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

The Community Programs for Clinical Research on AIDS (CPCRA) presented several recent findings from clinical trials at the International Conference on AIDS. Weekly doses of fluconazole can safely prevent persistent yeast infections in HIV-infected women who frequently develop yeast infections of the mouth, vagina and throat. Combination antibiotic therapy given intermittently is an effective initial treatment for persons with HIV-related tuberculosis. High dosages of clarithromycin should not be given to patients with Mycobacterium avium complex (MAC); doses above 500 mg are associated with higher mortality levels. Researchers have also determined the genetic sequence of the virus that causes molluscum contagiosum, a skin disease affecting up to 18 percent of AIDS patients.
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PMID:CPCRA researchers present OI studies at Vancouver. 1136 24

Vaginal health is related to the risk of acquiring or transmitting HIV and other STDs. Significant factors in that risk analysis include pH level, local immune factors, hormone levels, menstrual cycle, sexual maturity, the use of contraceptives, douching, and sexual practices. The vagina, if healthy, has a number of natural protections against HIV and STDs. Inflammation can contribute to increased disease susceptibility, and can be caused either by organisms or mechanical trauma. High levels of HIV in vaginal secretions are directly associated with high plasma levels, and there is some correlation to cervicovaginal secretions levels as well. Vaginal health can be enhanced by self-inspection, gynecological care, and prompt treatment of infections. A table details comfort measures for vaginal conditions.
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PMID:HIV and the vaginal ecosystem. 1136 59

Mitchell Katz, Julie Gerberding, and Steve Boswell, experts involved in post-exposure prophylaxis of HIV infection, discuss using such measures to prevent possible sexual transmission of HIV infection. The risk of contracting HIV via sexual exposure is similar to the risk from an occupational needlestick injury; however, the type of sex, i.e., anal vs. vagina or insertive vs. receptive, dictates the degree of risk. Due to uncertainties in predicting the exact risk, the physicians recommend offering prophylaxis to people who have had sex with someone known to be HIV-infected or at high risk for being infected. Minimum program needs to provide effective post-sexual exposure prophylaxis are outlined, including the types of facilities best suited to treat patients. Emergency rooms are convenient; however, staff generally lack the expertise to properly treat these patients. If emergency rooms are used, follow-up should be received at other facilities, such as STD clinics. Persons seeking repeated post-sexual exposure prophylaxis should be dealt with on a case-by-case basis. The public health system or government should bear the treatment costs under the rubric of research.
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PMID:Post-sexual exposure prophylaxis: a roundtable discussion. 1136 78

Several new studies link the loss of vaginal flora with an increased risk of sexually transmitted diseases. Women who lack lactobacillus are more predisposed to acquiring HIV and other STDs. Sharon Hillier, of Magee-Women's Hospital at the University of Pittsburgh, states that vaginal mucosa produce lactobacilli, which help the vagina maintain a low pH and produce hydrogen peroxide killing pathogens. Much loss of natural microflora is attributed to bacterial vaginosis, excessive douching, and unsafe sex. As a result, Dr. Hillier speaks out strongly against the use of douches. Studies of sex workers in Thailand and Mombassa have demonstrated that women with a low prevalence of lactobacilli are at significantly higher risk of acquiring disease.
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PMID:Does loss of vaginal flora increase risk of STD? 1136 89

Microbicides are a chemical barrier that women apply vaginally to protect themselves against sexual transmission of HIV and other sexually transmitted diseases. In addition to killing HIV microbicides need to be sensitive to the lining of the vagina to prevent irritation and keep HIV from binding to the vaginal wall. The 12th World AIDS Conference exhibited presentations on the safety and efficacy of microbicide products currently in development, including: Pro-2000 (Procept), BufferGel ( ReProtect), Protectaid (Biopharm Laboratories), and C31G (Biosyn). Research was also presented on the cultural and regional issues that may determine whether women will use this form of protection. Use of microbicides can only be considered a part of the solution for women to curb the spread of HIV, until a more comprehensive means can be reached.
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PMID:Microbicides: putting women in control. 1136 70

Late-stage laboratory testing will begin for Geda, an experimental microbicide, which is inserted by plunger into the vagina up to four hours before having sex. It contains the active ingredients octoxynol-9 and benzalkonium chloride. Preliminary tests show Geda kills HIV, E. coli, and hepatitis B virus. Another product with the same active ingredients, PrevenTx, is already marketed as a hand wash. Manufacturer Empyrean Bioscience is developing disinfectant and mouthwash versions of PrevenTx.
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PMID:Intravaginal microbicidal gel to be tested. 1136 85

