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)

Substance abuse and psychiatric disorders commonly occur together. This form of dual diagnosis is notable because it complicates assessment and makes treatment more difficult for both psychiatric and drug abuse problems. Drugs can cause psychiatric disorders and can also be used as an attempt to "cure" them by self-medication. The spread of the human immunodeficiency virus (HIV) among drug users has added a third potential clinical problem, that of the acquired immunodeficiency syndrome, to the difficulties already presented by drug abuse and psychiatric disorders. Patients with this triple diagnosis pose challenges to primary care physicians as well as addiction medicine specialists or psychiatrists. Assessment should include a drug abuse history, preferably corroborated by others, evaluation of the mental state, and examination focusing on signs of drug abuse and HIV infection. Treatment should include the management of HIV disease, abstinence from drug abuse, and access to psychiatric care. New systems of health care service, including interdisciplinary case management, may be needed to manage patients with a triple diagnosis.
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PMID:Drug abuse, psychiatric disorders, and AIDS. Dual and triple diagnosis. 219 Apr 23

Intravenous drug abuse is a principal factor in the spread of AIDS. In contrast to many countries in the Western world, most of the heroin addicts in Israel do not inject. This study attempts to clarify the link between the pattern of drug abuse and seroprevalence for human immunodeficiency virus (HIV) among volunteers attending a detoxification clinic in Jerusalem. Three hundred heroin abusers were interviewed about their drug habits and sexual preference. In addition, all participants underwent HIV serological testing. The majority of them took heroin by smoking, with only 19% injecting the drug. None of the participants in the study were HIV seropositive. An association is seen between the pattern of illicit drug use in Israel and the low incidence of AIDS in this country.
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PMID:Pattern of drug abuse and prevalence of antibodies to human immunodeficiency virus in heroin addicts in Jerusalem, 1989. 225 77

To identify the diagnostic characteristics and counseling needs of individuals at risk for acquired immune deficiency syndrome (AIDS), standardized DSM-III-R diagnoses were given to 207 physically asymptomatic adults when they sought serological testing for the human immunodeficiency virus (HIV). The subjects had high lifetime rates of mood disorders. Even after the 20 subjects with intravenous drug use as a risk factor were eliminated, lifetime rates of nonalcohol substance dependence were also high. These findings suggest that even before they are notified of HIV test results, many individuals at perceived risk for AIDS may be vulnerable to future depression and nonintravenous drug abuse.
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PMID:Psychiatric diagnosis before serological testing for the human immunodeficiency virus. 229 94

A serologic survey of 4863 patients attending two inner-city sexually transmitted disease clinics was conducted in 1988 1 year after an initial survey to reassess the prevalence and associated risk factors for human immunodeficiency virus (HIV) infection. The HIV seroprevalence rates had not changed significantly (5.2% in 1987, 4.9% in 1988), and remained higher among men (5.6%) than among women (3.6%). The HIV seroprevalence increased steadily with age, to 34 years in women and to 39 years in men. Of patients with a reactive syphilis serologic test result, 24.3% were HIV infected compared with 3.5% of patients with a nonreactive test for syphilis. In multivariate analysis, a reactive serologic test for syphilis was significantly associated with HIV infection in all major risk behavior categories. Among heterosexuals who denied parenteral drug abuse, HIV infection rates were 6.8 and 8.7 times greater for women and men, respectively, who had a reactive serologic test for syphilis. Evidence of heterosexual transmission of HIV was further suggested by a change in HIV seroprevalence in women from 3.0% in 1987 to 3.6% in 1988, a male to female HIV infection ratio of 1.6, and 3.0% prevalence of infection among patients who denied established risk factors. This was most evident among those younger than 25 years, in whom 72% of infected women and 46.2% of infected men denied high-risk behaviors. These data demonstrate the strong association between syphilis and HIV infection and the importance of heterosexual HIV transmission in patients attending sexually transmitted disease clinics. This study underscores the need for a more comprehensive control program for sexually transmitted diseases, including syphilis and HIV infection.
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PMID:The association of syphilis with risk of human immunodeficiency virus infection in patients attending sexually transmitted disease clinics. 235 62

To assess the effect of the human immunodeficiency virus (HIV) on mortality in US women 15 to 44 years of age and to identify associated causes of death, we examined final (1980 through 1987) and provisional (1988) national mortality statistics. Between 1985 and 1988, the death rate for HIV/acquired immunodeficiency syndrome (AIDS) quadrupled (0.6 per 100,000 to 2.5 per 100,000), and by 1987, HIV/AIDS had become one of the 10 leading causes of death. In 1988, the death rate for black women (10.3 per 100,000) was nine times the rate for white women (1.2 per 100,000). The majority of deaths in both black and white women occurred in women 25 to 34 years of age, for whom HIV-related deaths accounted for 11% and 3% of all deaths in 1988, respectively. Among 1157 death certificates that included any mention of HIV/AIDS in 1987, other leading diagnoses included drug abuse (27%), Pneumocystis carinii pneumonia (20%), other pneumonias (14%), septicemia (10%), other infections not in the AIDS surveillance definition (7%), nephritis (6%), liver diseases (4%), and anemias (4%). If current mortality trends continue, HIV/AIDS can be expected to become one of the five leading causes of death by 1991 in women of reproductive age. Because women infected with HIV are the major source of infection for infants, these trends in AIDS mortality in women forecast the impact of HIV on mortality in children as well.
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PMID:Impact of the human immunodeficiency virus epidemic on mortality in women of reproductive age, United States. 235 44

