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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We assessed risk factors for human immunodeficiency virus (HIV) infection in 633 heterosexual intravenous drug users. The HIV seroprevalence was 26% in blacks, 10% in Hispanics, and 6% in whites. Intravenous cocaine use significantly increased the risk of HIV infection, with a seroprevalence of 35% in daily cocaine users (odds ratio, 6.4; 95% confidence interval, 3.0 to 13.3). Black subjects were more likely to use cocaine regularly. Drug use in shooting galleries and sharing of drug injection equipment were also associated with HIV infection and were more common in cocaine users. By multivariate analysis, black race, daily cocaine injection by blacks and Hispanics, all other cocaine injection, heavy use prior to entry into methadone treatment by blacks, and use of drugs in shooting galleries were independent predictors of HIV infection. Methadone therapy was associated with substantial reductions in heroin use and some reduction in cocaine use, but 24% of cocaine users receiving methadone began or increased cocaine injection after entry into treatment.
JAMA 1989 Jan 27
PMID:Cocaine use and HIV infection in intravenous drug users in San Francisco. 276 95

The latency period and/or incidence of the acquired immunodeficiency syndrome (AIDS) may differ in persons infected with the human immunodeficiency virus by different routes or having different "cofactors." We compared 79 hemophilic men in Pennsylvania and 117 homosexual and bisexual men in California, all having known dates of infection and long postinfection observation periods, to examine these hypotheses. By 1987, twenty-one percent of the hemophilic and 27% of the homosexual men had developed AIDS. However, seroconversion patterns differed for the two groups, and when this was taken into account, the conditional odds ratio for AIDS was 1.20. Kaplan-Meier survival analysis showed no significant difference in the cumulative proportion with AIDS, from time of infection. These results are limited by the small size and geographically localized nature of our study populations, but they suggest that currently the relative length of human immunodeficiency virus infection is of primary importance in comparing disease outcome for different populations.
JAMA 1989 Feb 03
PMID:Risk of developing AIDS in HIV-infected cohorts of hemophilic and homosexual men. 281 Jun 66

Intravenous drug users are the second largest group to develop the acquired immunodeficiency syndrome, and they are the primary source for heterosexual and perinatal transmission in the United States and Europe. Understanding long-term trends in the spread of human immunodeficiency virus among intravenous drug users is critical to controlling the acquired immunodeficiency syndrome epidemic. Acquired immunodeficiency syndrome surveillance data and seroprevalence studies of drug treatment program entrants are used to trace seroprevalence trends among intravenous drug users in the borough of Manhattan. The virus entered this drug-using group during the mid-1970s and spread rapidly in 1979 through 1983. From 1984 through 1987, the seroprevalence rate stabilized between 55% and 60%--well below hepatitis B seroprevalence rates. This relatively constant rate is attributed to new infections, new seronegative persons beginning drug injection, seropositive persons leaving drug injection, and increasing conscious risk reduction.
JAMA 1989 Feb 17
PMID:HIV-1 infection among intravenous drug users in Manhattan, New York City, from 1977 through 1987. 276 Oct 32

To determine the effects of human immunodeficiency virus (HIV) infection on pregnancy outcomes, we prospectively studied female intravenous drug users in a methadone program in New York City. Of 191 women with HIV status known prior to pregnancy, 17 (24%) of 70 seropositives and 26 (22%) of 121 seronegatives became pregnant during 28 months of follow-up. Including 54 additional women first tested for HIV antibody after becoming pregnant, 125 pregnancies were studied in 97 women (39 seropositive, 58 seronegative). None of the seropositive pregnant women had advanced HIV-related disease at entry, and only one developed symptomatic disease (oral candidiasis) during pregnancy. No differences were observed between groups in the frequency of spontaneous or elective abortion, ectopic pregnancy, preterm delivery, stillbirth, or low-birth-weight births. Among women giving birth to live infants, seropositives were more likely than seronegatives to be hospitalized for bacterial pneumonia during pregnancy and had an increased tendency for breech presentation, although these events were infrequent. There were otherwise no differences between groups in the occurrence of antenatal, intrapartum, or neonatal complications. Results suggest that asymptomatic HIV infection is not associated with a decreased pregnancy rate or an increased risk of adverse pregnancy outcomes in intravenous drug users, and that an acceleration in HIV-disease status during pregnancy is uncommon.
JAMA 1989 Mar 03
PMID:Prospective study of human immunodeficiency virus infection and pregnancy outcomes in intravenous drug users. 291 55

The prevalence of human immunodeficiency virus (HIV) infection was determined in women at the time of childbirth throughout New York State between November 30, 1987, and November 30, 1988. Mandatory blood specimens (276,609) obtained from all newborns were examined for HIV. The overall HIV seroprevalence rate was 0.66% (1816 newborns), with 0.16% in Upstate New York and 1.25% in New York City. Rates for newborns whose mothers were aged 20 to 29 years (1.30%) and 30 to 39 years (1.35%) were significantly higher than rates for those with mothers younger than 20 years of age (0.72%). Rates of seropositivity were higher among blacks (1.8%) and Hispanics (1.3%) than among whites (0.13%). Seropositivity of HIV was higher in zip code areas with high rates of drug use (2.2%) than in the rest of New York City (0.8%). It is estimated that more than 726 HIV-infected children were born in New York State during the 1-year study period, using 40% as the probable proportion of seropositives that will become infected.
JAMA
PMID:HIV seroprevalence in newborns in New York State. 229 84