In this paper we summarise the parasitological, clinical and epidemiological characteristics of female genital schistosomiasis (FGS), a frequent manifestation of the infection with Schistosoma haematobium. Means to diagnose and treat lesions in the lower and upper genital tract are discussed. Based on clinical findings and available pathophysiological as well as immunological data it is conceivable that FGS of the cervix and vagina not only facilitates the infection with agents of sexually transmitted diseases, but presumably also alters the natural history of such infections. Two infectious agents are of particular concern: the Human Immunodeficiency Virus and the oncogenic Human Papilloma Viruses. Possible interactions and their consequences are discussed and research areas which should be addressed are outlined.
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PMID:Female genital schistosomiasis: facts and hypotheses. 1141 3

'Microbicide' is the name for a number of new products currently under research which could become a new class of barrier method for use in the vagina and rectum for protection against HIV, prevention and/or treatment of other sexually transmitted diseases and/or act as a contraceptive. This is a summary report of this scientific conference, at which basic science, clinical trial efficacy and design, and ethical, behavioural and public health issues were on the agenda. There are many potential products but few have yet got beyond Phase I clinical trials. There is not likely to be an approved and available product for 5-10 years at best; finding a balance of low toxicity with high efficacy is the major challenge, given how rapidly HIV infection actually infects tissue. Phase III clinical trials of these products require new protocols and procedures. It was urged by many, and underscored by HIV positive women who were present that clinical trials must be treated as an opportunity to promote a total prevention package--STD treatment, voluntary HIV testing and counselling, condom use, practising safer sex--plus microbicides and contraception. Identifying effective products and making them available as soon as possible were obviously also a priority. How to do this--ethically and scientifically--were the main subject of the meeting.
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PMID:Microbicides 2000: report of an international conference, 13-16 March, Washington DC. 1142 60

HIV is transmitted to 6.4 million human beings per year and the majority of these transmissions are sexual. Condoms are highly effective and are recommended as the primary preventive. However, the fact that there are millions of sexual transmissions each year indicates that many people do not use condoms and that additional preventives are needed. The mechanisms of natural prevention of oral transmission by saliva may be adaptable to the susceptible vagina and rectum. The objective of our study was to reduce the sexual transmission of HIV by mimicking saliva's targeting of the transmitting infected leukocytes and any cell-free HIV in seminal fluid. The previously recommended anti-HIV topical microbicide, nonoxynol-9, has not prevented HIV transmission in humans, probably because it causes mucosal irritation and attracts CD4(+) cells. To identify effective preparations that are nonirritating, we studied the anti-HIV activity of commercially available, over-the-counter (OTC) lubricants and vaginal preparations that are judged safest by the U.S. Food and Drug Administration (FDA), and are nonirritating. The effect of OTC preparations on both the production of HIV by infected leukocytes and cell-free HIV suspended in seminal fluid was measured under simulated in vivo conditions. We surveyed 22 OTC vaginal preparations and excluded those with low inhibitory activity and those that were inhibitory but likely to be irritating. Three included preparations are highly active against both HIV-infected leukocytes suspended in seminal fluid and active against cell-free HIV, under in vitro conditions that simulate in vivo conditions. Since the preparations identified here as anti-HIV substances have the advantages of being widely available, inexpensive, acceptable, in the safest U.S. FDA category, and may be used by recipient women or men, they should be tested in clinical trials to help prevent sexual transmission of HIV.
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PMID:Practical prevention of vaginal and rectal transmission of HIV by adapting the oral defense: use of commercial lubricants. 1148 16

Vaginal prophylactic methodology may prevent heterosexual transmission of the HIV and other sexually transmitted disease-causing organisms as well as unplanned pregnancies. A new delivery system (ACIDFORM) was designed with acid-buffering, bioadhesive, and viscosity-retaining properties to (1) maintain the acidic vaginal milieu (the low pH inactivates many pathogens and spermatozoa), (2) form a protective layer over the vaginal/cervical epithelium (minimizing contact with pathogenic organisms), and (3) provide long-term vaginal retention. A Phase I clinical study with ACIDFORM provided initial information about its safety and showed the formation of a layer over the vaginal/cervical epithelium [1; Amaral et al., Contraception 1999;60:361-6]. To study the properties of the gel (without active ingredient) in more detail, ACIDFORM's acid-buffering, bioadhesive, viscosity-retaining, and spermicidal properties were compared in vitro to marketed formulations, and its long-term stability was assessed. ACIDFORM, either when titrated with NaOH or when mixed directly with semen, is highly acid buffering and much more effective than Aci-Jel, a commercial acid-buffering vaginal product. ACIDFORM adheres well to two model membranes (excised sheep vagina and cellophane) and is more bioadhesive than Conceptrol, Advantage S, Replens, Aci-Jel, and K-Y jelly. On dilution, ACIDFORM also retains its viscosity better than these marketed products. ACIDFORM is spermicidal and is stable for at least 2 years. These results suggest that ACIDFORM has advantages over presently marketed vaginal delivery systems. The gel may either be useful by itself as an antimicrobial contraceptive product or as a formulation vehicle for an active ingredient with antimicrobial and/or contraceptive properties.
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PMID:Properties of a new acid-buffering bioadhesive vaginal formulation (ACIDFORM). 1153 16


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