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

This study evaluates genetic influence on susceptibility to perinatal HIV-1 infection among 106 Black infants from New York and San Francisco born to mothers infected with HIV-1. Genes tested by molecular techniques are HLA class II loci DRB1, DPB1 and DQA1; HLA class III loci complement C4A and C4B; alpha and beta interferons; and the constant region of the T-cell receptor beta chain. Of the 106 infants analysed, 54 are infected with HIV and 52 remain uninfected at age 15 months and older. Genotypes in the HLA region appear to influence risk of HIV infection. Specifically, infants with the amino acid sequence -asp-glu-ala-val- at DPB1 positions #84-87 are more likely to be infected (P = 0.001) and infants with the allele DQA1*0102 are less likely to be infected (P = 0.031). Combinations of these two risk factors show a strong dose response (P = 0.0005). HLA DPB1 and DQA1 may play a direct role in immune response associated with HIV-1 infection, or the critical region may be located between these two genes. Characterisation of other class II HLA genes in these infants will allow more precise determination of the role of HLA loci in susceptibility to HIV-1 infection.
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PMID:Genetic risk factors for perinatally acquired HIV-1 infection. 158 23

Estimating the current prevalence of human immunodeficiency virus (HIV) and projecting the future incidence of AIDS require that trends in incidence be analyzed and interpreted. We analyzed AIDS incidence trends in the United States by exposure category and selected demographic factors. In 1987, the trend in United States AIDS incidence changed as growth in the number of cases diagnosed per quarter began to decline. The slowing in growth is due in large part to a plateau in quarterly incidence in men who have sex with men in the New York City, San Francisco, and Los Angeles metropolitan statistical areas (MSAs), and in injecting drug users in the New York City MSA and New Jersey. Incidence has also reached a plateau in both adult/adolescent and pediatric blood and blood product recipients. Quarterly U.S. AIDS incidence was roughly constant during 1990, but appears to have increased to a higher level during the first half of 1991. The variation in incidence trends among subgroups suggests that several factors have affected the trend in total incidence and that the burden of severe symptomatic HIV disease may be shifting.
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PMID:Changes in AIDS incidence trends in the United States. 158 89

The back-calculation method has been used to estimate the number of HIV infections from AIDS incidence data in a particular population. We present an extension of back calculation that provides estimates of the numbers of HIV infectives in different stages of infection. We model the staging process with a time-dependent Markov process that partitions the HIV infectious period into the following progressive stages and/or substages: stage 1, infected but antibody negative; substages 2-3; antibody positive but asymptomatic; substages 4-6, pre-AIDS symptoms and/or abnormal haematologic indicator, stage 7, clinical AIDS. We also model an eight stage, decreased due to AIDS. The model allows for time-dependent treatment effects that slow the rate of progression in substages 4-7. We use the estimated AIDS incubation period distribution for the Markov model in back calculation from AIDS incidence data to estimate the total number of HIV infections and the parameters of the infection probability distribution. We then use these estimates in the Markov model to estimate the stage-specific numbers of HIV infections over the course of the epidemic in the population under study. Example calculations employ data for epidemic in San Francisco City, Clinic Cohort.
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PMID:Estimating the stage-specific numbers of HIV infection using a Markov model and back-calculation. 159 20

Data from the 1989 Communication Technologies cross-sectional survey of gay men in San Francisco indicate that both levels and correlates of sexual risk are different between younger and older gay men. Gay men under the age of 30 report higher risk behavior for human immunodeficiency virus (HIV) infection than do gay men who are 30 years of age or older. Further, the set of correlates of unprotected anal intercourse are different between younger and older gay men. Both young and old gay men report that having a primary partner and a lower perceived impact of the AIDS epidemic on their sexual behavior are associated with risk. However, among young gay men, reporting a lower attributed risk for HIV infection to unprotected anal intercourse, higher concern about AIDS risks, and shorter length of residence in San Francisco are positively correlated with risk-taking behavior. These associations were not statistically significant among gay men 30 years of age or older. It appears that the circumstances and/or reasons for taking sexual risk are different between older and younger gay men. Prevention programs must be designed so that they are sensitive to the needs of each generation of gay men.
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PMID:A comparison of younger and older gay men's HIV risk-taking behaviors: the Communication Technologies 1989 Cross-Sectional Survey. 161 66

This study examined the impact of social support and HIV-related conditions on depression among 508 gay men participating in the San Francisco Men's Health Study, a population-based prospective study of single men aged 25-54 years. The number of HIV-related symptoms experienced significantly predicted depression cross-sectionally and 1 year later. Satisfaction with each of three types of social support (emotional, practical, informational) was inversely correlated with depression. Men who were more satisfied with the social support they received were less likely to show increased depression 1 year later. Degree of satisfaction with informational support appeared especially critical in buffering the stress associated with experiencing HIV symptoms. These findings offer valuable insight in understanding the psychological needs of gay men confronting the AIDS crisis and have important practical implications for designing mental health services to meet those needs.
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PMID:Social support, AIDS-related symptoms, and depression among gay men. 161

Neurological complications may occur even before immunosuppression is clinically observed, and can thus reveal HIV infection. Aseptic meningitis, subacute encephalitis, vacuolar myelopathy, inflammatory myopathy, and different types of polyneuropathies seem to be associated with HIV, but their pathogenesis has only recently begun to be understood. These complications must be distinguished from opportunistic infections and from intra-cerebral tumors with which they often coexist. The Sixth International Conference on AIDS in San Francisco has defined the extent and limits of our present knowledge, and has given new directions for research in this last, but not least important chapter of modern neurology.
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PMID:[Neurological complication of human immunodeficiency virus infection]. 164 74

