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

The mean whole blood selenium levels in male San Diego, CA patients with acquired immune deficiency syndrome (AiDS) are 0.123 +/- 0.030 micrograms/mL (n = 24), and 0.126 +/- 0.038 micrograms/mL (n = 26) in patients with AIDS-related complex (ARC), compared to 0.195 +/- 0.020 micrograms/mL (n = 28) in San Diego healthy controls (males). To establish whether intestinal absorption of dietary selenium is impaired in AIDS or ARC, a supplementation trial was conducted in which 19 symptomatic HIV-antibody positive male patients with AIDS or ARC were taking 400 micrograms of selenium/d in form of selenium yeast for up to 70 d. The mean whole blood Se levels increased to 0.28 +/- 0.08 micrograms/mL after 70 d of supplementation, the selenium supplements were well tolerated. A rationale for adjuvant selenium supplementation of symptomatic and asymptomatic HIV carriers is proposed.
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PMID:Selenium supplementation of symptomatic human immunodeficiency virus infected patients. 248 2

Between 1978 and 1980, 359 hepatitis B seronegative homosexual and bisexual men were recruited from the San Francisco municipal sexually transmitted disease clinic for hepatitis B vaccine trials. Of the 359 participants, 320 (89%) consented to have their stored blood samples tested for human immunodeficiency virus antibodies. The prevalence of human immunodeficiency virus infection in these 320 vaccine trial participants rose from 0.3% in 1978 to 50.9% in 1988. The annual incidence of human immunodeficiency virus infection showed that seroconversion peaked in 1980-1982, dropped significantly in 1983, and has remained low. Men less than 30 years old on entry into the study seroconverted earlier in the epidemic and had higher incidence rates than men 30 years or older (p = 0.07). No statistical difference in seroconversion rates was found for other demographic variables. Using a Kaplan-Meier survival curve of the cumulative proportion of men without acquired immunodeficiency syndrome by duration of human immunodeficiency virus infection, an estimated 39% (95% confidence interval 27%-51%) will develop acquired immunodeficiency syndrome within 9.2 years of infection. Cox proportional hazard stepwise analysis showed no correlation between age at seroconversion, race, or year of seroconversion and progression to acquired immunodeficiency syndrome.
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PMID:Prevalence, incidence, and progression of human immunodeficiency virus infection in homosexual and bisexual men in hepatitis B vaccine trials, 1978-1988. 253 43

Reports of an increased proportion of AIDS cases occurring in small and medium-sized cities suggest that the HIV epidemic may be spreading into locations that were previously characterized by their low HIV antibody prevalences. Studying the question of the geographic spread of the HIV infection epidemic (rather than the AIDS epidemic) has been difficult largely because most serial seroprevalence data have been gathered from cohorts of high risk individuals (e.g., homosexual/bisexual cohorts) in New York City, San Francisco, and other geographically circumscribed areas. The U.S. military applicant HIV screening data were used in the current report to examine rates and 24 month temporal trends in geographic areas characterized by their HIV endemicities. The data examined concern the seven most populous states and four hyperendemic metropolitan areas located within those states (New York City, Miami, Houston, and San Francisco). In the nonepidemic regions, seroprevalence rates increased among black and white applicants. In the four epidemic urban areas, only young black applicants had higher HIV seroprevalence rates during the second 12 month period. Six of the seven nonepidemic regions had positive HIV seroprevalence trends, and these trends were significant in Florida, California, Texas, Illinois, and Ohio. The increases in these regions were greater for young blacks (30% excess for year 2 vs. year 1) compared to young whites (12% excess for year 2 vs. year 1). These data provide evidence of birth year specific increases in seroprevalence over time occurring in presumed low HIV prevalence areas. These increases cannot be due to, but are observed in spite of, biases associated with increasing self-selection over time.
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PMID:Evidence for spread of the human immunodeficiency virus epidemic into low prevalence areas of the United States. 258 45

