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

Dehydroepiandrosterone (DHEA) and its interconvertible sulfate derivative (DHEA-S) are human androgenic steroids that have been reported to inhibit viral expression and have been associated with a decreased risk of cancer. The relationship between serum DHEA and DHEA-S levels and subsequent progression to AIDS was investigated in a sample of human immunodeficiency virus (HIV)-infected men from the San Francisco Men's Health Study followed prospectively since 1984. Among 108 men seropositive for HIV at study entry and with CD4 lymphocyte counts of 200-499 microliters 24 months later, serum DHEA levels below the lower limit of normal (less than 180 ng/dl) at this later date were predictive of subsequent progression to AIDS (relative hazard = 2.34; 95% confidence interval = 1.18-4.63; P = .01) after controlling for hematocrit, age, and log absolute CD4 cell number in a Cox proportional hazards model. This is the first large prospective cohort in which an endocrinologic variable has been observed to independently predict progression to AIDS. These observations, in addition to recent in vitro data, suggest that DHEA might have a protective effect in HIV infection.
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PMID:Decreased serum dehydroepiandrosterone is associated with an increased progression of human immunodeficiency virus infection in men with CD4 cell counts of 200-499. 168 93

Early intervention guidelines in HIV infection require knowledge of CD4+ lymphocyte count; however, CD4+ determinations require special laboratory procedures and may not be readily available in all situations. Using data from 207 HIV-seropositive homosexual men without AIDS, we evaluated the association of difference clinical conditions or serologic tests with CD4+ count. Men with conditions including seborrheic dermatitis, hairy leukoplakia, oral candidiasis and chronic diarrhea, and men with beta2-microglobulin levels greater than or equal to 4.0 mg/l had significantly lower CD4+ counts. However, the probability that a subject with such parameters had less than 200 x 10(6)/l CD4+ cells was limited (25-63%). Although the probability that a subject with such parameters had less than 500 x 10(6)/l CD4+ cells was better (76-88%), the probability that a person without these parameters had greater than or equal to 500 x 10(6)/l CD4+ cells was only 45-50%. Clinical and serologic parameters may provide important prognostic information, but cannot be used to reliably determine the level of CD4+ cells.
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PMID:The association of clinical conditions and serologic tests with CD4+ lymphocyte counts in HIV-infected subjects without AIDS. 168 78

To evaluate whether host genotype influences disease progression among persons infected with human immunodeficiency virus type 1 (HIV-1), molecular techniques were used to determine genotypes at immune response loci for 114 HIV-1-infected homosexual/bisexual white men in the San Francisco Men's Health Study. Candidate genes evaluated were HLA-DQA1 and -DRB1, complement C4A and C4B, alpha- and beta-interferons, and the heavy chain of immunoglobulin gamma 1. Of the 114 men, 29 were asymptomatic, 21 were symptomatic men and AIDS patients (p = 0.02). Specifically, the HLA haplotype DRB1*0702-DQA1*0201 was associated with absence of symptoms (p = 0.003). Conversely, the frequency of the complement C4B-L allele was higher among patients with symptoms or with AIDS than among asymptomatic subjects (p = 0.02). These results suggest that genes in or near the major histocompatibility complex may influence the rate of disease progression among HIV-1-infected men.
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PMID:Influence of host genotype on progression to AIDS among HIV-infected men. 185 93

The apparent detection of human immunodeficiency virus (HIV-1) DNA by the polymerase chain reaction (PCR) in seronegative individuals has been the subject of great concern. In this study, 324 seronegative participants in the San Francisco Men's Health Study were evaluated for evidence of infection using a PCR testing algorithm with multiple amplifications targeting different regions of the HIV-1 genome. While most PCR reactions were negative, 8.6% of the specimens showed weak reactivity with one or more primer sets. However, all were negative with at least one primer set and no definitively positive specimens were identified. This study addressed the possibility that some of these PCR reactions might represent latent infection or abortive exposure, leaving residual integrated DNA, rather than false-positive reactions. The frequency of such reactions was determined in homosexual men who have been at risk for HIV-1 infection and in exclusively heterosexual men who have little or no past exposure. The results demonstrate an identical frequency and distribution of equivocal PCR reactions in both populations. Assuming that there is minimal HIV-1 infection among seronegative heterosexual men in San Francisco, we conclude that PCR testing does not provide evidence for a reservoir of occult HIV-1 infection in seronegative homosexual men.
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PMID:An evaluation of the polymerase chain reaction in HIV-1 seronegative men. 185 94

