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)

Both cross-sectional and prospective studies in Africa have revealed an association between genital ulcer disease (GUD) and HIV-1; it is unclear, however, which of these infections facilitates the other. The epidemiology of GUD was investigated in a prospective cohort study of 302 female sex workers from a slum area in Nairobi, Kenya. At study intake in 1985, 157 women (52%) were HIV-1 seropositive. After a mean follow-up duration of 27.2 months, 36 (25%) initially HIV-negative women seroconverted. 189 women (62.5%) had at least 1 incident ulcer in the follow-up period and a total of 541 new cases were diagnosed. GUD incidence was significantly higher in HIV-positive women (82%) than initially seronegative women (48%). The mean number of new genital ulcerations recorded during the follow-up period was 1.8 (2.7 in initially seropositive women and 1.0 in initially seronegative women). The only significant risk factors for GUD incidence in the regression analyses were HIV-1 seropositivity (odds ratio (OR), 3.42), a CD4 count under 200/ml (OR, 1.94), and oral contraceptive use (OR, 1.35). The significant increase in GUD incidence observed relatively soon after primary HIV infection among the 36 seroconverters strongly suggests that HIV-1 itself plays a causal role in the etiology of genital ulcers. Moreover, the finding that the duration of prostitution was negatively associated with the incidence of ulcers in HIV-negative but not HIV-positive women implies that HIV-1 infection may attenuate the acquisition or retention of effective immune responses against the etiologic agents of GUD.
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PMID:Risk factors for genital ulcerations in Kenyan sex workers. The role of human immunodeficiency virus type 1 infection. 926 58

The specificity and ease of use of a novel red blood cell assay for detection of HIV-1/HIV-2 antibodies was evaluated on 125 blood donor samples in Nairobi. The specificity was estimated as > 99%. The assay correctly identified five positive samples in the population, and was easy and rapid to perform. The data confirm results obtained for the assay from other regions and suggest that the assay is suitable for detection of HIV-infected individuals by minimally equipped laboratories.
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PMID:Specificity of a novel red blood cell agglutination assay ('SimpliRED') for HIV-1/HIV-2 infection. 929 25

President Daniel arap Moi and the ruling party of Kenya, KANU (Kenyan African National Union), have bowed to election year pressure from anti-abortion groups and Catholic bishops, including Bishop Alfred Rotich who led a anti-sex education demonstration in Nairobi, and shelved a sessional paper on family life education that was to be discussed by parliament this month. If the paper had been adopted, sex education could have been introduced in the schools and integrated with primary health care. The document would have been the basis for making students aware of the dangers of adolescent pregnancy, abortion, drug abuse, HIV/AIDS, and sexually transmitted diseases (STDs). 12% of the girls who leave school are pregnant or have married early; 10,000 girls become pregnant per year according to Ministry of Education estimates. The local AIDS council believes that the pandemic is on the rise among Kenyan youth; it is estimated that 1-3 million persons will become infected by the year 2000 and that Kenya will have more than a million AIDS orphans. Real intervention would be to create awareness and provide family planning services, according to the council. Bishop John Njue, Chairman of the Kenya Episcopal Conference, states that the Catholic Church will fight any introduction of sex education in the schools.
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PMID:Moi scuppers sex-education plans in Kenya. 934 12

In an effort to identify an immunological basis for natural resistance to HIV-1 infection, we have examined serum antibody responses to HLA class I antigens in female prostitutes of the Nairobi Sex Workers Study. Anti-HLA antibodies are known to block HIV infectivity in vitro and can be protective against SIV challenge in macaques immunized with purified class I HLA. Thus, it was postulated that broadly cross-reactive alloantibodies recognizing common HLA alleles in the client population might contribute to the prevention of heterosexual transmission of HIV. In fact, 12% of the women were found to have serum IgG antibodies against class I alloantigens. However, this alloantibody did not correlate with the HIV status of the women and was found in a similar proportion of HIV-positive and HIV-resistant women. The observed levels of alloantibody did not increase with HIV infection in susceptible individuals, suggesting that potential antigenic mimicry between HIV and host HLA class I antigens does not significantly increase levels of anti-class I antibodies. The lack of correlation between serum anti-allo-class I HLA antibodies and the risk of sexual transmission indicates that this humoral immune response is unlikely to be the natural mechanism behind the HIV-resistance phenotype of persistently HIV-seronegative women. This result, however, does not preclude the further investigation of alloimmunization as an artificial HIV immunization strategy.
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PMID:Naturally occurring IgG anti-HLA alloantibody does not correlate with HIV type 1 resistance in Nairobi prostitutes. 946 20

