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

There has been considerable debate as to the risk of suicide, accidents, and homicide in populations at high risk for HIV infection. The purpose of the present investigation was to determine the incidence of sudden and unexpected deaths in a well-defined cohort of homosexual and bisexual men prospectively studied since 1984. All subjects were enrolled in the Pitt Men's Study, the Pittsburgh, Pennsylvania, component of the Multicenter AIDS Cohort Study. Of this group, 861 were between the ages of 20 and 44, and 35% were seropositive for HIV. There were 70 deaths attributed to AIDS. Five additional deaths were classified as sudden and unexpected, an annual rate of 0.08% (80/100,000). Only one of these was classified by the coroner's office as a suicide; three were due to accidents, and one was a drug overdose of undetermined cause. Only two of the five unexpected deaths were HIV seropositive, and none had the diagnosis of AIDS. The sudden and unexpected death rate in this cohort did not significantly differ from the 0.07% (70/100,000) yearly incidence in the age- and race-matched male population. Thus, in this well-defined male gay cohort, there does not appear to be an increased risk of violent and drug-related deaths in persons at risk for, or with a diagnosis of, AIDS.
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PMID:Sudden unexpected death in a male homosexual cohort. 782 57

Suicidal acts among people with HIV disease exceed those among the general population. Stress from the HIV diagnosis, treatment, and medications can lead to depression, which increases suicide risk. High quality care of depressed persons depends on sound scientific knowledge of evaluation of suicide. Incidence, epidemiology, risk factors, evaluation, and treatment of suicidal people are the core of this article. A patient's comment, "I'd be better off dead," deserves investigation as a cry for help and a clue to impending suicide.
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PMID:Management of suicidal patients with HIV disease. 786 3

Oral mucosal administration of natural human interferon alpha (IFN-alpha) lozenges has previously been applied to the treatment of HIV-1 seropositive patients with benefits including weight gain and amelioration of clinical signs and symptoms of disease. These previous studies have been of short duration and employed treatment at a constant dosage. In this interim report, we describe the positive effects of long-term administration of IFN-alpha lozenges given in increasing dosages over the time. Forty adult patients positive for HIV-1 by ELISA and Western Blot have been enrolled in an ongoing, open-label study. Patients have received IFN-alpha lozenges at dosages ranging from 75-600 IU administered once daily into the oral cavity to promote oral mucosal contact. Patients have been treated for variable periods, ranging from 19 days to over 700 days. A group of untreated and unmatched patients, positive for HIV-1 by ELISA and Western Blot, were also followed during this study. At the time of this interim report, only 18 patients had received long-term treatment (more than 168 days with one or more increases in dosage). Five of the 18 patients died; one committed suicide. Two died due to complications of Kaposi sarcoma and another two died of HIV-related causes. The remaining 13 patients have exhibited a significantly smaller mean monthly decrease in CD4+ cells than the untreated but unmatched patients monitored during the same time period (P < or = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:An interim report on the effect of natural human interferon alpha (IFN-alpha) lozenges in patients seropositive for the human immunodeficiency virus type 1 (HIV-1). 790 65

We have proposed that inappropriate induction of programmed cell death (PCD) or apoptosis, a physiological cell-suicide process, may play a role in the pathogenesis of AIDS. This model has been supported by several reports of abnormal levels of PCD in vitro in both CD4+ and CD8+ T cells from human immunodeficiency virus type 1 (HIV-1)-infected persons. To further assess the significance of such a process in AIDS pathogenesis, in vitro PCD was compared in HIV-1-infected persons and in various primate models that allow discrimination between pathogenic chronic lentiviral infection either in the same species, such as rhesus macaques infected with different simian immunodeficiency viruses (SIV), or in different species, such as SIV-infected African green monkeys and HIV-1-infected chimpanzees. Abnormal levels of PCD in CD4(+)-T-cell-depleted peripheral blood mononuclear cells (PBMC), containing the CD8+ T cells, were observed in both pathogenic and nonpathogenic models. However, abnormal levels of PCD in the CD8(+)-T-cell-depleted PBMC, containing the CD4+ T cells, was only observed in the two models leading to AIDS: HIV-1-infected persons and rhesus macaques infected with a pathogenic strain of SIV. This suggests that inappropriate T-cell PCD in HIV-1-infected persons involves two distinct processes: one, concerning CD4+ T cells, is closely related to AIDS pathogenesis; and the other, concerning CD8+ T cells, may be a consequence of immune stimulation with no direct link to AIDS pathogenesis.
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PMID:Programmed cell death and AIDS: significance of T-cell apoptosis in pathogenic and nonpathogenic primate lentiviral infections. 793 84

