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

AIDS and other expressions of HIV infection continue to present ever-increasing challenges to the health professions, including dentistry. Patients with oral manifestations of HIV disease present or are referred to dental practitioners for the diagnosis and treatment of their oral lesions. This review briefly summarizes the management approaches currently adopted at the Oral AIDS Center, University of California, San Francisco.
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PMID:Management of the oral lesions of HIV infection. 191 83

The immune response to the p24 core antigen of human immunodeficiency virus type 1 (HIV-1) was studied in serial samples collected prospectively from 52 homosexual males in two separate cohorts from Amsterdam and San Francisco. p24 antibody levels were quantified with an antigen sandwich immunoassay using p24 recombinant antigen as capture and probe. Titers and slopes of dilution curves reflecting antibody affinity were analyzed. Only 45 of 52 men developed a measurable primary immune response to p24. In 17 (33%) patients there was a low response with maximum antibody titer below 66, shallow (low affinity) dilution curve, and 10 of the 17 became HIV antigen positive over a 2 year period. In 24 (46%) of the 52 patients titers ranged from 100-4000, steeper dilution curves were noted, and none became HIV antigen positive. Four (8%) men developed a strong immune response with high titers (greater than 12,000) and high affinity type dilution curve. Over time, after the peak immune response, antibody titer declined in some individuals related in part to the formation of immune complexes between HIV-1 p24 antigen and antibody which were dissociable. In vitro, the addition of increasing amounts of purified p24 antigen corresponded to decreasing antibody titer and a shallower dilution curve suggesting a preferential consumption of high affinity antibodies for complex formation. The magnitude of immune response to HIV-1 p24 antigen varies widely in infected homosexual men. Both the intrinsic ability to mount an immune response and immune complex formation contribute to the measurable antibody level.
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PMID:Immune response to HIV p24 core protein during the early phases of human immunodeficiency virus infection. 193 Dec 33

We examined geographic and racial/ethnic variation in acquired immune deficiency syndrome (AIDS) incidence in homosexual and bisexual men (i.e., men who report sex with men: MSWM) not using i.v. drugs in the United States. The AIDS incidence in these men has continued to increase in the United States. Incidence increased much less rapidly after 1986 in the three metropolitan statistical areas (MSAs) with the most cases, New York City, Los Angeles, and San Francisco, and may have reached a plateau in these areas. This change in incidence occurred in non-Hispanic black and Hispanic MSWM as well as in non-Hispanic whites in these MSAs, but earlier in whites. There have been similar changes in incidence (but later in time) in all other MSAs with a population of at least 1,000,000 combined, with more tendency toward a plateau in whites than in non-whites. In contrast, incidence increased linearly through 1989 in MSAs with a population less than 1,000,000 and in rural areas, with no change in trend after 1986. Changes in human immunodeficiency virus (HIV) infection incidence before 1985, better therapy and medical care, and migration all contributed to these changes in incidence, as may have changes in reporting. Continued HIV seroconversions among MSWM show that efforts to prevent HIV infection must be continued in all areas of the United States.
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PMID:The geographic and ethnic diversity of AIDS incidence trends in homosexual/bisexual men in the United States. 194 25

Although treatment of HIV infections is possible, anecdotal data and research suggest that infected homosexual and bisexual men are developing sets of HIV-specific self-care behaviors that they believe will maintain their health or delay progressive disease. However, little is known about frequent use of HIV self-care in relationship to symptom distress or other factors commonly assessed by nurses. These deficits limit the ability of healthcare providers to intervene appropriately. Consequently, the following repeated-measures study retrospectively examined correlates of HIV self-care in 162 outpatients who were attending a major healthcare facility in San Francisco, CA. Standard and HIV-specific instruments created for the study were used in data collection. Results suggest that the men increased their use of 35 of 81 HIV self-care behaviors once they became aware of being HIV seropositive (p less than 0.001). Frequent use of HIV self-care behaviors was related to several variables, including previous patterns of self-care (p less than 0.001), and AIDS diagnosis (p less than 0.01), and a locus of control (LOC) indicator (e.g., the statement "What happens to me is beyond my control") (p less than 0.001). Symptom distress also was related to several variables, including selected LOC and quality-of-life (QOL) indicators, mood states, and recent diagnosis of selected AIDS-related diseases (p less than 0.01). Collectively, these results suggest that taking self-care and selected psychosocial histories will allow nurses to identify ambulatory patients with HIV infections who need intensive care.
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PMID:Potential correlates of self-care and symptom distress in homosexual/bisexual men who are HIV seropositive. 194 64