Transmission of the human immunodeficiency virus (HIV) and other blood-borne viruses in hospitals is discussed, and the infection control system and worker protection and education plan at San Francisco General Hospital (SFGH) are described. The acquired immunodeficiency syndrome (AIDS) epidemic has led to increased concern about occupationally acquired infections in health-care workers. As the number of HIV-infected persons increases, so does the risk of infection. Occupationally acquired HIV infection of health-care workers occurs principally in nurses, phlebotomists, and laboratory technicians through accidental subcutaneous injection of contaminated blood; splashing of blood onto open skin lesions, the eyes, and mucous membranes represents another route of exposure. The risk of infection from a single needle-stick exposure to HIV-infected blood is about 0.4%. Other blood-borne viruses to which employees are vulnerable include hepatitis B virus and human T-cell lymphotropic viruses, which may cause leukemia and lymphoma. SFGH has a comprehensive infection control system. Specimen containers are enclosed in transparent secondary containers, the worker is encouraged to wear protective clothing when necessary, and specific needle-stick precautions are promoted. There is also a health-care worker protection and education plan. The employee health services department provides immunizations, keeps records on accidental exposures, and operates a hot line. The education committee disseminates educational materials and arranges lectures. Infection control and education provide simple but effective measures for protecting hospital employees against HIV and other occupationally acquired infections.
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PMID:Infection of the health-care worker by HIV and other blood-borne viruses: risks, protection, and education. 261 Feb 20

As the epidemic of the acquired immunodeficiency syndrome (AIDS) expands, the prevalence of the human immunodeficiency virus (HIV) infection in health care environments will increase and health care workers in many locations are likely to be at increased risk for exposure. The Fifth Annual Advances in Occupational Cancer Conference, held in December 1988 in San Francisco, addressed occupational HIV infection. Symposium participants concluded that the risk of HIV infection for health care workers is low but not zero. Implementation of universal blood and body fluid precautions was agreed to as an appropriate method of preventing exposure to HIV, especially for preventing needlestick accidents. Current standards for hospital waste disposal were judged to be adequate to prevent transmission of HIV, and confidential testing for HIV antibody in health care workers with follow-up counseling was recommended where indicated. It was also agreed that the risk of occupational exposure to HIV does not free health care workers from the responsibility to provide care to infected persons.
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PMID:Occupational infection with human immunodeficiency virus (HIV). Risks and risk reduction. 264 24

We reviewed 92 published and unpublished studies of the prevalence of infection with the human immunodeficiency virus (HIV) among intravenous drug users (IVDUs) in the United States. Human immunodeficiency virus seroprevalence among IVDUs in drug treatment programs in the United States ranged from 0% to 65%. Seroprevalence was highest in the Northeast (10% to 65%) and Puerto Rico (45% to 59%); lower in the South Atlantic (7% to 29%) and in the metropolitan areas of Atlanta, Ga (10%), Detroit, Mich (7% to 13%), and San Francisco, Calif (7% to 13%); and 5% or less in other areas of the West, the Midwest, and the South. Among IVDUs seen in drug treatment programs, risk of infection was not associated with gender or age but was associated with black and Hispanic ethnicity, male homosexual orientation, and certain intravenous drug-use practices. Cross-sectional and cohort studies indicated increases in seroprevalence of between 0% and 14% per year among IVDUs in treatment. We estimated that between 61,000 and 398,000 IVDUs in the United States were infected with human immunodeficiency virus, or 5% to 33% of the IVDU population. High rates of infection among IVDUs in treatment in the Northeast indicate the potential for rapid spread in regions where rates are currently low. An urgent need exists to monitor human immunodeficiency virus infection levels and trends more widely and to develop effective programs to reduce the further spread of human immunodeficiency virus infection among IVDUs.
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PMID:Prevalence of HIV infection among intravenous drug users in the United States. 265 32

In this review, available human immunodeficiency virus (HIV) seroprevalence data are presented for United States women attending clinics related to reproductive health and for women in other settings. At family planning clinics, prenatal clinics, and in delivery room settings (cord blood testing), studies that have not targeted women at high risk for HIV infection have shown prevalence rates ranging from 0-4.3%. Higher rates (greater than 1%) have been observed in more urban areas--Newark, New York City, Baltimore, Miami, and San Juan; rates at settings outside these areas have generally been below 1%. Filter-paper testing for maternal HIV antibodies from neonatal heel-stick specimens has been conducted statewide in Massachusetts and New York; prevalence rates were 0.3% in Massachusetts in 1987, and 0.2% in upstate New York and 1.3% in New York City in 1987-1988. Prevalence rates of female military applicants and female blood donors are below 0.03% and 0.1%, respectively, and have been relatively stable over time. Where age data are available, prevalence rates are near 0 in women below age 20 years, are higher for young adult and early middle-aged women, and decline thereafter. Studies have also been conducted using blood samples from women undergoing premarital testing for syphilis serology, from women attending sexually transmitted disease clinics and drug treatment centers, and from patients at sentinel hospital sites. Information on the prevalence of HIV infection in United States women is useful to identify specific populations at risk for HIV infection and to target and evaluate education and prevention efforts.
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PMID:Review of human immunodeficiency virus infection in women in the United States. 268 15

