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

The Joint UN Program on AIDS reports that India has more than 3 million adults infected with HIV, more HIV-infected adults than any other country in the world. By the year 2005, India will have more people infected with HIV than does Africa. Having sex with a Bombay housewife today is at least twice as risky as it was to have sex with a prostitute in the city's red light district in 1988. 2-3% of all women in the city are infected with HIV. There is ignorance, apathy, corruption, and lack of commitment at all levels with regard to HIV/AIDS. Accordingly, India's lackluster campaign against AIDS launched 10 years ago has lost momentum just as the epidemic is exploding and at a time when traditional beliefs about cultural barriers and the sexual behavior of Indian males are being called into question. Considerable homosexual behavior occurs in India. However, the most important factor contributing to the spread of HIV throughout India is the virus' spread from urban areas into small villages, often through migrant laborers. Ignorance, illiteracy, and poverty in villages will make AIDS prevention especially difficult. Indian government policy forbidding the distribution of condoms in prisons, needles to injectable-drug users, and free drugs to AIDS patients further contributes to the spread of HIV.
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PMID:AIDS in position to ravage India. 878 42

The authors examined the relationship between apathy, depression, and cognitive performance in 48 HIV-1-seropositive and 21 seronegative (control) subjects, using reaction time (RT) and working memory tasks. Apathy, but not depression, was associated with working memory deficits among HIV-seropositive subjects. The cognitive-affective component of the Beck Depression Inventory (BDI), but not apathy, was associated with slowing and decreased accuracy on a choice RT task. The BDI cognitive-affective component was more closely associated than the BDI somatic component with both RT slowing and apathy. Results suggest that prominent symptoms of apathy, independent of depression, may be an important indicator of CNS involvement in HIV infection. Total BDI scores showed a less consistent relationship with neurocognitive performance, suggesting that somatic symptomatology is diagnostically ambiguous among HIV-infected subjects.
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PMID:Apathy, depression, and cognitive performance in HIV-1 infection. 970 40

Pregnant, drug dependent women present for treatment with a variety of medical and psychosocial issues. When medical sequelae include HIV infection, effective medical and psychosocial management is essential for both mother and fetus/infant. To better understand and characterize this high-risk population, the present study examined personality features and psychopathology in a sample of HIV+, pregnant, drug dependent women. Personality was assessed using the Minnesota Multiphasic Personality Inventory--Revised (MMPI-2). The mean MMPI-2 codetype, (6-8), although relatively rare in standard drug treatment settings, characterized nearly one-fifth of study participants. The 6-8 codetype is typically associated with unusual thought processes, feelings of hostility and suspiciousness as well as apathy, which may mask symptoms of nervousness, anxiety and depression. Treatment implications of study findings are discussed.
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PMID:Personality characteristics of treatment-seeking HIV+ pregnant drug dependent women. 978 62

HIV-associated neurological manifestations: dementia, myelopathy, and neuropathy, have become one of the commonest causes of neurological disorders in young people. Cognitive impairment develops in about 30 p. 100 of patients with AIDS and frank dementia in 15 to 20 p. 100 with an annual incidence after AIDS of approximatively 7 p. 100. Typically, the onset of dementia is relatively abrupt over a few weeks or months. The clinical manifestations of the encephalopathy now termed "HIV-dementia", suggest predominant subcortical or frontal involvement. Typical presentation includes apathy and inertia, memory loss and cognitive slowing, minor depressive symptoms and withdrawal from usual activities. Neurological examination may show hypertonia of lower limbs, tremor, clonus, frontal release signs and hyperactive reflexes. Terminally, the patient is bedbound, incontinent, abulic or mute with decorticate posturing leading to death over 3 to 6 months. However, a stabilisation and even a regression of the cognitive disorders have been observed following antiretroviral treatment. Radiological features of HIV dementia include both central and cortical atrophy and white matter rarefaction. However they are neither invariable nor specific. Together with CSF examination, they are more important to exclude opportunistic infections. Indeed, although a completely normal CSF profile may reasonably exclude the diagnosis; at present, no single test or combination of tests can reliably diagnose HIV dementia. Although the clinical characteristics of HIV-dementia are now clearly established, its pathogenesis is unclear and its pathological counterpart remains a matter of debate. A number of "HIV-induced" lesions may be found in the brain of AIDS patients and their causative role in HIV-dementia has been considered. They include HIV encephalitis due to productive CNS infection by the virus, diffuse white matter pallor "HIV-leukoencephalopathy" reflecting an abnormality of the blood brain barrier, involvement of the grey matter, "diffuse poliodystrophy", with neuronal loss that results, at least partly, from a process of programmed cell death and axonal damage. These changes are variably associated in patients with HIV dementia, however none of them can be closely related to the cognitive disorders. This suggests that the neuronal dysfunction underlying HIV-dementia results from different mechanisms that are variably associated and may interact mutually. These include production of viral proteins, microglial activation with consequent production of neurotoxic factors such as proinflammatory cytokines, free radicals, derivates of arachidonic acid, or quinoleic acid, and blood borne neurotoxic factors in particular cytokines.
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PMID:[Dementia and human inmmunodeficiency virus infection]. 983 49