Studies in a Baltimore emergency room identified the patient with penetrating trauma as having the highest incidence of Human Immunodeficiency Virus Type I (HIV-1) infection. Anonymous testing over a 15-month period of 165 victims of penetrating trauma presenting to the Medical Center Hospital Emergency Center (San Antonio, Texas) revealed a 0% incidence of HIV-1. This data suggests that HIV-1 trauma patient incidence can be expected to vary between specific geographic areas and patient populations served, independent of community-wide AIDS incidence.
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PMID:Surveillance for HIV antibody and antigen in trauma patients. 195 74

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

Little information is available regarding the risk of human immunodeficiency virus type 1 (HIV-1) infection for patients transfused before routine anti-HIV-1 screening of blood donors was instituted in March 1985. A model was developed for estimating both the proportion and the number of transfusion recipients in the San Francisco Bay area who were infected by HIV-1 during each of the 7 years preceding routine donor screening for anti-HIV-1. The model is based on analysis of 1) donation histories of HIV-1-infected donors identified at the regional blood center; 2) HIV-1 seroprevalence estimates for homosexual and bisexual men in San Francisco; and 3) HIV-1 infection and survival rates for recipients traced by the Transfusion Safety Study and Irwin Memorial Blood Centers' Look Back Program. The incidence of transfusion-associated HIV-1 infection is estimated to have risen rapidly from the first occurrence in 1978 to a peak in late 1982 of approximately 1.1 percent per transfused unit. The decrease after 1982 coincided with the implementation of high-risk donor deferral measures. It is estimated that, overall, approximately 2135 transfusion recipients were infected with HIV-1 in the San Francisco region alone. This number suggests a higher prevalence of transfusion-associated HIV-1 infection than has been generally recognized and indicates the need for continued tracing of potentially exposed recipients. The data also strongly support the effectiveness of early donor education and self-exclusion measures and emphasize the importance of continued research and development in this area.
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PMID:Risk of human immunodeficiency virus (HIV) transmission by blood transfusions before the implementation of HIV-1 antibody screening. The Transfusion Safety Study Group. 198 62

We examined data from San Francisco and other areas participating in the Surveillance, Epidemiology, and End Results (SEER) Program to determine the effect of the human immunodeficiency virus (HIV) epidemic on cancer incidence between 1973 and 1987. In this period, non-Hodgkin's lymphoma incidence has increased over 10-fold and Kaposi's sarcoma incidence has increased over 5000-fold in single San Francisco men 20 to 49 years of age. Increases in non-Hodgkin's lymphoma have been restricted to high-grade and diffuse large-cell (intermediate-grade) histological types. With the exceptions of non-Hodgkin's lymphoma and Kaposi's sarcoma, no other tumor has significantly increased in incidence. During 1987, we estimate that HIV-seropositive men in San Francisco had a 0.47% risk of developing non-Hodgkin's lymphoma and a 1.6% risk of developing Kaposi's sarcoma. The relative risks for non-Hodgkin's lymphoma and Kaposi's sarcoma associated with HIV infection were 104 and 40,000, respectively. For 1987, HIV was associated with 14% of all reported cancers (except non-melanoma skin cancer) in men aged 20 to 49. We expect that 1,890 to 2,730 excess cases of non-Hodgkin's lymphoma and 6,490 to 8,320 excess cases of Kaposi's sarcoma will occur in the United States in 1990.
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PMID:Increasing incidence of cancers associated with the human immunodeficiency virus epidemic. 200 49

Observation of an essentially linear growth in time of U.S. and New York City AIDS cases, from about 1984 through early 1988, is shown to imply a relatively constant rate of transmission of HIV infection in its early stages, as has been observed for limited times in cohorts of male homosexuals in San Francisco and New York City. Observation by Potterat et al. of an exceptionally close intertwining of spatial and social patterns of endemic gonorrhea within a minority population, coupled with a percolation process model of HIV transmission within geographically constrained social networks, leads to inference that a constant rate of HIV transmission, in turn, implies a 'surface growth' phenomenon resulting in a traveling wave of infection advancing at a fixed 'velocity' along a 'one dimensional socio-geographic network.' Implications of this view are discussed for both data collection and analysis, and for intervention. Differences for the processes of disease transmission and control, based on the relative stability of socio-geographic networks, are postulated between the ghettoes of the middle-class male homosexual community and the physically devastated and socially distintegrated ghettoes of the minority urban poor.
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PMID:Traveling waves of HIV infection on a low dimensional 'socio-geographic' network. 202 80


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