Gene/Protein Disease Symptom Drug Enzyme Compound
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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-1) infection continues to spread in developing countries, mostly through heterosexual transmission. The development of a safe and cost-effective topical microbicide, effective against a range of STDs including HIV-1, would greatly impact the ongoing epidemic. When formulated in a vehicle, a micronized form of cellulose acetate phthalate (CAP), which is an inactive pharmaceutical excipient, has been shown to inactivate HIV-1, herpes simplex virus types 1 and 2, cytomegalovirus, Neisseria gonorrhoeae, Trichomonas vaginalis, Haemophilus ducreyi, and Chlamydia trachomatis in vitro. Formulated CAP was also shown to be effective against herpes simplex virus type 2 in vivo. Here we show that a formulation of CAP protected four of six rhesus monkeys from vaginal infection with simian immunodeficiency virus. Thus, CAP may be a candidate for use as a topical microbicide for preventing HIV-1 infection in humans.
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PMID:Effect of a cellulose acetate phthalate topical cream on vaginal transmission of simian immunodeficiency virus in rhesus monkeys. 1103 53

Chancroid is a major cause of genital ulcer disease worldwide, and occurred at epidemic rates in the United States in the late 1980s. Though the recent epidemic in the U.S. appears to be waning, a number of areas continue to report significant numbers of cases. Chancroid is a particular concern, because, like other diseases that cause genital ulceration, it is associated with an increased risk for transmission or acquisition of human immunodeficiency virus (HIV). Recent studies have advanced the understanding of chancroid epidemiology, and new diagnostic tests may improve the ability to recognize and appropriately treat chancroid. Increased awareness of chancroid, with appropriate treatment for suspected lesions, along with public health efforts to implement prevention in high-risk populations, will be critical to prevent ongoing transmission of chancroid, and potentially ongoing transmission of HIV.
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PMID:Update on chancroid: an important cause of genital ulcer disease. 1136 92

Haemophilus ducreyi is the etiologic agent of chancroid, a sexually transmitted genital ulcer disease that facilitates the transmission of human immunodeficiency virus. In the human model of infection, the histopathology of infected sites in part resembles a delayed-type hypersensitivity (DTH) response. In this study, T cells were isolated from skin biopsy specimens obtained from 24 subjects who were infected for 7 to 14 days. One clone and 12 lines that responded to H. ducreyi antigens were obtained from 12 of the subjects. Fluorescence-activated cell sorter analysis showed that the antigen-responsive lines and clone were predominantly CD3(+) and CD4(+). The lines and clone responded to H. ducreyi antigen in a dose-dependent manner and produced gamma interferon (IFN-gamma) alone or IFN-gamma and interleukin-10 (IL-10) but no IL-4 or IL-5 in response to H. ducreyi. Proliferation of T cells was dependent on the presence of autologous antigen-presenting cells. The lines showed little response to antigens prepared from other members of the Pasteurellaceae and responded to different fractions of H. ducreyi separated by preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis. We conclude that T cells that recognize H. ducreyi antigens are recruited to sites experimentally infected with the organism. The lack of cross-reactivity to the Pasteurellaceae and the response of the lines to different antigen fractions suggest that subjects are sensitized to H. ducreyi during the course of infection.
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PMID:Characterization of Haemophilus ducreyi-specific T-cell lines from lesions of experimentally infected human subjects. 1140 58

