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

A medical officer for the Expanded Program on Immunization (EPI) of the World Health Organization (WHO) calls for staff at all health facilities to screen and, if appropriate, immunize every infant, child, and woman of reproductive age attending health facilities. Routine immunization services tend to miss many women and children who should be immunized. Three important components comprise the health team approach needed to avoid missed opportunities: awareness to screen, a well-organized referral system within each health facility, and regular availability of vaccines. In the health facility, the nonimmunized child is at risk of contracting measles, so all such children should be immunized before they leave the health facility. The WHO/EPI medical officer presents five ways to avoid missed opportunities: screen and immunize at every opportunity, administer all required vaccines, stress real and avoid false contraindications, train staff, and open new vials of vaccine when needed. Contraindications to immunization include severe adverse reactions after a dose of vaccine (collapse or shock, convulsions without fever, anaphylaxis, or encephalitis/encephalopathy), neurological disease (for vaccines containing whole cell pertussis), immune deficiency diseases or immunosuppression due to drugs (generally for live vaccines), and symptomatic HIV infections (for BCG or yellow fever vaccines). The following conditions do not preclude immunization: minor illnesses (e.g., upper respiratory infections); allergy, asthma, hay fever, or "snuffles"; prematurity, small-for-date infants; malnutrition; breast feeding; family history of convulsions; treatment with antibiotics, low-dose corticosteroids, or locally acting steroids; eczema or localized skin infection; chronic diseases of the heart, lung, kidney, or liver; stable neurological conditions (e.g., Down syndrome), and history of jaundice after birth. WHO/EPI has an exit survey for use at district-level clinics or hospitals available so program managers can learn if they are missing chances to immunize children.
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PMID:Opportunities to immunise. 1229 31

This article reviews the literature on migration, HIV/AIDS, and sexually transmitted diseases in Eastern Europe and the Community of Independent States (CIS): Bulgaria, Czechoslovakia, Hungary, Poland, Romania, and the former Yugoslavian countries; and Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Russian Federation, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan. There is little in-depth research on the prevalence of HIV/AIDS. After the collapse of the USSR, the opening up of borders presented greater options for the spread of HIV. During 1991-1996, HIV-infected persons increased from 0.3/100,000 to 7.8/100,000. Syphilis and gonorrhea also spread in the 1990s. The increased prevalence is attributed to changes in sexual behavior due to increased travel and migration, disruption among families, and changes in sexual mores; and changes in the structure, availability, and effectiveness of health services. Many migrants in the CIS are young people. Mobile populations in the CIS include labor migrants, refugees, persons displaced by armed conflicts, repatriates, forced migrants, resettlement of formerly deported persons, and ecological migrants. It is general knowledge that migrants are poorly informed about HIV/AIDS. Condoms are not readily available in the CIS. Eastern Europe has high rates of HIV among migrant sex workers.
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PMID:Eastern Europe and Community of Independent States. 1229 97

A rebuttal is made to an article by Stuart Derbyshire criticizing the World Health Organization (WHO) for inflating AIDS figures. In essence, the article argues that AIDS in Africa is not as serious as the press, the WHO, and statistics make it appear. The HIV/AIDS epidemic is one of a number of serious problems facing Africa; furthermore, the apocalyptic predictions of massive increases in mortality and the collapse of societies made in the 1980s have not come to pass. However, Derbyshire notes that seroprevalence surveys were used to predict AIDS mortality, and this does not bear any resemblance to the actual recorded cases. It is known that cases in Africa are totally underreported. The WHO data show that some African countries have not updated their figures for 3 years. In recent years, data have become available showing a definite increase in mortality in young adults and this can only be explained by the increase in HIV/AIDS. The increase in morbidity and mortality from other diseases may be linked with HIV/AIDS. This is proven in the case of tuberculosis and may also account for some of the malarial morbidity. In some countries the level of HIV prevalence in the young adult population appears to have leveled off at lower levels than expected (5%), in others it has reached higher levels (30-40%). How the HIV epidemic progresses and has an affect on the population is determined by many social, economic, and political factors. The impact of the epidemic will be felt for many more years, but African societies are quite resilient. This article is right to question the perception of HIV/AIDS as the most serious problem facing Africa and Asia tomorrow. However, its importance should neither be underestimated nor should the other health and economic crises facing Africa be ignored.
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PMID:Apocalypse now -- or never? 1231 63