Seventy-five homosexual men with lymphadenopathy syndrome (LAS) for three months or more and antibody against the human immunodeficiency virus were enrolled in a prospective study in Atlanta in 1982 and 1983. Fourteen developed the acquired immunodeficiency syndrome (AIDS) three to 38 months after enrollment in the study and five to 56 months after onset of LAS. The five-year cumulative incidence rate of AIDS after onset of LAS was 29%; yearly incidence rates showed no decreasing trend with time. Of 18 patients with constitutional symptoms and a low T-helper cell count at their first visit, nine developed AIDS; of the remaining 57 patients, five developed AIDS (five-year cumulative incidence rates, 57% and 18%, respectively, P less than .001). Patients with lymphadenopathy syndrome are at continuing risk for the development of AIDS. Those with constitutional symptoms and a low T-helper cell count at their first visit appear to be at higher risk; other LAS patients are at lower risk but may still develop AIDS.
JAMA 1987 Jan 16
PMID:Lymphadenopathy syndrome in homosexual men. Evidence for continuing risk of developing the acquired immunodeficiency syndrome. 294 32

Transmission of human immunodeficiency virus (HIV) is known to occur perinatally, through sexual contact, and after exposure to infected blood or blood products. The possibility that breast milk may transmit HIV continues to be evaluated. There is no epidemiologic evidence that contact with saliva, tears, or urine has resulted in HIV infection. However, because HIV has (in some cases rarely) been isolated from these body fluids, guidelines have been developed to reduce more extensive exposures to such secretions. Laboratory and epidemiologic data strongly indicate that HIV is not transmitted through immune globulin preparations, the hepatitis B vaccine, or contact with insects. Increasing evidence from many studies also indicates that HIV is not transmitted through casual contact. All individuals need to be aware of how HIV is and is not transmitted, to reduce high-risk behaviors and to avoid unnecessary fears and actions.
JAMA 1988 Mar 04
PMID:Do alternate modes for transmission of human immunodeficiency virus exist? A review. 296 51

Seventy-five homosexual men with generalized lymphadenopathy for at least three months (lymphadenopathy syndrome [LAS]), subsequently shown to be seropositive for antibody against human immunodeficiency virus, were enrolled in a prospective study in Atlanta in 1982 and 1983. As of Nov 30, 1987, twenty-two (29%) of the 75 were known to have developed acquired immunodeficiency syndrome (AIDS) three to 60 months after enrollment and five to 69 months after onset of LAS. The six-year cumulative incidence of AIDS, by Kaplan-Meier survival analysis, was 38%. The cumulative incidence in years 4, 5, and 6 (30%) was significantly higher than in years 1, 2, and 3 (11%), suggesting that the risk for AIDS increases after the third year of LAS and that many more study participants will eventually develop AIDS. A precipitous decline in the T-helper cell count frequently heralds the diagnosis of AIDS; this decrease appears to occur at different times after the onset of LAS in different persons. The four-year cumulative incidence of AIDS following observations of T-helper cell counts less than 200/mm3, 200 to 299/mm3, 300 to 399/mm3, and 400/mm3 or greater was 84%, 41%, 25%, and 18%, respectively; these data are important for determining prognosis in the individual patient as well as for determining the suitability of candidates and baseline data for drug trials.
JAMA 1988 Nov 11
PMID:A six-year follow-up of HIV-infected homosexual men with lymphadenopathy. Evidence for an increased risk for developing AIDS after the third year of lymphadenopathy. 297 46

Human immunodeficiency virus (HIV)-related thrombocytopenia has been well described and requires therapy in about one half of the patients. Conventional modes of therapy with prednisone, danazol, immunoglobulin, and/or splenectomy have not been uniformly successful. We have administered zidovudine to three patients with HIV-related thrombocytopenia. All three patients responded with a sustained increase in their platelet counts, despite discontinuation of conventional therapy. Interruption of zidovudine therapy was associated with a decrease in platelet count. Concomitant with the elevation in platelet count with zidovudine therapy, there was a reduction in the circulating p24 antigen levels. Whether the elevations in the platelet count in these patients with HIV-related thrombocytopenia is due to the antiviral effect of zidovudine is unknown. It is clear that further studies examining the prospective use of zidovudine in the treatment of HIV-related thrombocytopenia are indicated.
JAMA 1988 Nov 25
PMID:Treatment of human immunodeficiency virus-related thrombocytopenia with zidovudine. 297 51

A randomized, double-blind clinical trial of plasma-derived and DNA recombinant hepatitis B virus vaccines was conducted in 186 homosexual men. Nine months after the immunization series (three doses) began, the seroconversion rate in the plasma vaccine group was 88% (68/77); this was significantly higher than the 74% (60/81) response rate of the recombinant vaccine group. Men positive for antibody to the human immunodeficiency virus (HIV) had a considerably higher nonresponse rate to either vaccine than expected in non-HIV-infected homosexual men. The odds ratios of nonresponse to hepatitis B virus vaccine for HIV-seropositive vs HIV-seronegative subjects were 12.0 (95% confidence interval, 1.7 to 89.3) and 13.6 (95% confidence interval, 2.3 to 148.3) for the plasma and DNA recombinant vaccines, respectively.
JAMA
PMID:Comparative immunogenicity of plasma and recombinant hepatitis B virus vaccines in homosexual men. 297 31


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