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

The prevalence of HIV antibodies, as well as evidence of hepatitis B, syphilis, and Chagas' disease, was tested in 87 male and 13 female clients of a church-funded medical clinic in Rio de Janeiro who often donated blood to commercial blood banks. 5 individuals were seropositive for HIV, 2 homosexuals, 1 bisexual, and 2 heterosexuals. 21 had evidence of hepatitis B, including 2 with HBsag antibodies. 13 tested positive for syphilis, and 5 were positive for T. cruzi (Chagas' disease). The high incidence of positive tests for hepatitis B and Chagas' disease was possibly due to donation by plasmapheresis, which has been suspected to cause outbreaks of non-A, non-B hepatitis and malaria in this area. The practice of selling contaminated blood to unsuspecting recipients should be prevented no matter how high the cost.
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PMID:HIV antibodies in beggar blood donors in Rio de Janeiro, Brazil. 314 88

In the efforts to develop a vaccine for human immunodeficiency virus (HIV), attention has focused on sub-Saharan Africa, where large populations at risk for HIV infection could be studied easily. Cross cultural bioethics must be examined to address the ethical implications and cultural obstacles of such research. Autonomy and informed consent are difficult to achieve in cultures with limited personal choice. In some cultures, individual personhood is secondary to social relationships in the tribe or village. Language barriers, illiteracy, and the lack of knowledge about modern science all make it difficult to adequately inform participants. While the Helsinki Declaration emphasizes that a subject's well-being takes precedence over the interests of science and society, health policy decisions in nonautonomous populations often place state interests over the individual. Political sensitivities have been aroused by attempts to attribute the origin of AIDS to western or central Africa, leading political controversy and discrimination against Africans. Foreign researchers often exclude African participation once they have obtained the body fluid samples for study. Without joint collaboration and education, human research in developing countries can easily become exploitative. Justice dictates that research subjects be chosen for scientific reasons, not due to easy availability or ability to be manipulated. In vaccine development, Africans should not experience a disproportionate amount of risk without an equal share in the benefits. Furthermore, malnutrition, malaria, tuberculosis, and many other diseases present more urgent health problems to the developing world than AIDS. The health care priorities of the developing nations must be considered.
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PMID:Ethical considerations of human investigation in developing countries: the AIDS dilemma. 317 36

HIV infection in Africa is primarily acquired through heterosexual activity, accounting for up to 80% of cases. Prostitutes and sexually promiscuous individuals are at particularly high risk of acquiring infection via this route. In the general population, women between the ages of 18 and 30 years are at increased risk of transmission. The role of cofactors, particularly concurrent sexually transmitted diseases (STDs), appears to facilitate heterosexual spread. These groups represent opportunities for targeted prevention programs aimed at education, increased condom use, prompt treatment of STDs, and reduction in the number of sexual partners. HIV infection acquired via blood transfusion may account for up to 10% of new cases of HIV infection. Children with malaria and nutritionally induced anemias are at special risk of acquiring infection by this route. Early treatment of malaria, surveillance for and treatment of malnutrition, adoption of rigorous criteria for blood transfusion, and implementation of machine-independent, low cost HIV screening programs in transfusion centers will help prevent these infections. As the epidemiology of HIV infection becomes better understood, other opportunities for technologically appropriate, cost-effective interventions will become available and will facilitate African HIV control and prevention programs.
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PMID:Epidemiology of HIV infection in Africa. 322 42

2 cases are reported from Nigeria of patients with illnesses compatible with a diagnosis of AIDS, but whose serum was HIV-negative. The 1st patient had Kaposi's sarcoma and cervical lymphadenopathy. The 2nd patient had lymph node tuberculosis and generalized lymphadenopathy. The 1st patient had had intramuscular injections for malaria at a local pharmacy, and the 2nd patient had received a blood transfusion after an appendectomy. They may have been infected with HIV-related but antigenically distinct retroviruses.
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PMID:Deaths from AIDS-like illnesses in west Africans. 323 78