Pneumococcus has been recognized as an important HIV-related pathogen in Africa and may cause significant excess mortality in severely immunocompromised HIV patients. This relationship was investigated in depth in Nairobi, Kenya, in 1988-93 through the linkage of a clinical HIV project sponsored by Wellcome Trust/Kenya Medical Research Institute with facilities for microbiological research. Kenyan HIV patients were prone to higher rates of colonization and invasive disease than seronegative patients and HIV infection was associated with a different pattern of serotypes and higher rates of antibiotic resistance. In one study, HIV infection was associated with a relative risk of 17.8 for pneumococcal infection. The pneumococcal carriage rate was 28% in HIV-positive patients compared with 16% in HIV-negative individuals. In a longitudinal study of a cohort of HIV patients, 25% were resistant to penicillin; 11 resistant strains were identified, with evidence of horizontal spread of penicillin-binding protein genes between separate lineages. Molecular characterization of isolates from patients with recurrent pneumococcal disease suggested the occurrence of both relapse and reinfection. There was an 82% concurrence between pernasal and blood isolates in pneumonia cases. Compared with HIV-negative persons, HIV-positive patients were significantly more prone to infection with penicillin-resistant (7% and 27%, respectively) and tetracycline-resistant (17% and 40%, respectively) organisms. Continued monitoring of resistance patterns and assessments of the significance of pneumococcal disease in other parts of Africa are recommended.
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PMID:Royal Society of Tropical Medicine and Hygiene Meeting at Manson House, London, 12 December 1996. HIV and pneumococcal infection in Africa. Microbiological aspects. 950 67

During the asymptomatic phase of HIV infection, HIV-specific cytotoxic T lymphocytes (CTL) are believed to play a major role in controlling virus levels. The design of an HIV vaccine requires knowledge about whether protective immunity can ever develop after exposure to the virus and the mechanisms underlying such natural immunity. The authors' research has focused on HIV-specific CTL responses in highly HIV-exposed commercial sex workers in The Gambia, West Africa, and in Nairobi, Kenya. HIV CTL was detected in 5 of 6 repeatedly exposed, persistently seronegative female sex workers in The Gambia. Their CTL recognized epitopes presented by HLA-835 that are cross-reactive between HIV-1 and HIV-2, suggesting they could have been primed first by HIV-2 exposure and subsequently boosted by exposure to HIV-1. Through use of previously identified clade B HIV-1 epitope peptides, the authors also detected HIV-specific CTL in 6 of 15 highly exposed and apparently resistant Kenyan prostitutes, predominantly toward epitopes highly conserved between B and Kenyan A and D clades of HIV-1. This CTL activity toward conserved virus epitopes may represent protective immunity to HIV in response to HIV generated by repeated exposure. HIV vaccines should aim to generate similar CTL responses. There is currently no evidence that genetic factors, other than weak HLA associations, influence susceptibility or resistance to HIV infection.
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PMID:The role of cytotoxic T-cells in HIV infection. 955 77

Both the International Planned Parenthood Federation and the World Health Organization have warned against use of IUDs in HIV-infected women due to theoretical concerns about pelvic infection and increased blood loss. No published studies have investigated this concern, however. The validity of this recommendation was investigated in a comparative study of 156 HIV-1-infected and 493 non-infected women from two public family planning clinics (Kenyatta National Hospital and Riruta City Clinic) in Nairobi, Kenya, who requested and met local eligibility criteria for IUD insertion. At 1 and 4 months after insertion, information was collected from physicians--blinded as to the patient's HIV status--on IUD-related complications such as pelvic inflammatory disease (PID), removals, expulsions, and pregnancies. Complications were identified in 11 (7.6%) HIV-positive and 37 (7.9%) HIV-negative women. There were only 3 incident cases of PID, 2 of which occurred in HIV-infected women. IUD removal due to pain or infection occurred in 10 (6.9%) HIV-infected and 27 (5.7%) noninfected women. There were no differences in overall IUD complications in HIV-1-infected women by CD4 status (severely, moderately, or mildly immunocompromised). After adjustment for marital status, study site, previous IUD use, ethnic origin, and frequency of sexual intercourse, multivariate analysis suggested no association between HIV-1 infection and increased risks for overall IUD-related complications (odds ratio (OR), 0.8; 95% confidence interval (CI), 0.4-1.7) or infection-related complications (OR, 1.0; 95% CI, 0.5-2.3). These findings suggest that the IUD may be a safe contraceptive method for appropriately selected HIV-infected women with continuing access to medical services.
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PMID:Complications of use of intrauterine devices among HIV-1-infected women. 965 92