2 research studies of changes in condom use among homosexual males in San Francisco for the period 1984-88 are discussed. The 1st study examined attrition and cohort bias effects on self-reported condom use in a longitudinal cohort and multiple sample investigation. An initial baseline sample of 500 self-identified gay men was sampled and interviewed by telephone as the longitudinal cohort, with 3 cross-sectional samples later surveyed for comparison. The frequency of receptive or insertive anal intercourse with and without condoms with primary and secondary sex partners was queried for the 30-day period prior to the survey in both studies. This 1st study found a 4-fold increase in condom use over the period 1984-87 to be neither effected by repeated assessments of the longitudinal cohort, nor respondent attrition. As determinants of condom use in this population for the period 1984-88, the 2nd study examined the influence of formal and informal social support for sex behavior change, being in a mutually monogamous sexual relationships, knowing the primary partner's HIV-antibody status, knowing one's antibody status, and the expected consequences of condom use on one's self-worth, sexual pleasure, health, and perceptions of one's sex partner. Research was based on AIDS Behavioral Research Project data obtained through recruitment in bathhouses and gay bars. 529 predominantly white, while collar, college-educated men of mean age 39 years remained in the study through 1988. While condom use increased by almost 4-fold, these men have been slower to change condom use behavior than respondents in the 1st study. Informal support and knowing one's HIV status are strong predictors of condom use 1 year later. Men always using condoms were found to have more social support from informal sources, more positive expectations of condoms, positive interpersonal and personal consequences, and were more likely to be HIV-positive than occasional or non-users. Programs best suited to effect condom use changes will focus on social support, sexual pleasure, self-worth, and relationship issues. Attention should also be placed upon the erotic/pleasure dimension of using condoms, changing community norms, and factors influencing HIV-negative people to take precautions against HIV infection. Methodological limitations are discussed regarding result reliability and validity, with further research encouraged.
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PMID:Changes in condom use among homosexual men in San Francisco. 187 91

Researchers took blood samples from 4228 adults aged 15 years in The Gambia to determine the prevalence of HIV-2 infection and risk factors. HIV-2 infection was more prevalent than HIV-1 infection. HIV-2 prevalence stood at 39% for females and 31% for males, but the difference was insignificant. Individuals 25 years old were more likely to be HIV-2 seropositive than those 25 (p.01). Further, HIV-2 prevalence was significantly higher in the small towns of Soma and Farafenni on the Trans-Gambia Highway than other areas of the country (p.01; 3.2% vs. 1.3% for Greater Banjul and 1.4% for the remainder of the country). It also was greater for people who had their blood samples taken at a health center than those who gave theirs elsewhere (p.01). HIV-2 infection was more prevalent for people born in Guinea- Bissau and in the Manjago tribe which originated from Guinea-Bissau than those born in The Gambia or elsewhere (p.025 for place of birth and p.01 for tribe). Marital status played an insignificant role in seropositivity for men, but divorced and widowed women had a significantly greater infection rate than other women (p.001; odds ratio [OR] 10.4 vs. 1-20). Further, infection significantly increased as the number of husbands women had had increased (p.05; OR 6.8). HIV- 2 positivity was significantly higher among women who reported using a condom at least once during the past year with casual partners (p.01; OR 16.7). Skilled manual laborers, businessmen, and traders were more likely to be infected with HIV-2 than farmers, unskilled laborers, and while collar men (p.05). Men with at least a secondary education were at significantly lower risk than men with less than a secondary education (p.01; OR .1 VS. .7-1.6). Men who had had at least 2 cases of urethral discharge had a significantly higher infection rate than those who did not (p.005; OR 4.8 vs. .8-1).
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PMID:Risk factors for HIV-2 infection in The Gambia. 193 Jul 76