Anxiety is a prominent feature of human immunodeficiency virus (HIV)-related psychiatric disorders. Psychiatric disorders are associated with poor drug abuse treatment outcome in both healthy and HIV-infected drug users. While it is important to treat anxiety, the use of traditional antianxiety agents such as benzodiazepines can lead to adverse effects such as sedation and misuse, especially in patients with drug abuse problems. A retrospective chart review was employed to examine the use of buspirone in treating anxiety in intravenous drug users with acquired immune deficiency syndrome (AIDS) or AIDS-related complex who were receiving methadone maintenance treatment. All patients were opiate users, and most were also secondary users of other substances, including stimulants and alcohol. Of 17 patients who were started on buspirone, 14 remained on medication for more than 2 weeks. Of this latter group, all showed at least temporary improvement in one or more of the following areas: subjective reduction of anxiety, reduction of prescribed benzodiazepine use, or reduction in the number of urine tests positive for drugs of abuse, particularly morphine. Buspirone was well tolerated by all but three of these patients; there was no evidence of buspirone misuse. Given its favorable adverse effects profile, buspirone may be particularly useful in the treatment of anxiety in HIV-infected drug users.
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PMID:Buspirone in drug users with AIDS or AIDS-related complex. 237 26

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

We investigated differences in behaviors important for human immunodeficiency virus (HIV) transmission and HIV antibody status among 927 recent needle users enrolled in a multi-site HIV surveillance project in Worcester, Massachusetts. Subjects were enrolled at drug abuse treatment centers reported less risky injection practices unexplained by demographic variables. Risky sexual practices were in general reported more frequently by men at the jail than men at other sites. However, HIV status showed little relation to enrollment site. These results have implications both for targeting of acquired immunodeficiency syndrome (AIDS) prevention programs to needle users not in drug abuse treatment and for potential selection bias in studies of intravenous drug users.
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PMID:Demographic characteristics, risk behaviors, and HIV seroprevalence among intravenous drug users by site of contact: results from a community-wide HIV surveillance project. 238 42

Following a long-term decline, death rates in men 25-44 years of age increased from 212 deaths/100,000 in 1983 to 236 deaths/100,000 in 1987. To assess the impact of human immunodeficiency virus (HIV) infections on this trend and to identify causes that are increasing in association with the HIV epidemic, we analyzed national mortality statistics and compared death rates in states with high and low incidence of acquired immunodeficiency syndrome (AIDS). In 1987, there were 10,248 deaths with HIV infection, AIDS, or conditions in the AIDS surveillance definition assigned as the underlying cause, representing 11 percent of deaths for men in this age group compared to less than 1 percent in 1980. In addition, deaths with other underlying causes, such as other infections, drug abuse, and unknown/unspecified causes, had diverging and higher rates in states with high versus low AIDS incidence. In the absence of deaths due to HIV/AIDS and excess deaths due to these associated conditions, we estimate that death rates for men 25-44 years of age would have been 201-209/100,000 in 1987. For 1987, approximately 70-90 percent of HIV-related deaths were reported through national AIDS surveillance. The HIV epidemic has led to a reversal in mortality trends and to increases in various causes of death for young men.
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PMID:Impact of the human immunodeficiency virus epidemic on mortality trends in young men, United States. 238 45

Information is scant regarding epidemiologic risk factors for human immunodeficiency virus (HIV) infection among parenteral drug abusers (PDAs) residing in areas of low seroprevalence. A detailed interview and HIV serologic testing were conducted among PDAs hospitalized at Detroit Receiving Hospital for reasons unrelated to HIV infection. The study involved 22 seropositive (17 men, 5 women) and 52 seronegative (34 men, 18 women) drug abusers in Detroit, Michigan, an area of relatively low HIV prevalence. The interviews included inquiries regarding risk factors such as duration of drug abuse, visits to "shooting galleries," use of "hit men," needle sharing, sterile injection techniques, use of "street" antibiotics, promiscuity, visits to prostitutes, homosexuality, history of sexually transmitted diseases, and history of travel to areas of high HIV prevalence. A strong association was noted between the number of risk factors present and HIV seropositivity. The presence of any three or more risk factors was significantly associated (P less than .05) with seropositivity. Awareness of epidemiologic risk factors for HIV infection among PDAs in a low-prevalence area is useful in identification of seropositive drug abusers and is crucial in designing educational interventional strategies to interrupt viral transmission.
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PMID:Risk factors for human immunodeficiency virus infection among parenteral drug abusers in a low-prevalence area. 240 66


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