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

Much attention has recently been given to the serious health implications of AIDS, hepatitis B infection and the human papillomavirus. In spite of these, syphilis/gonorrhea are still the most common of the "old" sexually transmitted diseases (STDs) and syphilis is, with the exception of AIDS, the STD with potentially the most destructive sequelae. Recent observations indicate that syphilis may be an important cofactor in facilitating transmission of HIV. A history of syphilis or a positive serologic test for syphilis is associated with HIV seropositivity in men. Although the incidence of syphilis in the UK is 1 of the lowest in the world, syphilis is increased in most countries. In several areas of the US there has been a dramatic increase in the prevalence of syphilis and in some first-world areas congenital syphilis is now considered epidemic. Syphilis is considerably more common in Africa than in Europe/US. Syphilis is also prevalent in most developing countries. The worldwide resurgence of syphilis has a serious implication on neonatal morbidity. The aim of this study was to evaluate the seroprevalence of syphilis in men attending and infertility clinic. Blood samples from 782 males were screened using the titrated RPR/TPHA tests. If either of these tests was positive, FTA-Abs IgG was performed. The RPR was positive in 63 (8%) cases. In 24 (3%) patients the titer was or= 1/8 with positive TPHA and FTA-Abs IgG tests and these were regarded as current infections. 39 (5%) cases had RPR titers 1/8 with positive specific tests (Table 1). These were probably patients either treated inadequately, or in the early stage of primary syphilis. In addition 92 (2%) patients were RPR negative but TPHA and FTA positive. This was evidence of previous exposure to syphilis. The overall seropositivity in this group was 20% (155 cases). 627 (80%) tested negative with RPR and TPHA. Syphilis may still have a major impact on health in Southern Africa. Since syphilis is significantly associated with HIV seropositivity, efforts to prevent and control syphilis may also be important in limiting HIV spread. The 3-8% incidence of active disease among an asymptomatic group of men, referred for evaluation of infertility underlines the statement that "serologic screening should be done at the least indication". A community-based program with continuous adequate screening and treatment would be of great help. While the absolute yield for such screening may be low, the potential for reducing the morbidity and mortality of congenital syphilis is great. (full text)
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PMID:Syphilis serology in men at an andrology clinic in South Africa. 1234 7

The 153-327 million new cases of treatable sexually transmitted diseases (STDs) each year are a critical health problem and are increasingly associated with transmission of HIV infections. There is strong epidemiological evidence that STDs (especially HIV-1 and genital ulcer diseases such as syphilis, herpes, and chancroid) increase a person's ability to transmit or acquire an HIV infection. In addition, HIV may alter the clinical presentation, natural history, diagnosis, and responsiveness to therapy of STDs; and STDs may alter the natural history of HIV infection by inducing immunosuppression, by chronic immune stimulation, or by direct viral interactions. Most reports on HIV infection and syphilis document neurological manifestation of syphilis in HIV-1 infected individuals. HIV-1 may modify an individual's response to syphilis infection, producing more persistent and higher RPR titres, increasing the likelihood of losing reactivity to treponemal tests correlating with advanced HIV disease, and increasing biological false-positive reactions. HIV also appears to reduce the responsiveness of chancroid to standard therapy, especially single-dose therapy, thus requiring multiple-dose therapy over 5-7 days. Herpes simplex viral infections are more frequent and severe in HIV-infected individuals, but dosage adjusted acyclovir therapy is effective in most patients. Gonorrhea does not appear to be affected by the presence of HIV infection, except that HIV-infected women may be more susceptible to cervical gonococcal infection and pelvic inflammatory disease. The clinical presentation of human papilloma virus, however, is altered by HIV infection as is the rate of recurrence and the responsiveness to standard therapy. Because of the recognition of the interaction of HIV and STDs, STD control is now recognized as an essential component of HIV prevention programs. Parallel prevention campaigns, such as condom promotion, could reduce both.
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PMID:HIV and STDS: how are they linked? 1234 49