Current efforts to control the spread of AIDS in the US are lacking for a variety of reasons. Pattern 1 male homosexual transmission has seen a significant drop because of education and prevention campaigns within the gay community. Pattern 2 heterosexual/maternal-fetal transmission has seen a significant increase because of a lack of effective programs to directly address this particular subepidemic. The AIDS deaths for women 15-44 have increased 75% over 3 years. Neonatal infection rates of 1.0-2.4% are common in metropolitan hospitals. The best method of serving this need is the sexual self-defense(SSD) concept. This program incorporates changing heterosexual women's attitudes an perceptions about risk, and changing their behavior so that they universally use double barrier protection for all sexual activity. Double barrier protection includes condoms and spermicides like nonoxynol-9. The biggest obstacle has been a failure by women to see their risk factor properly. Another problem has been the Bush administration's failure to properly frame the problem. The Presidential Commission on The Human Immunodeficiency Virus lists hemophiliacs over bisexuals an IV drug users as risk groups. Studies has shown that 50% of HIV-infected women attending family planning clinics do not associate their sexual behavior with high risk. Thus voluntary testing for HIV could be missing 50% of the infected women because they do not consider themselves at risk and thus do not get tested. Another problem stems from the fact that condom use is very low in primary relationships. Men may use condoms when they see prostitutes, but will not use them with their girlfriend. This behavior exemplifies the misperception of risk. Just as the defensive driving program got people to drive safely, SSD must get people to have sex safely. It is the responsibility of the government to educate the people about SSD, just as the surgeon general educated people about the risks of smoking in 1964.
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PMID:Sexual self-defense versus the liaison dangereuse: a strategy for AIDS prevention in the '90s. 193 Nov 42

Heterosexual contact with drug users is a major route of AIDS transmission. This study of 135 male and 109 female methadone maintenance patients described subjects' sexual behavior, preventive practices and attitudes toward safer sex; explored ethnic-racial differences in high risk sexual behavior and attitudes; and examined the relationship between attitudes toward safer sex and frequency of condom use for men and women. Reported condom use was low, and it correlated with attitudes toward safer sex. Men tended to report higher rates of sexual risk-taking, although women reported more frequent sex with IV drug users. Study findings have implications for developing intervention strategies to reduce risk behavior associated with HIV transmission.
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PMID:Sexual behavior, attitudes toward safer sex, and gender among a cohort of 244 recovering i.v. drug users. 196 4

We assessed the immunopathologic role of circulating immune complexes in human immunodeficiency virus infection by evaluating the data base and the serum bank of the San Francisco Men's Health Study, a longitudinal clinical and epidemiological investigation conducted since 1983. A group of 4,276 sera from 1,023 (including 811 homosexual/bisexual) men were tested for circulating immune complexes. We used a modification of the commercially available enzyme immunoassay test, based on monoclonal anti-C1q antibodies coupled to the solid phase, for capturing circulating immune complexes from the test serum, followed by detection of circulating immune complexes with either anti-IgG or with anti-IgM probes. Although persistent IgM and IgG circulating immune complexes were most frequently encountered in human immunodeficiency virus-seropositive homosexual/bisexual men, they were not an indicator of disease progression as assessed by abnormalities in the absolute numbers or ratios of CD4- and CD8-positive T cells, or clinical signs and symptoms of AIDS/ARC.
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PMID:Persistent immune complexes and abnormal CD4/CD8 ratios in HIV infection. 196 8

The effect of cigarette smoking on CD4+ T lymphocytes was investigated in the San Francisco Men's Health Study cohort. The cohort was established by probability sampling in 1984 to study infection with HIV. Smoking showed an association with increased CD4+ cell counts in all men but the effect was attenuated in HIV-seropositive men (85 cells/microliter difference in median counts, non-smokers compared with smokers) compared with HIV-seronegative men (230 cells/microliter difference in median counts). The positive dose response between packs smoked per day and CD4+ counts observed in uninfected men was substantially reduced in infected men (slope 87 versus 27 cells/microliter). Analysis of data from HIV seroconverters suggest that smokers' counts fall faster than non-smokers' following infection, and that response to smoking becomes less pronounced soon after infection. This report demonstrates that those who monitor CD4+ cell counts in HIV-infected individuals for clinical and/or research purposes should also consider smoking status.
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PMID:HIV infection, cigarette smoking and CD4+ T-lymphocyte counts: preliminary results from the San Francisco Men's Health Study. 197 21


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