Mortality in young Edinburgh males aged 20-34 years was analysed over the period 1979-88. Proportional mortality was calculated from cause of death data: 23% of deaths were caused by accidents, 16% by infection, 15% by suicide and 9% of deaths were due to cancer. Area mortality rates were measured, and rates were significantly higher (P < 0.001) in sectors of low socio-economic status. Edinburgh has the highest HIV positive prevalence rate in the UK (111 per 100,000) and 10% of known UK HIV positive cases in 1988 were traced to Lothian. The Edinburgh rate for AIDS-related deaths in males aged 20-34 years was 0.57 per 100,000, and has been contrasted with the pattern of mortality in New York where the rate was 35.8 per 100,000. The pattern of mortality amongst young Edinburgh males is likely to register a significant change over the next ten years. The results presented may be used as a standard against which change can be measured.
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PMID:Mortality before AIDS: a review of causes of death in young men in the city of Edinburgh (1979-88). 797 76

The association between suicide and medical disorder has not received as much attention as the association between suicide and psychiatric disorder. We identified by statistical overview medical disorders with an altered suicide risk. We found reports on the mortality of 63 medical disorders (ICD9 001-289, 320-999) said to have an altered suicide risk. English-language reports were located on MEDLINE with the search terms "disease name with mortality and follow-up"; and from the reference lists of these reports. We abstracted 235 reports of mortality studies of medical disorders with 2 years or more of follow-up, less than 10% loss of subjects, observed numbers of suicides given, and either the expected number or the facts from which to derive this. The ratio of the sum of the observed to the sum of the expected suicides, for each disorder, tested by the Poisson distribution gave an assessment of altered risk of death from suicide. Increased risk (p < 0.05) was seen for HIV/AIDS, malignant neoplasms as a group, head and neck cancers, Huntington disease, multiple sclerosis, peptic ulcer, renal disease, spinal cord injury, and systemic lupus erythematosus. Inconclusive evidence for increased risk was observed for amputation, heart valve replacement and surgery, disorders of the intestine (Crohn disease, ileostomy, ulcerative colitis), hormone replacement therapy, alcoholic liver disease, neurofibromatosis, systemic sclerosis, and Parkinson disease. Pregnancy and the puerperium had decreased risks (p < 0.05). There was no evidence of either increased or decreased risk for any of the other disorders studied.
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PMID:Suicide as an outcome for medical disorders. 798 80

During October-November 1988 in Kenya, 344 undergraduate male and female students at Kenyatta University completed a questionnaire designed to determine their knowledge, attitude, and practices towards AIDS. This survey also aimed to shed some light on the success of the media campaign launched in February 1988. 98% were familiar with AIDS. Men and women were equally familiar with AIDS. The leading sources of information on AIDS were newspapers (166) and radio (123). Most students knew that weight loss was a symptom of AIDS. Many also knew that coughing was a symptom. Students had vague knowledge of HIV. Students tended to know that AIDS is transmitted through heterosexual intercourse. Men were more likely to have sexual experience than women (72% vs. 28%). The most common way the students would reduce the risk of contracting AIDS was having 1 sex partner (204 students). Few students (44) would use a condom. Creating awareness (174) was the leading way society should fight AIDS. Only 25 students mentioned condom use as a way to prevent AIDS. Most students (60%) thought that persons with AIDS should be quarantined. Most students had an apathetic attitude if they themselves had AIDS. The leading responses to what the students would do if they learned that they had AIDS included wait to die (193) and commit suicide (120). 20% would not help a family member with AIDS and would let him/her die. These findings suggest that, even though almost everyone knew about AIDS, their misperceptions about and attitudes towards persons with AIDS reflect a need for more information on AIDS prevention and on dealing with HIV infected persons. The Ministry of Health needs to put more effort into counseling AIDS patients and to reduce the hopelessness and stigmatizing of persons with AIDS.
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PMID:Kenyan university students' views on AIDS. 803 74