Transfusion of blood and blood products is a widely used method for therapy in medicine, however it may result with the transmission of infectious agents from donor to recipient. In order to achieve safe blood transfusions and to minimize post-transfusion infections, several screening tests for infectious agents are routinely done all around the world as well as in our country. In this study, HBsAg, anti-HCV, anti-HIV and syphilis reagin antibody tests results have been retrospectively evaluated for 33.766 blood donors during January 1, 1997 to December 31, 2000 in Blood Center of Farabi Hospital, Black Sea Technical University. Testing for HBsAg, anti-HIV and anti-HCV has been done by using commercially available micro and/or macro enzyme immunoassays, and syphilis reagin antibody test by latex agglutination (RPR) method. The indeterminate results were confirmed by retesting of sera with microparticle enzyme immunoassay and Western blot methods. As a result, in 1331 (3.94%) subjects HBsAg, in 250 (0.74%) subjects anti-HCV, and in 161 (0.47%) subjects RPR were found positive. Twenty samples which have had the results in gray-zone for anti-HIV, have been found negative with the confirmation tests.
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PMID:[Retrospective evaluation of HBsAg, anti-HCV, anti-HIV and syphilis reagin antibody seropositivity in blood donors at the Trabzon Farabi Hospital]. 1247 71

Blood transfusion is an important mode of transmission of infections to the recipient. The aim of the study was to assess the prevalence of transfusion transmissible infections and the possible risk factors among blood donors. During the study period (1994-99) donor samples were screened for HBsAg, HIV, HCV and Syphilis. The relevant donor history was examined to identify the risk factors leading to transfusion transmissible infections. The prevalence of infection was 3.1% among donors, with HBsAg constituting 1.3%, HCV 1.4%, HIV 0.2% and RPR 0.2%. In a classification based on occupation, class III donors (drivers, Businessmen & men in uniform) showed a significantly higher incidence of transfusion transmissible infections for HIV (0.38%) and Syphilis (0.36%). Health care workers constituted only a small fraction of the study; prevalence of infections was low among them. History of jaundice or hospitalization was not associated with higher incidence of seropositivity. Seropositivity for HIV is relatively low compared to similar studies conducted in other regions of the country. This finding is attributed to the pre donation counseling in donor selection. An important outcome of the study is that Class III donors form a high-risk group for transfusion transmissible infections.
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PMID:Profile of transfusion transmissible infections and associated risk factors among blood donors of Kerala. 1278 75

Consequences of syphilis for mother, pregnancy, fetus and child are considerable, but preventable. Serological screening must be offered at the first prenatal visit, using both a treponemal (eg. TPHA) and a non treponemal (eg. VDRL or RPR) test. When the results are compatible with any type of active syphilis, treatment is required. The treatment of choice is penicillin: benzathine penicillin G, 2.4 million units intramuscular, repeated one week later, and most authors recommend a third dose if a late latent syphilis is suspected, or in case of coinfection with HIV. Women with a proven penicillin allergy can be desensitized. Alternative therapies, such as macrolids, are less well evaluated. Follow-up during and after therapy must not be neglected. In case of Jarisch-Herxheimer reaction, the mother should be managed on an inpatient basis, and the fetus carefully monitored. The VDRL should be repeated (usually every trimester), and therapy be renewed if there is not a significant decrease in titer. The fetus should be followed by serial ultrasound examinations. Finally, the child must be followed up clinically and biologically, and treated in case of congenital syphilis. The residual risk of adverse outcome is increased in case of reinfection, lack of maternal therapy or incomplete treatment, or when diagnosis and therapy are performed late in pregnancy.
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PMID:[Syphilis and pregnancy]. 1510 74