By February 1996, the South African life insurance industry had paid out more than R75 million in AIDS-related claims. This situation requires imposition of controls that will make economic sense while reflecting the social responsibility of the insurance companies. AIDS mortality rates suggest that for each 10% of the infected insured population, the risk premium rates should increase 400%. Thus, without controls, the life insurance sector may collapse. While it has been charged that HIV testing associated with the provision of life insurance discriminates against infected individuals, failure to test compromises the rights of uninfected individuals in the individual assurance market. HIV test protocols can be used that protect applicants from false positive results, prevent fraud, and preserve confidentiality. Proposals to require five-year retesting have also been criticized but would protect the interests of uninfected individuals who want life insurance to remain affordable. In an innovative move, South Africa now includes "full-blown AIDS" among the list of "dreaded diseases" that trigger an immediate pay-out. While purchasing life insurance may fall low on the list of priorities of an infected person, demand continues, and two companies offer expensive products to those with Stage I and II disease. Medical insurance is also threatened by the increased costs associated with HIV/AIDS, and treatment protocols may be the only way to control medical expenses and assure the future of medical insurance. At this stage of the epidemic, no one seems prepared to meet their share of the costs associated with HIV/AIDS.
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PMID:What new policies should South Africa's life insurance industry adopt? 1232 May 28

This brief article indicates that Professor Vadim Povkrovsky of the Russian Scientific Systematic Center for Prevention and the Fight Against AIDS estimated the current number of HIV-infected persons in Russia to be about 10,000. He also estimated that 100,000 people could be HIV-infected by the end of 1997 and 500,000 a year later. Povkrovsky urged the parliament to approve an anti-AIDS program, as did the director of the anti-AIDS program. In 1996 the registry indicated 1033 new cases of HIV, which was five times the number registered in 1995 and more than the number for the entire 10-year period. The transmission of HIV is highest among drug users. The director of the anti-AIDS program reported that fewer than 2100 people were carriers of HIV, 245 people had AIDS, and 60 were infected with HIV every day. Russia has a total population of 150 million, which dwarfs the number of AIDS and HIV cases. The concern is the potential for exponential growth in cases and the currently high levels of sexually transmitted diseases, which facilitate HIV infection. HIV incidence in 1996 among drug addicts was an estimated 750 cases, which is an increase of 747 over the course of a year. The Russian parliament passed legislation that would prohibit foreigners with AIDS from entering the country and that would require long-term visitors to prove their non-HIV status. Implementation has not yet taken place. Over the past 10 years the spread of AIDS has been slow due to the country's isolation, conventional sexual behavior, and low drug abuse levels. The collapse of the Soviet Union in 1991 and a more open economy may be contributing influences in the more rapid spread of AIDS.
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PMID:Expert forecasts AIDS epidemic. International (Russia). 1232 Jul 18

Fusion proteins of many viruses, including HIV-1 envelope protein (Env), fold into six-helix bundle structures. Fusion between individual Env-expressing cells and target cells was studied by fluorescence microscopy, and a temperature jump technique, to determine whether folding of Env into a bundle is complete by the time fusion pores have formed. Lowering temperature to 4 degrees C immediately after a pore opened halted pore growth, which quickly resumed when temperature was raised again. HIV gp41-derived peptides that inhibit bundle formation (C34 or N36) caused the cold-arrested pore to quickly and irreversibly close, demonstrating that bundle formation is not complete by the time a pore has formed. In contrast, lowering the temperature to an intermediate value also halted pore growth, but the pore was not closed by the bundle-inhibiting peptides, and it enlarged when temperature was again elevated. This latter result shows that bundle formation is definitely required for the fusion process, but surprisingly, some (if not all) bundle formation occurs after a pore has formed. It is concluded that an essential function of the bundle is to stabilize the pore against collapse and ensure its growth.
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PMID:HIV-1 envelope proteins complete their folding into six-helix bundles immediately after fusion pore formation. 1263 14

The antisense method is one of the most promising anti-cancer methods, however, the design of antisense oligonucleotides is difficult because many factors affecting their activitiy and stability must be considered. Recently, the oligonucleotide stabilities related to the antisense effects were quantitatively investigated based on nearest-neighbor parameters. We demonstrated that DeltaG(o) (37, hyb), a free energy change for the hybridization of antisense oligodeoxynucleotides (ODNs) with target RNAs is related to the RNase H cleavage of TAg (SV40 large T antigen) mRNA, the expression of a rabbit globin mRNA, and the protein function encoded by hMDR1 (human multidrug resistance-1) mRNA, while DeltaG(o) (37, hp), a free-energy change for hairpin formations of the antisense ODNs significantly affected the arrest efficiency of the DHFR (dihydrofolate reductase) mRNA transcription, the expression of the proalpha1(I) chain of human, and the hybridization extent for HIV-1 alpha-1. For ras RNA (Ha-ras mRNA), DeltaG(o) (37, sc), a free energy change for the conformational change of the mRNA required for antisense ODN binding showed the best correlation with the equilibrium constants for the hybridization with their target RNA. On the other hand, the antisense effects ifor the HSV-1 IE5 (herpes simplex virus type 1 immediate early pre-mRNA5) showed less of a relationship to the hybridization stability of the antisense ODNs with the target pre-mRNA, because the antisense ODNs targeting the pre-mRNA must collapse its secondary structure around the splicing site to cancel out the expected antisense effects. Based on these results, we illustrate a new concept for the design of antisense ODNs based on DeltaG(o) (37, hyb), DeltaG(o) (37, hp), and DeltaG(o) (37, sc).
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PMID:A new concept for the design of antisense oligonucleotides based on nucleic acid thermostability. 1267 72