Since the advent of the antimicrobial era, single-dose therapy has been a valuable tool in the management of genital infection. Most of the common sexually transmitted infections (STIs) such as gonorrhoea, syphilis, trichomoniasis and chancroid can be treated in this way, as can genital infections which are not sexually transmitted such as bacterial vaginosis and genital tract candidiasis. Until recently, treatment for Chlamydia trachomatis infection required a multi-dose regimen, but single-dose azithromycin has now been shown to be an effective and acceptable alternative to this. Unfortunately, eradicative therapy has proven to be elusive for the viral STIs such as genital herpes simplex infection, human papilloma virus infection and human immunodeficiency virus (HIV) infection. The main advantage of single-dose therapy lies in its convenience and in its ability to ensure virtually 100% compliance. This addresses the problems of reduced clinical efficacy and the difficulties in assessing the response to therapy which complicates poor treatment compliance. However, some single-dose regimens for STIs do have drawbacks, particularly in certain situations. This may be with respect to efficacy, for example in syphilis with single-dose benzathine penicillin therapy, particularly for pregnant women and individuals infected with HI. Alternatively, it may involve toxicity, for example with single-dose metronidazole therapy for trichomoniasis or bacterial vaginosis where a higher rate of gastrointestinal adverse effects may be expected than if a lower multi-dose regimen is used. In addition, single-dose therapy, for example with nevirapine, given to the mother in labour and to the baby after delivery significantly reduces the risk of mother to child HIV transmission, but resistance mutations are frequently detected in the viral genome after the brief exposure to the drug, which could jeopardise its future use. Single-dose therapy clearly has both advantages and disadvantages. We have reviewed a range of these in a variety of situations, focussing on their applications, effectiveness, compliance and toxicity, highlighting how single-dose therapy may be a double-edged sword.
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PMID:Treatment of sexually transmitted infections with single-dose therapy: a double-edged sword. 1192 35

There has long been reason to anticipate a major heterosexual epidemic of acquired immunodeficiency syndrome (AIDS) in Papua New Guinea (PNG) and probably in the rest of Melanesia. From the social and behavioural perspectives, Melanesia is strikingly similar to other areas of the world with serious epidemics of AIDS. High levels of other sexually transmitted infections indicate behaviour patterns that would also facilitate transmission of human immunodeficiency virus (HIV) and presence of cofactors for HIV infection. Low levels of male circumcision parallel the situation in other epidemic areas. Near-parity by sex in cases reported so far in PNG is evidence that primary infection is largely heterosexual. The late start of a major epidemic in PNG can probably be attributed to: (a) the relatively small aggregation of people in urban centres (even Port Moresby has only one-quarter of a million people); (b) a highway system that does not network across the whole country; (c) limited size of the organized commercial sex sector; and (d) possibly low level of chancroid to act as a cofactor. The situation is now changing. Over the last seven years, HIV infection, probably the highest in Port Moresby and mostly measured there, has been rising by about 60% per annum. This rise is genuine and, if sustained, would infect 10% of the adult population of PNG in little more than 12 years. Some countries of sub-Saharan Africa have witnessed such exponential rises.
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PMID:AIDS in Papua New Guinea: situation in the Pacific. 1218 90

Due to the fact that an overwhelming majority of patients with Acquired Immune Deficiency Syndrome (AIDS) acquired the infection through sexual contact, it comes as no surprise that the same populations who are at increased risk for various sexually transmitted diseases (STDs) also experience high rates of human immunodeficiency virus (HIV) infection. There is increasing evidence that some STDs may enhance the efficiency of sexual transmissions of HIV. Genital ulcers are among the genital syndromes most convincingly implicated as cofactors for potential sexual transmission of HIV. Several cross-sectional studies among heterosexual men and women in Africa originally revealed that both a history of and the presence of genital ulcers was correlated with HIV infection. These findings are complemented by those of a study of HIV infection in homosexual men in the US. This study reports a strong association between HIV antibodies and a history of syphilis and of oral or anogenital herpes. The association between HIV antibodies and genital ulcers remained after controlling for the level of sexual activity. A prospective study conducted in Nairobi provided evidence that genital ulcers, particularly chancroid, increase the susceptibility to HIV infection among women. Another prospective study in Nairobi of men who acquired an STD from a group of prostitutes known to have a very high rate of HIV infection found that men who acquired genital ulcers had 5 times the rate of HIV infection as men who acquired urethritis. In the same cohort of prostitutes, "chlamydia trachomatis" infection also increased the risk of acquisition of HIV. Effective and inexpensive antimicrobial therapy is available for most bacterial STDs. Programs for the diagnosis and treatment of STDs should be integrated into AIDS control programs. The AIDS epidemic should not become a reason for decreasing support for STD control programs but rather an incentive to initiate or strengthen such programs.
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PMID:AIDS: the impact of other sexually transmitted diseases. 1228 Sep 52