The objective of this prospective pilot study was to evaluate the response of HIV-infected patients with asymptomatic syphilis to one of two intensive antibiotic treatment regimens. Thirty-one HIV-infected patients with serum rapid plasma reagin titre > or =1:4 and no clinical findings of syphilis were randomized to receive daily intramuscular injections of ceftriaxone or procaine penicillin (plus oral probenecid) for 15 days; 24 returned for follow-up study. Seven of 10 (70%) procaine penicillin-treated patients and 10 of 14 (71%) ceftriaxone-treated patients had a > or =4-fold decline in RPR (P=0.94); two penicillin-treated and one ceftriaxone-treated patient relapsed. Two patients failed ceftriaxone therapy. Three penicillin-treated, and two ceftriaxone-treated patients were serofast. Serological responses were similar in those patients with and without asymptomatic neurosyphilis. There was no difference in the serologic response to daily treatment with ceftriaxone vs that with procaine penicillin plus probenecid; both treatments were associated with comparatively high rates of serological non-response and relapse.
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PMID:Response of HIV-infected patients with asymptomatic syphilis to intensive intramuscular therapy with ceftriaxone or procaine penicillin. 1511 3

The appropriateness of sentinel sero-surveillance based upon ante-natal clinic (ANC) attendees to estimate HIV-1 prevalence in the general population has been questioned. In Ethiopia, where the population is heterogeneous and where economic and practical barriers to ANC attendance exist, problems of extrapolation may be exacerbated. We planned an unlinked anonymous sero-survey which included data on basic population characteristics to investigate whether sero-surveillance data from ANCs in Afar Region might be taken to represent the situation among the general population of the Region. 371 pregnant women attending Dubti Hospital and Assayta Health Centre were tested for HIV-1 (using a single ELISA test) and active syphilis (RPR test). Socio-demographic characteristics were collected for each woman. Of the women tested, 278 (75%) were 28 years of age or younger. Two hundred eighty (76%) were urban residents and 237 (64%) described themselves as being of Amhara ethnicity. Overall, 73 (19.7%) were HIV-1 positive, but prevalence was three times higher among the 237 women of Amhara ethnicity compared to the 112 of Afar ethnicity (24.9% vs 8.0%, p < 0.001), and almost three times higher for urban compared to rural residents (23.2% vs 8.8%, p < 0.001). Positive RPR results were strongly associated with HIV-1 infection (OR 3.37, 95% CI 1.47-7.71). According to the Demographic and Health Survey (DHS) 2000, only 4.5% of the population of Afar Region is of Amhara ethnicity, and 7.8% urban residents. We have demonstrated that basing ANC sero-surveillance in urban areas of Afar Region over-samples urban residents of Amhara ethnicity and yields a major over-estimation of overall HIV-1 prevalence for the Region. Reliable estimation of HIV-1 prevalence in Afar Region will require more flexible strategies that permit sampling of rural Afar residents.
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PMID:Overall HIV-1 prevalence in pregnant women over-estimates HIV-1 in the predominantly rural population of Afar Region. 1522 80

Sexually transmitted disease (STD) remains a major public health challenge in developed countries, exacerbated by the advent of the HIV epidemic. The objectives of this study were to assess the prevalence of serological markers of syphilis, HIV-1/2, HTLV-I/II, HBV, and HCV infections among immigrant sex workers in Madrid, Spain and to characterize the HIV-1 variants in seropositive individuals. Sera from 762 immigrant commercial sex workers (75.3% from sub-Saharan Africa, 18.2% from South America, and 6.4% from Eastern Europe) were collected between 1998 and 2003 in Madrid and examined. Antibody detection was performed by screening assays (RPR, ELISAs) and confirmed by FTA-Abs, LIAs and Western-blot tests. HIV-1 subtyping was carried out by phylogenetic analyses of the protease and envelope genes. Antibodies to HIV-1 were found in 5.2%, while 3.5% tested positive for HBsAg, 3% for syphilis antibodies, 0.8% for HCV antibodies, and 0.2% for HTLV-I antibodies. None were reactive for HIV-2 or HTLV-II antibodies. HIV-1 seroprevalence among Africans and Ecuadorians was 4.5 and 10.9%, respectively. All HIV-1 seropositive Ecuadorians were transsexual men, and 28.6% had active syphilis infection. Up to 80% of HIV-1 positive specimens were characterized as non-B subtypes, with subtypes G, A, and G/A recombinants being the most frequent among African individuals. In contrast, South Americans with HIV-1 infection carried exclusively subtype B variants. A relatively high proportion of immigrant sex workers in Madrid were infected with HIV-1 and syphilis, whereas infections with hepatitis viruses or HTLV were uncommon.
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PMID:Prevalence of HIV-1 non-B subtypes, syphilis, HTLV, and hepatitis B and C viruses among immigrant sex workers in Madrid, Spain. 1548 70