We studied the natural history of herpes simplex virus (HSV) infection and its association with specific serum antibody in a sample of 68 HIV-infected patients with a first episode of Pneumocystis carinii pneumonia at San Francisco General Hospital in 1986. Seroprevalence was 66 and 77% for HSV-1 and HSV-2 antibody, respectively, by immunoblot assay. Twenty-seven patients had 45 HSV outbreaks diagnosed during 739 patient-months of follow-up. Median frequency of recurrence resulting in a medical visit was once every 6.5 months, and median duration of treated outbreak was 10 days. Fourteen of 48 evaluable patients seropositive for HSV-2 had no outbreak of HSV during a median follow-up of 7.5 months. Our data suggests that neither frequency nor severity of HSV were substantially increased in this group of patients, despite severe immunosuppression caused by HIV. However, validation of these results by a prospective study is required.
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PMID:Clinical and serologic features of herpes simplex virus infection in patients with AIDS. 165 40

From the San Francisco Men's Health Study (SFMHS) and the San Francisco General Hospital Cohort we derived partially population-based estimates of zidovudine (ZDV) use in San Francisco from 1987 to 1989. Data from the SFMHS alone were used to make estimates of aerosol pentamidine (AP) use in 1989. From 1987 to 1989, zidovudine use increased from 36 to 68% in participants with AIDS. In participants with symptomatic HIV infection without AIDS and in those with less than 200 CD4 cells, ZDV use increased initially but then leveled off (from 6 to 25% and 24 to 55%, respectively). Zidovudine use with more than 500 CD4 cells increased from 0.5 to 4%. In 1989 AP use with less than 200 CD4 cells was 42% and with AIDS was 44%. Whereas 50% of participants with AIDS and less than 200 CD4 were using both ZDV and AP, only 14% of those without AIDS but with less than 200 CD4 cells were using both. Surprisingly few members of these cohorts are using therapies proven effective in reducing the morbidity and mortality of HIV infection.
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PMID:Population-based estimates of zidovudine and aerosol pentamidine use in San Francisco: 1987-1989. 167 79

We evaluated and compared four staging classification systems for HIV infection in a population-based cohort: (1) a staging based on prodromal clinical criteria; (2) the Walter Reed Staging Classification (WRSC); (3) the immunologic staging system (ISS), and (4) a simple staging based on oral disease and CD4+ T-cell depletion. The staging systems were applied to 386 HIV-infected men in the San Francisco Men's Health Study cohort who did not have AIDS at the baseline examination. After 48-56 months of follow-up the cumulative incidence of AIDS and the cumulative mortality by stage was determined for each staging. Unlike the other systems, the WRSC could not classify a substantial proportion of HIV-infected men (51.9%). The WRSC and ISS include one or more stages which did not appear to be associated with a prognosis substantially different from that of adjacent stages. The simplified staging system based on CD4+ T-cell depletion and oral disease may be the most effective of the systems studied. A more complete understanding of the pathophysiology during the evolution of HIV infection will be required to define a more detailed staging of this disease.
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PMID:The natural history of HIV-1 infection: staging classifications of disease. 167 78

A summary of events at the Second International Conference for Non-Governmental Organizations working on AIDS, held in Paris November 1-4, 1990 is presented with comments on the effectiveness of arrangement, planning and sessions. The meeting was fraught with obstacles, the worst of which was a change of venue from San Francisco to Paris at the last minute, with serious consequences to speakers whose U.S. travel funds had to be found elsewhere. The goal of the conference was to facilitate international networking among AIDS Service, national and regional organizations. To this end 44 sessions were held informally. Plenary sessions were marked by moving presentations of such items as an international memorial quilt, and topics such as how children and women are affected by HIV, and how human rights abuses are often unseen. The need for solidarity among NGOs was stressed by Dr. J. Mann, who noted that NGOs perform up to half the health care in some countries. The major substance of the conference was 5 Seminar tracks of 5.5 hours duration on the topics of services and care, education and prevention, drugs and treatment, human rights, and organizational development. Human rights recognized internationally were described, but in some places lack of resources makes them a privilege. Illegal drug programs, decriminalization and research on cultural obstacles were within the broad range of issues addressed under services and care. While traditional symptomatic treatments and older drugs such as gentian violet as a treatment for candidiasis are being developed in African countries, serious social problems arise when people sell their possessions for a few doses of AZT or Kemron there. In the seminars on organizational development useful exchanges between major donors and project organizers explored professional methods of applying for grants, as well as accounting for funds spent later. ICASO the International Council of AIDS Service Organizations was ratified and a meeting in Florence in June 1991 was authorized, with reservations of those who felt that regional cooperation is needed even more. Problems and incidents marked other aspects of the meeting, from lack of translators, photocopiers, accommodations, refreshments, and late starting to an ill-timed demonstration during the last Plenary session address of Dr. Mann by ACT-UP France. Larger problems of balance of interests and priorities, and whether there are too many AIDS conferences must also be approached.
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PMID:Policies for solidarity. A personal view of the Second International Conference for non governmental organizations working on AIDS, Paris 1-4 November 1990. 167 73


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