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

The risk of human immunodeficiency virus (HIV) transmission was studied by interviewing and testing the serum of heterosexual contacts and casual family contacts of adults with transfusion-associated HIV infections. Two (8%) of 25 husbands and ten (18%) of 55 wives who had had sexual contact with infected spouses were seropositive for HIV. Compared with seronegative wives, the seropositive wives were older (median ages, 54 and 62 years; P = .08) and actually reported somewhat fewer sexual contacts with their infected husbands (means, 156 and 82; P greater than .1). There was no difference in the types of sexual contact or methods of contraception of the seropositive and seronegative spouses. There was no evidence of HIV transmission to the 63 other family members. Although most husbands and wives remained uninfected despite repeated sexual contact without protection, some acquired infection after only a few contacts. This is consistent with an as yet unexplained biologic variation in transmissibility or susceptibility.
JAMA 1988 Jan 01
PMID:Risk of human immunodeficiency virus transmission from heterosexual adults with transfusion-associated infections. 333 72

Dicroceliasis is an unusual zoonotic trematode infection caused by the lancet liver fluke, Dicrocoelium dendriticum. Grazing herbivores (usually sheep or cattle) are the definitive hosts. The life cycle proceeds through two intermediate hosts: the land snail and the field ant. Human infection is acquired by consuming the field ant. This case report describes a human immunodeficiency virus-seropositive patient who presumably acquired this parasite from bottled water contaminated with ants. A brief discussion of the parasitology, pathology, clinical findings and treatment is presented.
JAMA
PMID:Dicroceliasis (lancet fluke disease) in an HIV seropositive man. 333 79

Through Sept 30, 1987, two thousand fifty-nine patients with acquired immunodeficiency syndrome (AIDS) and no recognized risk factors were reported to the Centers for Disease Control. Risk history was incomplete or unobtainable for 921 (45%) of them. Risk factors were ultimately identified for 825 (72%) of the remaining 1138. Another 32 persons (3%) did not meet the case definition for AIDS. Risk factors could not be identified for the remaining 281 patients (25%), despite additional information. Of these, 178 (63%) were interviewed with standard questionnaires; 38% reported sexually transmitted diseases and 34% of the men reported sexual contact with prostitutes. There was no evidence for new transmission modes. Although the proportion of AIDS patients with undetermined risk factors has increased significantly during the past year, the adjusted proportion shows no significant change over time. Thus, follow-up of AIDS patients with no apparent risk factors suggests that modes of transmission for human immunodeficiency virus have remained stable.
JAMA 1988 Mar 04
PMID:Investigations of AIDS patients with no previously identified risk factors. 333 38

In 1987 the authors conducted a survey of practices and policies concerning human immunodeficiency virus (HIV) antibody testing at 189 United States hospitals with infectious disease fellowship programs and at 160 short-term care Minnesota hospitals. The survey questions pertained to HIV antibody test ordering policies, specific physician education programs about the HIV antibody test, informed consent to testing, specific HIV antibody test consent forms, and providing patients with risk reduction information. The marked differences in the handling of test results raise concerns about confidentiality. Because of significant policy differences among hospitals revealed by the survey, the authors urge that a consensus be sought that would provide guidance on the issues raised at both state and national levels.
JAMA 1988 Mar 25
PMID:Human immunodeficiency virus antibody testing. A description of practices and policies at US infectious disease-teaching hospitals and Minnesota hospitals. 334 89

We report four patients with antibodies to human immunodeficiency virus and/or acquired immunodeficiency syndrome who were noted to have unique vascular lesions that clinically resembled Kaposi's sarcoma or pyogenic granulomas. The lesions were asymptomatic erythematous-violaceous papules and nodules. They erupted over several weeks, without predilection for a specific cutaneous site. Most lesions resolved spontaneously. Histologically these lesions revealed a proliferation of vascular spaces lined by plump, cuboidal endothelial cells embedded in an edematous stroma with an inflammatory infiltrate. It is unclear if these lesions represent Kaposi's sarcoma or pyogenic granulomas or if they are distinct neoplasms associated with human immunodeficiency virus.
JAMA
PMID:Unique vascular skin lesions associated with human immunodeficiency virus. 338 9

Results of voluntary, anonymous human immunodeficiency virus (HIV) antibody testing and counseling offered to all patients attending a sexually transmitted disease (STD) clinic showed that men who refused testing were 5.3 times more likely to be infected than men who accepted testing, and that male homosexuals and black and Hispanic men who refused testing were even more likely to be infected than their counterparts who accepted testing. The prevalence of HIV infection in persons refusing HIV testing was determined in a retrospective, blinded study using stored serum specimens originally drawn for syphilis testing. It is recommended that HIV testing and counseling should be routinely offered to STD clinic patients; male STD clinic patients who refuse voluntary HIV testing should be counseled about reducing their risk for HIV transmission.
JAMA 1988 Aug 19
PMID:Comparison of HIV-antibody prevalence in patients consenting to and declining HIV-antibody testing in an STD clinic. 339 98