The prevalence of HIV has been continually increasing both in urban and rural Ethiopia. As yet, there has been no report on the magnitude of the problem in the elderly and rural population. This study assessed the seroprevalence of HIV and syphilis infection among 706 elderly and predominantly rural subjects in Northwest Ethiopia. Socio-demographic information was collected using a structured questionnaire. Venous blood was collected and the serostatus of HIV and that of syphilis were checked by ELISA and RPR, respectively. The total HIV-1 seroprevalence was 5% (35/706). Sex-specific prevalences of HIV for males and females were 5.6 and 4.7% respectively. A 4.2% difference in prevalence was observed by area of residence, which was statistically significant, P = 0.018. Only 6% of subjects positive for syphilis were also positive for HIV, while 4.9% of subjects negative for syphilis were positive for HIV. The data indicates that the prevalence of HIV among elderly people in Northwest Ethiopia was high. This indicates the importance of involving the elderly in HIV/AIDS prevention and control programs.
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PMID:HIV and syphilis infection among elderly people in northwest Ethiopia. 1562 52

A cross-sectional group of 1548 blood donors (voluntary--554 and replacement--994 blood donors) during the period February 2001 to April 2003 at Blood Bank Centre (being run by Nepal Red Cross Society) in our Teaching Hospital in Bhairahawa, were studied and screened for antibodies to Human immunodeficiency virus type 1 and type 2 (HIV- 1 & 2), Hepatitis C virus (HCV) and hepatitis B surface antigen (HBsAg) by enzyme immunoassays and for reagin antibody for syphils by (Rapid Plasma Reagin, RPR) flocculation method. The results revealed that the overall prevalence of anti-HIV-1 was 0.13%, anti-HCV--0.13%, HBsAg positivity--0.45% and RPR reactivity for syphilis was 0.39%. HIV and HCV seropositivity was 0.20% and 0.20% respectively among replacement blood donors. None of the voluntary blood donors were found to be seropositive for HIV and HCV antibodies. HBsAg seropositivity was found to be higher among replacement (0.50%) than voluntary blood donors (0.36%). Voluntary blood donors showed a higher RPR seropositivity (0.72%) than replacement blood donors (0.20%). Males constituted 1418 (91.6%) and females were 130 (8.4%) of the total blood donors studied. The highest numbers of blood donors were in the age group of 15-29 years, both for males 902 (58.27%) and females 96 (6.2%). All the seventeen seropositive cases for all the infectious disease markers studied belonged to the sexually active and productive age group of 15-45 years and all seropositives were males except one female case (i.e HBsAg positive). One blood donor was found to be seropositive for both HIV-1 and HCV infections. None was found to be seropositive for HIV-2. Blood group status was also examined for all the blood donors tested. Maximum numbers of blood donors belonged to blood group O--516 (33.33%), followed by B 497 (32.11%), A 407 (26.29%) and AB 128 (8.27%). None of the seropositive blood donor was found to belonged to blood group AB.
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PMID:Status of infectious disease markers among blood donors in a teaching hospital, Bhairahawa, western Nepal. 1579 11


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