Since Plasmodium falciparum malaria is a frequent cause of anemia among African children, and blood transfusions, unscreened for human immunodeficiency virus (HIV) antibody, are used frequently in the treatment of children with severe malaria, the relationships between malaria, transfusions, and HIV seropositivity were investigated in a pediatric population in Kinshasa, Zaire. In a cross-sectional survey of 167 hospitalized children, 112 (67%) had malaria, 78 (47%) had received transfusions during the current hospitalization, and 21 (13%) were HIV seropositive. Ten of the 11 seropositive malaria patients had received transfusions during the current hospitalization; pretransfusion specimens were available for four of these children and were seronegative. Of all blood transfusions, 87% were administered to malaria patients, and there was a strong dose-response association between transfusions and HIV seropositivity. A review of 1000 emergency ward records demonstrated that 69% of transfusions were administered to malaria patients, and 97% of children who received transfusions had pretransfusion hematocrits of 0.25 or less (less than or equal to 25%). The treatment of malaria with blood transfusions is an important factor in the exposure of Kinshasa children to HIV infection.
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PMID:The association between malaria, blood transfusions, and HIV seropositivity in a pediatric population in Kinshasa, Zaire. 327 15

The possible associations between Plasmodium falciparum malaria and HIV (human immunodeficiency virus) seropositivity were investigated in 1986 at the Mama Yemo Hospital in Kinshasa, Zaire. No significant difference was found in the HIV seropositivity rate of 164 children presenting with P. falciparum malaria (1.2%) and 169 healthy controls (0.6%). Secondly, no association was found between P. falciparum slide positivity (51.6%) and HIV seropositivity (3.8%) among 1046 children presenting to the hospital with medical complaints. Infants less than 6 months old had the lowest slide-positivity rate, but among infected children the younger ones more frequently had high parasitaemias. HIV seropositivity rates were highest for children less than 6 months old. In older children, seropositivity was strongly associated with a history of blood transfusion. Thus, in Kinshasa children, P. falciparum malaria is a major public health problem; perinatal transmission and blood transfusions constitute important mechanisms of HIV infection; and P. falciparum does not appear to act as an opportunistic agent in children infected with HIV.
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PMID:Absence of association between Plasmodium falciparum malaria and human immunodeficiency virus infection in children in Kinshasa, Zaire. 332

In different countries opinions differ as to which chemotherapeutic methods should be used for malaria prophylaxis. It has long been the opinion of the Nordic countries, that WHO should give an official recommendation and the result is reflected now in the publication "Vaccination certificate requirements and health advice for internation travel." The malaria-endemic regions of the world are divided into 3 categories: regions without risk and no need for prophylaxis, low risk regions (A) with predominantly vivax inflections, risk regions (B) with predominantly chloroquine sensitive P. falciparum, and high risk regions (C) with often both chloroquine as well as sulfa/pyrimethamine resistance. Chloroquine is a sufficient prophylaxis for A-regions. For B-regions proguanil should be added and for C-regions only mefloquine is given. Proguanil was reintroduced basically because of Swedish research results in Liberia. An American initiative recommends for all regions, A-C, chemorprophylaxis as an alternative. However, a precondition is an observant traveller and clear instructions for self-treatment. Travellers who fall ill in a B-region should choose between Fansidar, mefloquine and quinine for self-treatment. Mefloquine has the least serious side effects, whereas quinine is therapeutically more safe. Fansidar very seldom gives any side effects. For C-regions only mefloquine is recommended for self-treatment. Nordic colleagues have recommended to double prophylaxis (chloroquine + Paludrine) treatment for the entire African tropical region. For short-time travellers to Kenya, Tanzania and Uganda, 6 tablets Lariam should be added. Only chloroquine is recommended for India and the Amazon region of South America. No chemoprophylaxis can guarantee full protection. Insect protection is therefore more important than ever. Malaria decreases the unspecific immune defense system. Surprisingly, repeated tests have shown that the AIDS frequency is not higher in patients with chronic malaria than for persons without plasmodia in the blood. In WHO's new little yellow booklet, a page concerning prophylaxis against AIDS appears. Equipment that is not new should be steamed or cooked for a least 20 minutes or treated with chemical disinfectants for at least 30 minutes. These measures should be enough to prevent HIV-infection.
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PMID:[Malaria and HIV prevention in WHO's "little gem"]. 338 44

