological and sociological aspects of HIV-infection in developing countries. 305 51

Some 200 cases of malaria are officially reported yearly in Switzerland. It is estimated that 2000-8000 Swiss travellers are infected by the anopheles mosquito annually, with 90% protected by chemoprophylaxis. An attack of malaria appears to have a better prognosis when the symptoms start in Africa, since treatment is initiated immediately, than in industrialized countries where the mortality is 1-4%. Failure to inquire into travel history is often responsible for the delay in initiating treatment. Severe falciparum malaria is treated by repeated slow quinine infusions followed by 1500 mg sulfadoxine, 75 mg pyrimethamine and 750 mg mefloquine (single dose). This adult dose corresponds to 3 tablets of Lariam and 3 of Fansidar (or 3 of Fansimef). The increase in chloroquine resistance among falciparum strains has led to the use of Fansidar for chemoprophylaxis, followed by the use of mefloquine when Fansidar resistance occurs. The dosage of mefloquine is 250 mg weekly (1 tablet Lariam) for 4 weeks, followed by 1 tablet every fortnight. Treatment is continued for 1 month after return. If the risk of transmission is low, chemoprophylaxis may be replaced by prescription of a reserve drug to be taken in case of fever and headache. A sulfadoxine-pyrimethamine-mefloquine combination (i.e. 3 tablets Fansimef) has been tested in this indication. Ineffective chemoprophylaxis may lead to atypical clinical syndromes, e.g. anemia, hepatosplenomegaly and jaundice, without episodes of fever. HIV positive subjects may risk travelling in tropical countries if they have undergone correct chemoprophylaxis.
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PMID:[Malaria in Switzerland]. 306 91

AIDS in rural Africa seems to differ in its epidemiology from hepatitis B and appears to be spread predominantly by preexisting patterns of heterosexual activity responsible for high rates of other sexually transmitted diseases. The authors compared the seroepidemiologies of AIDS, hepatitis B, and syphilis at 2 rural hospitals in southwest Uganda. During August 1986, 3% of 357 outpatients, reflecting the age and sex composition of the general population, were anti-HIV positive. Anti-HIV seropositivity, both in the outpatients and among 36 suspected prostitutes and 14 suspected AIDS cases, was confined to individuals aged 20 or over. For men, seropositivity was associated with sexual contact with prostitutes (a risk factor for 61% of young men in the study). In the prostitute group, 25% were anti-HIV positive and 46% were positive on the Treponema pallidum hemagglutination (TPHA) test for syphilis. The risk factors for HIV, but not hepatitis B, were the same as for having a history of sexually transmitted disease (STD). However, there was, surprisingly, an association between a history of STD and seropositivity for hepatitis B virus but not for HIV infection. The geographical and age distributions of seropositivity for HIV and hepatitis B virus were also quite different. Finally, blood transfusions, scarification, and exposure to mosquitoes (as assessed by a history of malaria) were not evident risk factors for either HIV or hepatitis B virus.
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PMID:Risk factors for the spread of AIDS in rural Africa: evidence from a comparative seroepidemiological survey of AIDS, hepatitis B and syphilis in southwestern Uganda. 314 Aug 31


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