The impact of the escalating demand for HIV/AIDS-related care on hospital services in Nairobi, Kenya, was investigated in two prospective cross-sectional studies conducted at Kenyatta National Hospital. Data on age, gender, number of admissions, length of stay, HIV status, clinical AIDS, final diagnosis, case mix, and outcome were compared in a 1988-89 study that enrolled 506 consecutive patients in a total of 22 24-hour periods and in a 1992 study of 374 patients admitted in 15 24-hour periods. 18.7% of hospital patients in 1988-89 were HIV-positive compared with 38.5% in 1992, with a concomitant decline of 18% in the number of HIV-negative admissions. Clinical surveillance for AIDS consistently identified less than 40% of HIV-positive patients. Tuberculosis and pneumococcal pneumonia were the leading diagnoses in both surveys among HIV-positive and HIV-negative patients. Diagnoses recorded for HIV-positive patients did not change over time; however, among HIV-negative patients, there was a significant narrowing in the range of diagnoses seen. Mortality among HIV-positive patients remained constant at 35% in both surveys. Among HIV-negative patients, mortality increased from 13.9% in 1988-89 to 23% in 1992 (2.6 and 3.5 deaths per 24-hour period, respectively). These findings suggest that increasing demand for hospital care by HIV-positive patients has been accompanied by deteriorating conditions for HIV-negative patients, especially an admissions selection process that favors HIV/AIDS patients. Recommended to address the worsening crisis in health care delivery are general guidelines on admission criteria that neither crowd out HIV-negative patients nor discriminate against those with HIV/AIDS.
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PMID:Some effects of the rising case load of adult HIV-related disease on a hospital in Nairobi. 966

Chancroid is caused by infection with Hemophilus ducreyi, and is associated with an increased risk for the sexual transmission of HIV-1. The authors assessed whether the clinical and histological features of chancroid are changed by HIV infection, using 320 male patients who presented during February-November 1994 to the City of Nairobi Special Treatment Clinic with a clinical diagnosis of chancroid. 109 subjects were HIV seropositive and 211 were HIV seronegative. A detailed history, physical examination, swabs for Hemophilus ducreyi culture and blood for HIV serology, syphilis serology, and CD4 counts were obtained from all patients. Punch biopsies from an ulcer were obtained from 10 patients and either fixed in 10% formalin or snap frozen in Optimum Cutting Temperature (OCT) medium compound at -70 degrees Celsius. Patients were treated with erythromycin and followed for 3 weeks. HIV patients had ulcers of longer duration than did HIV-seronegative patients. Although cure rates were similar at 3 weeks, HIV patients had lower cure rates at 1 week (23% vs. 54%). A dense interstitial and perivascular inflammatory infiltrate extending from the reticular to deep dermis was present in all biopsies. The infiltrate consisted of equal amounts of CD4 and CD8 T-lymphocytes as well as macrophages. The histological and immunohistochemical picture was identical for HIV-positive and HIV-negative patients. Study findings therefore indicate that HIV infection slows the healing rates of chancroid ulcers despite appropriate antibiotic therapy. The clinical difference cannot be attributed to an altered histopathological response to HIV infection.
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PMID:Clinical and in situ cellular responses to Haemophilus ducreyi in the presence or absence of HIV infection. 976 37

To determine the effect of human immunodeficiency virus type 1 (HIV-1) infection upon pelvic inflammatory disease (PID), a laparoscopic study of acute PID was conducted in Nairobi, Kenya. Subjects underwent diagnostic laparoscopy, HIV-1 serology, and testing for sexually transmitted diseases. Of the 133 women with laparoscopically verified salpingitis, 52 (39%) were HIV-1-seropositive. Tubo-ovarian abscesses (TOA) were found in 33% of HIV-1-infected and 15% of HIV-1-uninfected women (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.2-6.5). Among seropositive women, TOA was found in 55% of those with CD4 cell percent <14% vs. 28% with CD4 cell percent>14% (OR 3.1, 95% CI 0.6-15.3). Neisseria gonorrhoeae was detected in 37 women (28%) and Chlamydia trachomatis in 12 (9%); neither was significantly related to HIV-1 seropositivity. Length of hospitalization was not affected by HIV-1 serostatus overall but was prolonged among HIV-1-infected women with CD4 cell percent <14%. Among patients with acute salpingitis, likelihood of TOA was related to HIV-1 infection and advanced immunosuppression. In general, HIV-1-seropositive women with acute salpingitis responded well to treatment.
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PMID:Effect of human immunodeficiency virus type 1 infection upon acute salpingitis: a laparoscopic study. 978 Feb 55


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