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

Human immunodeficiency virus, type 1 (HIV), seroprevalence studies are needed to determine the level and trends of HIV infection among women attending family planning, abortion, and prenatal care clinics in the United States. A review of published and unpublished studies showed that HIV seroprevalence among women attending women's health clinics was 0 to 2.6 percent, although the studies were difficult to compare because of differences in methodology. The Centers for Disease Control, in association with State and local health departments, has developed a standardized protocol to determine HIV seroprevalence among women attending women's health clinics in selected metropolitan areas. Blinded HIV serosurveys (serologic test results not identified with a person) are being conducted annually in selected sentinel clinics in order to obtain estimates of HIV seroprevalence unbiased by self-selection, as well as to monitor trends in infection among clients attending these clinics. In areas with high HIV seroprevalence, nonblinded serosurveys (in which clients voluntarily agree to participate) will be used to assess behaviors that may place women at increased risk of exposure to HIV. Data from the surveys can be used in developing age-specific and culturally appropriate AIDS educational materials, assessing the amount and type of counseling activities required, and evaluating acquired immunodeficiency syndrome (AIDS) prevention activities. The information will provide epidemiologic data to complement the results of other surveys in characterizing the scope of HIV infection among women of childbearing age in the United States.
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PMID:Determining HIV seroprevalence among women in women's health clinics. 210 57

In 1988 to 1989, 698 adult cadavers in Abidjan's two largest morgues were studied, representing 38 to 43% of all adult deaths in the city over the study period, and 6 to 7% of annual deaths. Forty-one percent of male and 32% of female cadavers were infected with human immunodeficiency virus (HIV). Fifteen percent of adult male and 13% of adult female annual deaths are due to acquired immunodeficiency syndrome (AIDS). In Abidjan, AIDS is the leading cause of death and years of potential life lost in adult men, followed by unintentional injuries and tuberculosis. In women, AIDS is the second leading cause of death and premature mortality, after deaths related to pregnancy and abortion. AIDS-specific and AIDS-proportional mortality rates may be higher in other African cities where AIDS has been found for a longer time than in Abidjan.
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PMID:AIDS--the leading cause of adult death in the West African City of Abidjan, Ivory Coast. 216 15

Over a period of 3 years (mean 16, extremes 3 and 36 months), we compared clinical and laboratory parameters of 128 female, human immunodeficiency virus (HIV)-infected patients, all in clinical stage II or III (CDC classification). 34 patients were pregnant and delivered a viable infant after at least 28 weeks of amenorrhea (group I), 29 patients were pregnant and had a spontaneous or induced abortion during the first or second trimester (group II), and 64 were non-pregnant female control patients (group III). The changes in the clinical stages over time were not statistically significant between the groups. The only laboratory parameters that were significantly higher in group I at the time of the delivery were: leucocyte count (p less than 0.001), lymphocyte count (p less than 0.05), and sedimentation rate (p less than 0.001). These changes are known to be related to pregnancy and not to HIV disease. All other laboratory parameters showed no significant differences within and between the groups. We conclude, that pregnancy--carried to term or interrupted--does not aggravate the natural evolution of HIV infection in clinical stage II and III patients.
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PMID:Influence of pregnancy on human immunodeficiency virus disease. 222 65

In response to the finding of human immunodeficiency virus (HIV) infection rates of 1-5% among pregnant women in areas where high-risk behaviors are widespread, the Centers for Disease Control and the American College of Obstetricians and Gynecologists are recommending that reproductive-age women at risk of HIV infection be tested. Although this policy was formulated to facilitate informed reproductive decision making, there is--at this point--little evidence that knowledge of HIV serostatus is having a significant impact on decisions about pregnancy. Data from New York City indicate that HIV-positive women become pregnant at a rate similar to that for seronegative women and are no more likely to abort. It appears that cultural and psychosocial factors exert a more important influence on decisions about pregnancy than the possibility of perinatal transmission and acceleration of the disease process in the mother. In many cases, the 50% risk of having an uninfected infant makes continuation of the pregnancy an acceptable risk. Many women are not diagnosed as HIV-seropositive until the 2nd trimester of pregnancy, when abortion is more difficult to accept as an option. Many black women equate abortion with genocide, while others oppose abortion on religious grounds. In some cultures, a woman is not considered "complete" until she has a child, and the male partner may exert significant pressure to continue with the pregnancy. Infected intravenous drug users are likely to have faulty judgment and be unable to follow through with either abortion or prenatal care. Finally, even when HIV-infected women do choose to abort, they often face barriers in obtaining services and discrimination from health care facilities. It is essential that physicians are aware of these complexities and learn more about the underlying causes of reproductive decisions on a case-by-case basis.
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PMID:Influence of human immunodeficiency virus infection on reproductive decisions. 224 92