At present, about 250 million new cases of sexually transmitted diseases (STDs) occur in the world each year. This statistics includes 120 million cases of trichomoniasis, 50 million cases of chlamydia, 30 million cases of genital warts, 25 million gonorrhea cases, 20 million cases of genital herpes, 3.5 million syphilis cases, 2.5 million case of hepatitis B virus, 2 million cases of chancroid, and 1 million infections with human immunodeficiency virus (HIV). Among the adverse health sequelae the STDs are sterility, infertility, stillbirth, miscarriage, blindness, brain damage, and cancer. The greatest incidence of STDs is in the 20-24-year age group, followed by persons 15-19 years of age. The finding that lesions caused by some STDs can increase the risk of HIV infection by more than 300% has led governments concerned with control of acquired immunodeficiency syndrome (AIDS) to take a more aggressive stance toward the prevention and treatment of STDs. There are many obstacles to STD prevention, however, including the development of treatment-resistant strains, inadequate infrastructure for diagnostic testing and penicillin treatment, resistance to changing sexual behavior, increased travel and migration, and the practice of exchanging sex for drugs. Even in some developed countries where the rate of STD infection has finally stabilized, the level remains unacceptably high and STDs cannot be considered as under control. In developing countries, STDs have reached epidemic levels and the number of new infections reported annually shows a pattern of steady increase. The World Health Organization is urging governments to intensify STD prevention activities through funding research, health education, and more accessible clinic services.
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PMID:Sexually transmitted infections increasing -- 250 million new infections annually. 1231 65

Haemophilus ducreyi is the etiologic agent of chancroid, a sexually transmitted disease that increases the rate of transmission of human immunodeficiency virus. Chancroid ulcerations are difficult to distinguish from those produced by syphilis and herpes. Diagnosis based solely on clinical grounds is inaccurate, and culture is insensitive. Highly sensitive PCR has largely superseded culture as the preferred method of laboratory diagnosis; however, neither culture nor PCR is feasible where chancroid is endemic. We developed a rapid (15-min) diagnostic test based on monoclonal antibodies (MAbs) to the hemoglobin receptor of H. ducreyi, HgbA. This outer membrane protein is conserved in all strains of H. ducreyi tested and is required for the establishment of experimental human infection. MAbs to HgbA were generated and tested for cross-reactivity against a panel of geographically diverse strains. Three MAbs were found to be unique and noncompetitive and bound to all strains of H. ducreyi tested. Using an immunochromatography format, we evaluated the sensitivity and specificity of the test using geographically diverse strains of H. ducreyi, other Haemophilus strains, and other bacteria known to superinfect genital ulcers. All H. ducreyi strains were positive, and all other bacteria were negative, resulting in a specificity of 100%. The minimum number of CFU of H. ducreyi detected was 2 x 10(6) CFU, and the minimum amount of purified HgbA protein detected was 8.5 ng. Although this level of sensitivity may not be sufficient to detect H. ducreyi in all clinical specimens, further work to increase the sensitivity could potentially make this a valuable bedside tool in areas where chancroid is endemic.
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PMID:Development of a rapid immunodiagnostic test for Haemophilus ducreyi. 1235 68

Haemophilus ducreyi is the causative agent of the genital ulcer disease chancroid. Chancroid is common in developing countries and facilitates human immunodeficiency virus transmission. In this review, the clinical features, epidemiology, and prospects for disease control are discussed in the context of experimental and natural infection of humans.
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PMID:Haemophilus ducreyi: clinical features, epidemiology, and prospects for disease control. 1236 14

Chancroid is a sexually transmitted disease (STD) caused by the Gram negative bacterium Haemophilus ducreyi and is characterised by necrotising genital ulceration which may be accompanied by inguinal lymphadenitis or bubo formation. H ducreyi is a fastidious organism which is difficult to culture from genital ulcer material. DNA amplification techniques have shown improved diagnostic sensitivity but are only performed in a few laboratories. The management of chancroid in the tropics tends to be undertaken in the context of syndromic management of genital ulcer disease and treatment is usually with erythromycin. A number of single dose regimens are also available to treat H ducreyi infection. Genital ulceration as a syndrome has been associated with increased transmission of human immunodeficiency virus (HIV) infection in several cross sectional and longitudinal studies. Effective and early treatment of genital ulceration is therefore an important part of any strategy to control the spread of HIV infection in tropical countries.
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PMID:Chancroid: clinical manifestations, diagnosis, and management. 1257 20


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