Recent studies have identified genes involved in resistance to intracellular pathogens. Such genes include the murine MHC class I gene, Ld (toxoplasmosis), HLA-BW53, HLA DRB1* 1302-DQ B10s01 and TNF2 (malaria), murine Nramp (toxoplasmosis, leishmaniasis and tuberculosis), gene(s) modulating the T-helper type 1 and type 2 dichotomy (leishmaniasis, leprosy and HIV infection) and the natural killer cell complex (cytomegalovirus infection). There also have been other advances in immunogenetics that have led to a better understanding of resistance to intracellular pathogens. These include effector mechanisms of immune response genes and factors modulating genetic susceptibility. Identification of genes that determine resistance/susceptibility (and their effector mechanisms) has impacted on vaccine development. Immunogenetics has been important in characterizing roles of TCR genes, superantigens, and host genes that play a role in molecular mimicry in disease pathogenesis. In addition, recent work with gene knockout, recombinant inbred or congenic, mutant, consomic, and transgenic mice, positional cloning, mouse/human gene homologies to identify candidate human resistance genes, and the rapid expansion of the gene transcription maps of the human genome, have been important in analysis of resistance to intracellular pathogens.
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PMID:Immunogenetics in the analysis of resistance to intracellular pathogens. 749 19

Researchers analyzed data on 2608 women attending one of four prenatal clinics in Mangochi District in Malawi during 1987-1990 to study the relationship between maternal HIV infection, placental malaria infection, and infant mortality. 5.8% (138) of the women were HIV-1 seropositive. HIV-1 seroprevalence increased from 2.3% to 5.8% between 1987 and 1993. Infants born to HIV-1 positive mothers were much more likely to die during the first year of life than those born to HIV-1 negative mothers (235/1000 vs. 144/1000 live births; p 0.001). The excess deaths occurred during the postneonatal period (49 vs. 44, p = 0.3, for neonatal mortality, compared to 186 vs. 100, p 0.001, for postneonatal mortality). In the postneonatal period, diarrhea or gastrointestinal illness was more common as a cause of death among infants of HIV-1 positive mothers than those of HIV-1 negative mothers (8.7% vs. 3.6%; relative risk = 2.4; p = 0.0002). The researchers stratified the effect of maternal HIV infection on postneonatal death according to birth weight and placental malaria infection to control for potential confounding. They found that, when compared with normal birth weight infants born to seronegative mothers with no placental malaria infection, low birth weight infants born to HIV-1 positive mothers with placental malaria had an 11.49 increased odds of dying during the postneonatal period. The multivariate analysis showed that an infant born to an HIV-infected mother with placental malaria was 4.5 times more likely to die during the first year of life than an infant born to a mother with only placental malaria and 2.7-7.7 times (depending on birth weight) more likely to die than an infant born to a mother with only HIV infection. These findings suggest that malaria chemoprophylaxis during pregnancy would reduce the likelihood of HIV transmission from mother to infant in addition to reducing the burden of malaria infection during pregnancy, malaria-associated low birth weight, and their subsequent effect on child survival.
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PMID:Maternal HIV infection and infant mortality in Malawi: evidence for increased mortality due to placental malaria infection. 754 17

A blood transfusion can never become a completely risk free event. Almost all kinds of infectious agents; viruses, bacteria and parasites, can be transmitted by blood. So far, hepatitis and HIV-infections have been focused. The state of readiness to meet these infections must be kept while we prepare for "new" agents, like parvovirus B19. Extensive international travelling will increase the possibility of blood-borne parasitic infections, like malaria and Chagas' disease, even with the very high quality demands imposed for Norwegian blood donors. We can keep a better eye on the infectivity of the blood products by strictly realizing our objective of national self-sufficiency. Recent research results indicate transfusion-mediated effects to the immune system, particularly of allogeneic transfusions containing leucocytes. This immunomodulation seems to enhance the risk of secondary infections. So far, it is impossible to tell whether this immunomodulation has any impact on the long-term outcome of malignant diseases. A blood transfusion will always represent a risk, although small, to the patient. This recognition makes it essential to carefully consider whether to give a patient a transfusion, and to document this decision properly.
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PMID:[Blood transmission and infections]. 757 May 35


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