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

Acyclovir has become the treatment of choice for varicella-zoster virus (VZV) infections in immunocompromised individuals. This article describes a 4-year-old girl congenitally infected with human immunodeficiency virus who developed a continuous cutaneous infection with VZV that persisted over a 14-month period until her death. Initial episodes of varicella and zoster were responsive to acyclovir treatment; however, subsequent recurrences necessitated administration of multiple courses of acyclovir. Lesions became markedly hyperkeratotic, slow healing, and persistent despite acyclovir therapy. Numerous attempts to isolate virus from the lesions yielded only one isolate late in the course of therapy. This virus clearly demonstrated acyclovir resistance in vitro. Bizarre manifestations of VZV infection could present both diagnostic and therapeutic dilemmas. Prolonged acyclovir treatment of highly immunocompromised patients with acquired immunodeficiency syndrome and severe VZV may lead to the appearance of resistant virus.
JAMA 1988 Nov 18
PMID:Continuous varicella-zoster infection associated with acyclovir resistance in a child with AIDS. 318 52

The authors studied screening for the human immunodeficiency virus (HIV) at the St. Paul-Ramsey Medical Center in Minneapolis and its affiliated clinics when there were no restrictions on screening and recommendations were limited to patient consent and provision of risk reduction information. Only 10% of the tests performed met the criteria for screening--medically indicated, informed consent obtained, and counseling provided with all steps documented in the medical record. The authors maintain that education of health personnel about HIV, which was given at the Medical Center, may be insufficient to change ordering patterns. They suggest that clinicians' attitudes differ from public policy statements on HIV screening and urge the development of a community consensus encompassing public health officials, local medical associations, and hospital associations, to be translated into standardized guidelines.
JAMA 1988 Jan 08
PMID:Analysis of the use of HIV antibody testing in a Minnesota hospital. 327 10

Since Plasmodium falciparum malaria is a frequent cause of anemia among African children, and blood transfusions, unscreened for human immunodeficiency virus (HIV) antibody, are used frequently in the treatment of children with severe malaria, the relationships between malaria, transfusions, and HIV seropositivity were investigated in a pediatric population in Kinshasa, Zaire. In a cross-sectional survey of 167 hospitalized children, 112 (67%) had malaria, 78 (47%) had received transfusions during the current hospitalization, and 21 (13%) were HIV seropositive. Ten of the 11 seropositive malaria patients had received transfusions during the current hospitalization; pretransfusion specimens were available for four of these children and were seronegative. Of all blood transfusions, 87% were administered to malaria patients, and there was a strong dose-response association between transfusions and HIV seropositivity. A review of 1000 emergency ward records demonstrated that 69% of transfusions were administered to malaria patients, and 97% of children who received transfusions had pretransfusion hematocrits of 0.25 or less (less than or equal to 25%). The treatment of malaria with blood transfusions is an important factor in the exposure of Kinshasa children to HIV infection.
JAMA
PMID:The association between malaria, blood transfusions, and HIV seropositivity in a pediatric population in Kinshasa, Zaire. 327 15

The authors examine data on the risk of human immunodeficiency virus (HIV) infection in various low- and high-risk populations and in surgical personnel. They conclude that the risk of HIV infection to surgeons, nurses, and technicians using barrier precautions is of the same order of magnitude as the risk to sexual participants who use barrier precautions. Further, the authors assert that routine preoperative screening could be even more socially destructive than screening the general population because privacy will be more seriously compromised and because the occurrence of false-positive tests is probably higher in chronically ill patients than in healthy persons. They question whether it is rational or ethical to imply that preventing HIV infection in surgical personnel is more important than preventing such infection in others.
JAMA 1988 Mar 04
PMID:Routine preoperative screening for HIV. Does the risk to the surgeon outweigh the risk to the patient? 327 50

The authors review the literature on the accuracy of currently employed tests for human immunodeficiency virus (HIV) infection and urge improvements in standardization of procedures, mandatory proficiency testing, and licensing of clinical laboratories doing such tests. They discuss test use in several voluntary and mandatory situations; attendant problems of anonymity, confidentiality, and informed consent; and the need to consider ethical principles in defining, quantifying, and balancing the risks and benefits to the parties involved.
JAMA 1988 May 06
PMID:Human immunodeficiency virus test evaluation, performance, and use. Proposals to make good tests better. 328 84