The purpose of this paper is to give an overview of the psychiatric aspects of acquired immunodeficiency syndrome (AIDS)/human immunodeficiency virus (HIV) infection and sexually transmitted disease (STD) under the following subheadings: AIDS-related complex, AIDS hypochondriasis, AIDS dementia complex, AIDS and increased risk of suicide, psychiatric aspects of STD, and implications for the management of patients. The psychiatric aspects of HIV infection and AIDS include problems of adjustment to a diagnosis with a stigma and the threat of death, reactive depression and potential risk of suicide, personality disorder, AIDS-related complex (ARC), and AIDS-related dementia. The paper gives an overview of clinical, neuropathological and psychopathological experience in other countries with relevant examples from Papua New Guinea if available. STDs are mentioned because HIV transmission in Papua New Guinea is mostly by heterosexual means. The paper concludes by emphasizing the psychiatric principles of management of HIV-infected/AIDS/STD patients, which include pharmacotherapy but are always based on supportive psychotherapy and counselling.
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PMID:Psychiatric aspects of acquired immunodeficiency syndrome (AIDS)/human immunodeficiency virus (HIV) infection and sexually transmitted disease (STD): an overview. 805 45

The Division of AIDS (DAIDS), National Institute of Allergy and Infectious Diseases (NIAID), sponsored a Workshop on HIV-Mediated Defects in Immune Regulation on September 29-30, 1993. Workshop participants included investigators in basic research of immune regulation, animal models of HIV disease, HIV epidemiology, and HIV clinical research and treatment. The purpose of the workshop was to describe and evaluate biological mechanisms of HIV-mediated immune deficiency other than direct killing of infected CD4+ cells. The workshop focused on HIV-mediated dysfunction in signal transduction and in T cell development and maturation. Mechanisms by which HIV has been proposed to influence signal transduction include gp120 ligation to CD4, HIV superantigen(s), and HIV-mediated perturbations in signal pathway components (e.g., receptors, kinases, phosphatases, cytokines, and cyclins). As a result of signal dysfunction, cells may fail to respond to foreign antigens (anergy) or become predisposed to enter suicide pathways, otherwise known as programmed cell death or apoptosis. Programmed cell death is a normal immune regulatory mechanism that is activated to prevent anti-self responses and also to delete expanded but no longer needed cell populations. In the immune system, new cells are constantly produced from stem cells to replace those that die from age, pathological response, or programmed cell death. Dysfunction in these new cells may occur if HIV causes changes in the structural environment of the thymus and lymph nodes, or in cytokine signals.
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PMID:HIV-mediated defects in immune regulation. 806 18

It has been suggested that HIV infection is associated with an increased risk of suicidal behaviour. This paper reviews the literature on suicide in patients with HIV disease and discusses methodological problems encountered in studying the incidence of suicide in this population. A snowballing method was used to identify cases of suicide in patients who were receiving treatment for HIV disease in a central London health district. The possible under detection of suicides among AIDS patients is considered. The six case reports are described to illustrate the clinical and psychosocial characteristics of suicides, and they are discussed in relation to other findings on suicide in patients with HIV disease and other physical illnesses.
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PMID:Suicide and HIV disease. 811 Aug 53


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