Recent work on HIV counselling suggests that the protection of the moral status of the recipient is a key factor in the successful uptake of advice. This study suggests it may be equally important in the uptake of health promotion messages. A discourse analysis of the talk of 20 young injecting drug users (IDUs) identified a contradiction between their asserted self-identity as careful and socially responsible injectors, and their admission of risky lending and borrowing of injecting equipment. This contradiction was resolved by the production of discourses of exoneration, differentially tailored to the moral implications of lending and of borrowing. Lenders argued a form of 'market morality' wherein it was the duty of each to accept the consequences of his/her decisions. Lenders were therefore morally exonerated since moral failure was the 'borrowers'. Borrowing was usually depicted as 'desperate measures' for which moral culpability was disavowed because of 'powerlessness'. The exception of routine borrowing, acknowledged as risky and against community norms, was accounted for in a nihilistic discourse of indifference to infection and death. The need for a 'counter discourse' around notions of community is discussed.
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PMID:The moral universe of injecting drug users in the era of AIDS: sharing injecting equipment and the protection of moral standing. 992 27

This article highlights the challenge made by Chinese AIDS experts to intensify the education campaign against HIV. Professors Zeng Yi and Xu Hua expressed their opinion on the probable arrest of the spread of AIDS if the government makes an effort in HIV education and prevention campaign. Indifference of some government officials, lack of financial resources, misconceptions on the severity of the situation, and lack of a good HIV epidemiological surveillance system are among the obstacles encountered in stopping this disease in China. Moreover, the biggest challenge of any prevention effort will be to reach the millions of migrant workers who are usually in their sexually active years and are most probably the carriers of the disease.
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PMID:Chinese AIDS experts call for more education to halt HIV epidemic. 1057 54

Prominent apathy and/or irritability are frequently observed among individuals infected with the human immunodeficiency virus (HIV). Although these symptoms often occur as part of a mood disorder, compelling evidence suggests that they may occur independently of depression in neurologic disease/disorder. The current study examined the prevalence of both apathy and irritability among a sample of HIV-infected individuals and explored the degree to which these neuropsychiatric (NP) phenomena were associated with performance on neuro-cognitive measures thought to be sensitive to the potential CNS effects of HIV-1. Clinician-administered rating scales assessing apathy and irritability were administered to 65 HIV-seropositive (HIV+) and 21 HIV-seronegative (HIV-) participants who also completed a dual-task reaction time paradigm and the Stroop task. NP disturbance was significantly more prevalent among HIV+ participants compared with HIV- controls and was associated with specific neuro-cognitive deficits suggestive of executive dysfunction. Relative to both HIV- controls and to neuro-psychiatrically intact HIV+ participants, those HIV+ individuals with evidence of prominent apathy and/or irritability showed deficits in dual-task, but not single-task, performance and on the interference condition of the Stroop. Unexpectedly, NP disturbance did not show a robust relationship with HIV disease stage. These results suggest that the presence of prominent apathy and/or irritability among HIV+ individuals may signify greater HIV-associated CNS involvement. In HIV/AIDS, the disruption of frontal-subcortical circuits may be a common mechanism causing both executive dysfunction and NP disturbance.
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PMID:Neuropsychiatric disturbance is associated with executive dysfunction in HIV-1 infection. 1157 99

The modern era of tuberculosis(TB) began in the mid 1980s. In 1993, WHO took the unique step of declaring TB to be a world emergency. Despite this intervention it is estimated that deaths from TB will increase from 3 million a year currently to 5 million by the year 2050. There are 4 principal reasons: World population's increase, co-infection with HIV/AIDS, poverty and programme decline. Other causes contributing to the global epidemic are multidrug resistant TB, immigration, and indifference. The practical solution must concentrate on the completed correct treatment of the disease particularly in those who are sputum smear positive. For this reason WHO is vigorously promoting the Directly Observed Therapy Short course (DOTS) campaign. Doctors treating TB should ideally be part of the public health system. They should have access to first class bacteriological services, good quality of drugs and should make sure that the patient receives the drugs under supervision. Though the reasons for increasing TB are multifactorial it is within the capability of the world to re-exert control providing that the political will is present.
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PMID:Tuberculosis: the global epidemic. 1101 61

This study was designed to determine whether apathy is associated with neurocognitive symptoms and/or depressive symptoms in HIV/AIDS and also whether apathy is associated with patient expectancies about antiretroviral medication adherence. Seventy-five HIV+ homosexual men and 58 HIV+ women were assessed for depressive disorders and symptoms. Neuropsychological tests measured attention, concentration, learning, memory, executive function, and psychomotor speed. Other measures included Marin's Apathy Evaluation Scale, the Adherence Determinants Questionnaire, CD4 cell count, and HIV RNA viral load. Apathy was consistently related to depression and unrelated to neuropsychological impairment. Patient expectancies regarding medication adherence were unrelated to apathy when the analysis was controlled for depressive symptoms.
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PMID:Relationships among apathy, depression, and cognitive impairment in HIV/AIDS. 1108 61

The clinical features of human immunodeficiency virus (HIV) dementia exhibit the hallmarks of a subcortical dementia. These features include psychomotor slowing, apathy, bradykinesia and altered posture and gait similar to those observed in advanced Parkinson's disease. The dementia has the hallmarks attributed to subcortical dementia. The exquisite sensitivity of many of these patients to dopamine receptor blockade suggested a profound and, perhaps, selective abnormality of striatal dopaminergic systems. Additional investigations, electrophysiological, pathological, virological, metabolic and radiological studies, indicate that the basal ganglia are a major target of HIV infection. In this review, we describe the evidence for involvement of basal ganglia and, in particular, the dopaminergic systems, in HIV dementia. We also suggest novel therapeutic strategies that may be beneficial in the treatment of this disorder.
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PMID:HIV dementia: the role of the basal ganglia and dopaminergic systems. 1110 99


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