The author contends that reliance cannot be placed on the law to protect the confidentiality of medical data and identity of persons infected with the human immunodeficiency virus (HIV). He demonstrates how the law may be used to compel, justify, tolerate, and excuse disclosure of information. Dickens argues that, rather than enacting further legislation in an attempt to protect confidentiality, laws against discrimination in education, employment, housing, insurance, and access to medical care should be strengthened and enforced in cases involving persons infected with HIV.
JAMA 1988 Jun 17
PMID:Legal limits of AIDS confidentiality. 328 16

Unscreened blood transfusions continue to be one of the major modes of transmission of the human immunodeficiency virus (HIV) in developing countries, such as in Central Africa, where 5% to 18% of blood donors are HIV seropositive. We evaluated a rapid latex agglutination assay using a novel recombinant envelope polypeptide of HIV for the detection of HIV antibodies among 2820 blood donors and clinical patients from diverse geographic regions, including on-site testing in Central Africa of 1600 blood donors. Overall, 29.2% of the serum samples were positive by Western blot assay. On a single determination, the latex agglutination slide test was found to be highly sensitive and specific compared with Western blot results in these populations with a relatively high prevalence of infection. Use of this assay will allow the immediate implementation of serologic screening for HIV in developing areas of the world, where standard screening procedures are impractical or not available, and in many other clinical settings, such as sexually transmitted diseases clinics and hospitals, where testing and counseling could be promptly implemented.
JAMA
PMID:Rapid latex agglutination assay using recombinant envelope polypeptide for the detection of antibody to the HIV. 329 May 24

Early diagnosis of acute human immunodeficiency virus (HIV) infection is difficult because patients may be seronegative for HIV at the time of presentation. We have used a serum HIV antigen (HIV-Ag) enzyme immunoassay (EIA) to diagnose acute HIV infection in four high-risk patients. The clinical syndrome in these four patients was characterized by fever (four), rash (three), myalgias-arthralgias (three), and pharyngitis (two). All patients had spontaneous resolution of their symptoms within eight to 12 days. Serum HIV antibody, as measured by a commercially available screening EIA and by Western blot analysis, was negative in all patients at time of presentation and all seroconverted on subsequent testing. Human immunodeficiency virus was isolated from two of two patients during the acute illness. Initial serum samples from all four patients were positive for HIV-Ag. Serum samples of three of four patients became negative for HIV-Ag and positive for HIV antibody. These data suggest that serum HIV-Ag detection by EIA may be useful in the diagnosis of the acute syndrome caused by HIV infection.
JAMA 1987 Sep 04
PMID:Diagnosis of human immunodeficiency virus infection in seronegative homosexuals presenting with an acute viral syndrome. 330 9

The authors were interested in determining the prevalence of human immunodeficiency virus (HIV) seropositivity in childbearing women from a population with a high incidence of AIDS. They collected cord blood samples from 602 newborns delivered at Brooklyn's Kings County Hospital Center, a facility serving an inner-city minority population. Twelve of the samples tested positive for HIV. In interviews, seven of the seropositive mothers revealed risk factors for AIDS, while five had no self-identified risk factors. The authors conclude that HIV infection of women of childbearing age in the inner cities is prevalent enough to justify offering HIV testing to all pregnant women in these areas. They suggest that hospitals throughout the country conduct serosurveys and use the information obtained to create counseling and testing programs for women of childbearing age.
JAMA 1987 Nov 20
PMID:Serosurvey of human immunodeficiency virus infection in parturients. Implications for human immunodeficiency virus testing programs of pregnant women. 331 62

As a result of increased screening of at-risk populations, obstetricians with limited experience with AIDS will find themselves caring for pregnant women infected with the human immunodeficiency viris (HIV). Minkoff, a physician affiliated with the Department of Obstetrics and Gynecology at the SUNY Health Science Center at Brooklyn, offers guidelines on the care of these patients. He reviews issues related to patient counseling and to the antepartum, intrapartum, and postpartum care of seropositive pregnant women.
JAMA 1987 Nov 20
PMID:Care of pregnant women infected with human immunodeficiency virus. 331 63


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