Women infected with the human immunodeficiency virus (HIV) face a 20-30% risk of transmitting the virus perinatally and 25-30% of infected infants die before 2 years of age. The phenomenon of growing numbers of HIV-infected women in the US raises complex ethical questions about the individual rights of these women to reproductive freedom versus the societal goal of reducing the spread of acquired immunodeficiency syndrome (AIDS). Proposed is a model for assessment of the ethical dimensions of reproductive choices comprised of 4 elements: 1) the ability and willingness of parents to assume proper responsibility for the child, 2) the magnitude of the threatened harm, 3) the probability that harm will actually occur, and 4) the burden that parents must assume to avert the threatened harm. The risks of perinatal HIV infection lie on the margins of societal acceptability, yet careful moral scrutiny is called for on a case-by-case basis. Use of the above model would suggest justification for an asymptomatic women recently infected with HIV, married to an uninfected man who is committed to raising a child with the help of a large extended family, and opposed to abortion, to continue with her pregnancy. On the other hand, the model would not support continuation of pregnancy in the case of a homeless drug addict in poor health whose previous children have been placed in foster care. Also problematic is determination of the type of counseling that should be provided to HIV-positive women. Most appropriate at this time appears to be a moral education model of nondirective counseling aimed at providing support to a woman's choice after she has pondered all the ethical dilemmas posed by reproduction.
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PMID:HIV and childbearing. 2. AIDS and reproductive decisions: having children in fear and trembling. 226 23

Anticardiolipin (aCL) antibodies were assessed in isotypes IgG, IgM and IgA by the enzyme immunochemical technique in serum of 86 subjects with diffuse connective tissue affections and in 75 subjects of three control groups (syphilis, syndrome of common variable immunodeficiency and blood donors). In systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and syphilis the mean values of the three isotypes of aCL antibodies were significantly higher than in blood donors (p = 0.05 to 0.001); in diffuse scleroderma and primary polymyositis/dermatomyositis in isotype IgG (p = 0.01-0.001). Positive findings of aCL antibodies (isolated or in combinations of Ig isotypes (were found most frequently in SLE (34.4%), RA (33.3%) and syphilis (66.6%); sera of blood donors were positive in 8.7%. Venous thrombosis was recorded in the case-records of 28% patients with SLE but only in 5.4% of those with RA. Spontaneous abortion terminated 8/66 pregnancies in 28 women with SLE. In one female patient with SLE the aCL syndrome was detected. On account of frequent positivity of aCL antibodies in syphilis, the authors consider it essential to rule out the coincidence of this disease. Examination of aCL-IgA antibodies extends the detection of positive cases (isolated or in combinations of Ig) in SLE and RA.
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PMID:[Anticardiolipin antibodies in diffuse connective tissue diseases with IgG, IgM and IgA isotypes]. 226 32

In an effort to improve the clinical signs of Parkinson's disease, we have implanted mesencephalic dopamine cells from a 7-week human embryo into the caudate and putamen of a 52-year-old man with Parkinson's disease. Fetal tissue was obtained from elective abortion. The woman and the patient with Parkinson's disease were unknown to each other. The woman gave specific consent and was not paid. The patient had a 20-year history of parkinsonism treated with multiple drug therapies including levodopa/carbidopa (Sinemet) every 2 1/2 hours. His symptoms were worse on the left side. For 5 months prior to transplantation, the patient underwent clinical evaluations by both a neurologist and a computer system installed in his home for daily measurement of walking and hand movements. Preoperative positron emission tomographic scanning with 6-L[18F]fluorodopa (fluorodopa) demonstrated severe dopamine depletion bilaterally. Fetal tissue was matched to the patient for ABO blood antigens, and maternal serum was screened for hepatitis B and human immunodeficiency virus type 1 prior to surgery. Fetal tissue was implanted stereotactically throughout the caudate and putamen on the right side of the brain via 10 needle tracks. The patient was not immunosuppressed. Results 12 months after surgery showed 42% improvement in left-hand speed before the first morning dose of drug and 40% greater response to drug therapy. Right-hand speed increased 15% before drug therapy and 23% after drug therapy. Reaction time was unaffected. Walking speed increased 33% after drug administration, although walking speed before the first morning dose of drugs declined 40%. Walking speed on an all-day basis improved 17%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Transplantation of human fetal dopamine cells for Parkinson's disease. Results at 1 year. 233 98