The inability of herpes simplex virus (HSV) to spread throughout an infected host suggests that the host's immune defense against extracellular HSV is exceptional. Given the basic similarities between HSV and HIV it is reasonable to conclude that the extracellular defense against HIV is similarly potent. HIV hides from this extracellular defense. Because initial hiding place saturation is low, little HIV escapes and it is quickly annihilated. Later, as hiding place saturation increases, the numbers of released HIV increases and the immune system is ultimately overwhelmed. The fact that some perinatally infected infants clear the virus suggests that hiding place saturation is reversible. A critical hiding place re-supplies and increases saturation of other hiding places. The success of bone marrow transplants suggests that bone marrow is a critical hiding place of HIV. The sustained purge of the vulnerable critical hiding place results in a collapse of latency. Steps should be taken to: (1) determine precisely the location of the vulnerable critical hiding place; and (2) determine how to purge this class of cells, as it is purged by infants that clear the virus.
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PMID:A hypothesis on HIV and subsequent implications: effectiveness of 'extracellular defense'; pathogenesis; how the disease might be treated. 1269 28

Post-infectious glomerulonephrites (GNs) include a wide spectrum of nephropathies, with known etiological agent, bacterial, parasitic, viral. Among GNs secondary to bacterial infections, post-streptococcal GN is the most frequent; nevertheless, its incidence in developed countries has decreased during the last 20 years, while some of the characteristics such as types of infection, exposed subjects, clinical and evolutionary patterns have changed. Prognosis has worsened and is correlated with some clinical and histological parameters. The viral infection-related GNs include those associated with HBV, HCV, HIV plus other rarer forms. Membranous GN (MGN), membranoproliferative GN (MPGN) and IgA nephropathy may occur in the course of HBV infection, while different GNs can be detected in relation to HCV, the most frequent being mixed cryoglobulinemic GN, a MPGN with peculiar morphological features. Multiple glomerular involvements are seen from HIV infection, the more characteristic form being the so-called HIV associated nephropathy (HIVAN), a focal segmental glomerulosclerosis with tuft collapse affecting African subjects, which starts with a nephrotic syndrome and rapidly develops into uraemia. Other GNs derive from HIV-related immunecomplexes, some with diffuse proliferative characteristics, or lupus like, with less severe clinical manifestations compared with HIVAN. Among the rare viral infections, we ultimately, mention the association between Parvovirus B19 and "collapsing" focal segmental glomerulosclerosis.
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PMID:[Post-infectious glomerulonephritis]. 1274 5

HIV/AIDS has emerged as a grave public health threat in Central and Eastern Europe and in the Central Asian republics over the past five years. Massive political, social, cultural, and behavioural changes - along with economic upheaval and collapse of the public health infrastructure in many countries - have created circumstances conducive to the rapid spread of HIV. This paper reviews HIV and sexually transmitted disease (STD) data for all countries in the region, as well as behavioural, social, cultural, and other HIV epidemic enabling factors. The epidemiological picture of HIV in the region is mixed. Russia, Ukraine, Moldova and Belarus already have advanced epidemics. Some other countries in the region share similar enabling factors and have seen a very high proportion of their total number of HIV infections detected in only the past 18 months, indicating the emergence of recent epidemics. Several countries are more stable in their HIV incidence. Behavioural studies indicate that risky sexual and injection related practices are common in many vulnerable populations. HIV prevention steps, if taken quickly enough and on a large scale, can limit the scope of the HIV epidemic that is now unfolding in Central and Eastern Europe. This will require new models of government/non-governmental organization cooperation, policy approaches for addressing structural factors underlying the epidemic, and attention to human rights protection.
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PMID:The newest epidemic: a review of HIV/AIDS in Central and Eastern Europe. 1281 62


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