The purpose of this investigation was to examine the risks of HIV transmission from artificial insemination in a sample of lesbians residing in California and inseminated between 1979 and 1987. This population was selected because lesbians are considered to be at low risk for HIV infection, and have traditionally used semen from men engaging in high-risk behaviors, namely, homosexual men. Each of the 98 participants had blood drawn for the HIV antibody test (ELISA) and completed a questionnaire inquiring about her sexual, health, and reproductive history, including detailed information about her inseminations (e.g., vaginal vs. uterine, fresh vs. frozen semen, sexual orientation, and antibody status of donor). One-half of the women had homosexual or bisexual donors, many of whom resided in the San Francisco Bay area; most of these inseminations were with fresh semen. The women reported a marked decline in the use of homosexual donors after 1982 and a corresponding increase in the use of donations from sperm banks and health practitioners. Based on the women's reports, as many as 11 women may have received semen from an infected donor. However, none of the 98 women tested seropositive. We attribute our negative findings to the change to low-risk donors in the years when HIV became more prevalent in the population, and to the potentially lower rates of infectivity with artificial insemination than with heterosexual intercourse. Nevertheless, we recommend that women continue to follow the CDC guidelines for screening donors prior to artificial insemination.
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PMID:HIV serology in artificially inseminated lesbians. 270 56

A group of 10 leukocyte and lymphocyte subsets were measured by simultaneous dual immunofluorescence and flow cytometry in a group of homosexual men from the San Francisco General cohort. Absolute numbers and percentages of lymphocytes were determined in 30 individuals who progressed to AIDS and 29 who did not over a 44-month period at annual intervals. At entry into the study, all subjects were asymptomatic, HIV seropositive, and had multiple changes in lymphocyte subsets compared to HIV-negative controls. In progressors, large changes occurred from the first visit to the last visit before progression in both absolute numbers and percentages of CD4 cells. The percentage of HLA-DR-bearing CD8 cells also increased. We utilized a proportional hazards model to assign a predictive value for progression to AIDS to lymphocyte subsets in both univariate and multivariate tests. Increased DR-positive CD8 cells, decreased CD4 cells, and increased CD8-positive, Leu 7-positive cells independently predicted progression to AIDS at P less than 0.006 (relative hazard 5.8-4.0). In a multivariate model, the most useful tests were either increased numbers or percentages of DR-positive CD8 cells. These data suggest parsimonious approaches to following HIV-positive individuals and further support the possibility of autoreactive T cells in the pathogenesis of HIV-associated diseases.
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PMID:Lymphocyte subset analysis to predict progression to AIDS in a cohort of homosexual men in San Francisco. 278 91

To determine the incidence of transfusion-associated human immunodeficiency virus (HIV) infection after routine screening of donated blood, a pilot study estimated the pretransfusion prevalence of HIV infection among blood product recipients in San Francisco. Among the 911 nonduplicate pretransfusion specimens from recipients without a clinical history of acquired immune deficiency syndrome (AIDS) or AIDS-related complex (ARC), the overall prevalence of antibody to HIV was 2.9 percent (5.2% among males and 0.6% among females; p = 0.00002). If recipients in specifically defined or possible high-risk groups (n = 348) were excluded, a seropositivity rate of 1.8 percent (10/563) was detected, with all the positives occurring in men (10/242, 4.1%) and none in women (0/321, 0%). This demonstrated prevalence of HIV infection among blood product recipients in San Francisco before transfusion was substantially higher than the known 0.02 to 0.04 percent prevalence in the donor population. Therefore, the population of women without known risk for AIDS is the best in which to assess the risk of HIV infection in patients who are currently receiving seronegative blood transfusions.
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PMID:Human immunodeficiency virus seroprevalence among blood product recipients in San Francisco before transfusion. 291 21


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