Infection with the human immunodeficiency virus (HIV) among reproductive-age women occurs disproportionately among inner-city minority populations. These women are at risk because of intravenous drug abuse and heterosexual transmission from partners infected through drug abuse. From July 1, 1988 to December 31, 1988, we conducted routine voluntary screening for HIV antibody among 923 women who requested induced first-trimester abortion at Grady Memorial Hospital. Eight (8.7 per 1000) women were seropositive on repeat enzyme-linked immunosorbent assay and Western blot testing. Two infected women had had heterosexual contact with a person at risk for HIV infection, two others reported "crack" cocaine use, and four acknowledged no risk factors. Thirteen percent of seronegative women reported risk factors for HIV infection. Nearly all women consented to HIV testing, and most completed the risk-behavior questionnaire. These data suggest that women seeking first-trimester abortion at our hospital are at risk for HIV infection.
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PMID:Routine human immunodeficiency virus infection screening of women requesting induced first-trimester abortion in an inner-city population. 238 11

Papal "pronouncements" have been a major cause of the Philippines' increasing poverty, and of its failure to promote the only method proved to limit the spread of the acquired immunodeficiency syndrome (AIDS). Kenya has a growth rate of 3-4% and will double its population in 17 years. The UK has an average family size of 1.8 children. This is due to contraceptive usage. The poor lack knowledge and funds to ignore the rulings of the Catholic Church. Families will have 7 or more children without access to modern contraceptives. The Philippine elite are 90% Catholic, and disregard church policy and use contraceptives. Therefore, they have small families. Abortion is widely used in Latin America. It is the leading cause of death of women aged 15-39. The Philippines is industrializing rapidly; businessmen, however, do not see a future in producing condoms here. Widespread availability of condoms would limit the spread of AIDS. Mainly surveys show that in 1989 only 5 to 10/1000 prostitutes were positive for human immunodeficiency virus (HIV). Other Asian countries have shown large increases in HIV infection occurrence in 2-3 years. Pope John Paul has been telling young people in Burkina Faso that they "must face the plagues of modern times." He did not identify these plaques. However, Monsignore Carlo Cafara, dean of John Paul II's Institute for Marriage and Family Studies at the Vatican, told a recent conference that when 1 partner of a married couple is positive for AIDS, it is preferable to risk catching the AIDS virus than to use condoms. St. Paul would have approved the use of modern contraceptive methods.
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PMID:Papal policy, poverty, and AIDS. 239 May 54

Perinatal transmission of human immunodeficiency virus (HIV) has become an important mode of acquisition, which results in the birth of severely ill infants who succumb early to their disease and who often are abandoned in the hospital nursery for the duration of their short lifetime. Consequently, prevention of perinatal transmission is a primary goal. Several recent studies of the seroprevalence of HIV in pregnant women have shown high rates of infection. Landesman et al. report a seroprevalence of 2% when cord blood samples were tested in a blinded fashion in an inner city municipal hospital in Brooklyn, New York. At this time, there is no evidence that HIV infection or Acquired Immune Deficiency Syndrome (AIDS) adversely affects fertility. Perinatal transmission of HIV infection occurs in 33-50% of affected pregnancies. Circumstantial evidence suggest that pregnancy adversely affects the course of disease. Once pregnancy is diagnosed, the patient should be counseled, and abortion and sterilization services should be offered. A table identifies the numerous arguments both in support of and against the routine screening of pregnant women.
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PMID:HIV infection and pregnancy. 264 66


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