We analyzed the association of herpes simplex virus (HSV) infection and syphilis, the two most common causes of genital ulceration in homosexual men, with human immunodeficiency virus (HIV) infection in 200 men enrolled between 1983 and 1986 into a study evaluating the microbial causes of acute proctitis. Infection with HIV was independently associated with a history of syphilis, serologic evidence of syphilis, a history of HSV infection, and antibody to HSV-2. Antibody to HIV was not associated with a history of other genital infections or with antibody to Chlamydia trachomatis or HSV-1. Similar associations were observed in 111 asymptomatic homosexuals seen for HIV screening. Men who presented with primary HSV proctitis had a lower prevalence of HIV antibody than those with preexisting HSV-2 antibody (44% vs 68%); this suggests that HSV-2 infection antedated HIV infection. These data suggest that genital ulcerative diseases are an important risk factor for the acquisition of HIV infection in homosexual men; measures directed at control of these diseases may reduce the transmission of HIV in this population.
JAMA 1988 Sep 09
PMID:The association between genital ulcer disease and acquisition of HIV infection in homosexual men. 340

To estimate the cost of hospital care for children infected with the human immunodeficiency virus (n = 37) at Harlem Hospital Center, New York, a cost-based inventory of medical resource consumption was developed. Six thousand thirty-five inpatient days were audited by retrospective chart review. The total cost of care between 1981 and 1986 was +3,362,597. Average lifetime costs were +90,347 per child. One third of the total inpatient days and over 20% of the cost resulted from social rather than medical factors. Per diem costs were highest for children with opportunistic infections (+705) and lowest for homeless "boarder babies" (+466). Boarder babies had a mean length of stay nearly four times longer than those with homes (339 days vs 89 days). The primary predictors of length of stay were maternal intravenous drug use and boarder baby status, regardless of medical need. The unique needs of human immunodeficiency virus-infected children require innovative medical, social, and financial solutions.
JAMA 1988 Oct 07
PMID:The medical care cost of human immunodeficiency virus-infected children in Harlem. 341 51

Stimulated by reports that some children who are seropositive for human immunodeficiency virus (HIV+) have been abandoned in the hospital, we studied the extent of, and reasons for, medically unnecessary hospital use at Yale-New Haven (Conn) Hospital among HIV+ children. We reviewed inpatient stays for all HIV+ children hospitalized through Oct 31, 1987. Hospital days were judged to be unnecessary if they failed to meet any of the criteria on the Pediatric Appropriateness Evaluation Protocol. Among 34 children eligible for the study, 54% of their hospital days were judged medically unnecessary; 59% of the children had at least one such day. Unnecessary use was 100% for one-day stays (all for gamma-globulin infusions) and 58% for stays longer than three weeks, with 94% of those unnecessary days being secondary to placement problems. The rate of unnecessary days has declined from 64% of all hospital days in 1983 and 1984 to 30% in 1987 as a result of improved outpatient services and access to foster care. Improved medical and social services could substantially reduce the cost of medically unnecessary hospital care in HIV+ children.
JAMA 1988 Oct 07
PMID:Medically unnecessary hospital use in children seropositive for human immunodeficiency virus. 341 52

The acquired immunodeficiency syndrome was first recognized as a clinical entity in the United States in the early 1980s; however, the issue of when human immunodeficiency virus, the causative agent of the acquired immunodeficiency syndrome, was introduced into at-risk populations in the United States is unresolved. Previously, we reported the case study of a 15-year-old black male who was admitted to St Louis City Hospital in 1968 for extensive lymphedema of the genitalia and lower extremities. Chlamydial organisms were widely disseminated and isolated from numerous body fluids and organs. Over a 16-month clinical course his condition progressively deteriorated, and at autopsy there was widespread Kaposi's sarcoma of the aggressive, disseminated type. Recently performed Western blot and antigen capture assays on serum and autopsy tissue specimens frozen since 1969 have disclosed that this sexually active teenager was infected with a virus closely related or identical to human immunodeficiency virus type 1. The clinical and immunologic findings together suggest that an immunosuppressive retrovirus existed in the United States before the late 1970s.
JAMA 1988 Oct 14
PMID:Documentation of an AIDS virus infection in the United States in 1968. 292 59


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