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)

The Los Angeles Enhanced Methadone Maintenance Project has incorporated case management in order to evaluate its effectiveness in reducing the risk of infection and/or transmission of human immunodeficiency virus among high-risk heroin addicts. Those recruited into the National Institute on Drug Abuse-funded treatment/research demonstration project were randomly assigned to either an enhanced group that received case management services or to a control group receiving standard methadone maintenance services. To date, the project has identified several barriers to implementation on a wide scale, including the inordinate amount of time spent assisting patients to procure basic necessities; the unwillingness of patients to participate in certain support services; and the reluctance of many service providers to work with methadone patients.
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PMID:Case management within a methadone maintenance program. A research demonstration project for HIV risk reduction. 773 89

Case management is a promising intervention that has been used widely in many settings but is not well evaluated with substance abusers. This article describes a case management approach for substance abusers with human immunodeficiency virus (HIV) disease. Clients are enrolled from emergency and outpatient clinics of a general hospital. Case management focuses on encouraging a substance-free lifestyle, linking clients with needed services, and reducing their risk of transmitting HIV. A research project is currently underway to determine the effect of case management on client outcomes, assess its cost-effectiveness, and identify predictors of treatment participation and retention. Innovative models, such as case management approaches, can link drug abuse treatment with health care. These approaches may reduce the costs of care and improve the health care delivery system.
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PMID:Case management of substance abusers with HIV disease. 773 90

Hemophilia-AIDS has been interpreted in terms of two hypotheses: the foreign-protein-AIDS hypothesis and the Human Immunodeficiency Virus (HIV)-AIDS hypothesis. The foreign-protein-AIDS hypothesis holds that proteins contaminating commercial clotting factor VIII cause immunosuppression. The foreign-protein hypothesis, but not the HIV hypothesis, correctly predicts seven characteristics of hemophilia-AIDS: 1) The increased life span of American hemophiliacs in the two decades before 1987, although 75% became infected by HIV--because factor VIII treatment, begun in the 1960s, extended their lives and simultaneously disseminated harmless HIV. After 1987 the life span of hemophiliacs appears to have decreased again, probably because of widespread treatment with the cytotoxic anti-HIV drug AZT. 2) The distinctly low, 1.3-2%, annual AIDS risk of hemophiliacs, compared to the higher 5-6% annual risk of intravenous drug users and male homosexual aphrodisiac drug users--because transfusion of foreign proteins is less immunosuppressive than recreational drug use. 3) The age bias of hemophilia-AIDS, i.e. that the annual AIDS risk increased 2-fold for each 10-year increase in age--because immunosuppression is a function of the lifetime dose of foreign proteins received from transfusions. 4) The restriction of hemophilia-AIDS to immunodeficiency diseases--because foreign proteins cannot cause non-immunodeficiency AIDS diseases, like Kaposi's sarcoma. 5) The absence of AIDS diseases above their normal background in sexual partners of hemophiliacs--because transfusion-mediated immunotoxicity is not contagious. 6) The occurrence of immunodeficiency in HIV-free hemophiliacs--because foreign proteins, not HIV, suppress their immune system. 7) Stabilization, even regeneration, of immunity of HIV-positive hemophiliacs by long-term treatment with pure factor VIII. This shows that neither HIV nor factor VIII plus HIV are immunosuppressive by themselves. Therefore, AIDS cannot be prevented by elimination of HIV from the blood supply and cannot be rationally treated with genotoxic antiviral drugs, like AZT. Instead, hemophilia-AIDS can be prevented and has even been reverted by treatment with pure factor VIII.
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PMID:Foreign-protein-mediated immunodeficiency in hemophiliacs with and without HIV. 774 63

Thymic tissue was collected from 11 human immunodeficiency virus 1 (HIV-1)-seropositive drug users who died suddenly of drug intoxication or trauma. None of the 11 individuals had symptoms related to HIV-1 infection or were known to be seropositive for HIV-1 before death. Secondary B-cell follicles were present in every thymus, and Warthin-Finckeldey giant cells were noted in three cases. These follicles were enlarged or fragmented and appeared similar to those in lymph nodes excised from the same individuals. Localization of viral RNA by in situ hybridization demonstrated abundant virus in a follicular center cell distribution within hyperplastic follicles and in scattered medullary lymphocytes. In nine thymus glands from seronegative drug addicts and five thymus glands from seronegative trauma victims who were not drug addicts, secondary follicles were absent and no hybridization signal was present. Other than the presence of germinal centers associated with HIV-1 RNA, there were no histologic differences among the thymus glands of seropositive drug addicts, seronegative drug addicts, and seronegative controls without a history of drug abuse. We conclude that the thymus gland in early stages of infection with HIV-1 is characterized by induction of secondary B-cell follicular hyperplasia in medullary tissues, the germinal centers of which contain abundant viral RNA.
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PMID:Localization of human immunodeficiency virus 1 RNA in thymic tissues from asymptomatic drug addicts. 780 51

We sought to evaluate the effect of vertical transmission of human immunodeficiency virus type 1 (HIV-1) on birthweight and length of gestation. For this purpose we used maternal and pregnancy data of 559 HIV-1-seropositive pregnant women delivered at 13 Italian centers from 1985 to 1991. The mother-to-child transmission rate of HIV infection was 18.2% (84/461). After adjustment for potential confounders with multiple linear regression analysis, there were no differences in birthweight, gestational age, and proportion of expected birthweight (observed birthweight/expected birthweight) between infected and uninfected children. Intravenous drug abuse during current pregnancy was the factor which correlated best with a reduction in birthweight (mean reduction, 214.4 g; 95% confidence interval (CI), 61.7-367.1), length of gestation (mean reduction, 9.3 days; 95% CI, 3.9-14.7) and proportion of expected birthweight (mean reduction, 12.1%; 95% CI, 4.7-19.5%). In our population, HIV-1 infection of the fetus has little effect on length of gestation and birthweight.
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PMID:The effect of fetal infection with human immunodeficiency virus type 1 on birthweight and length of gestation. SIGO Study Group of HIV Infection in Pregnancy. 782 96

This study compares the sociodemographic characteristics and human immunodeficiency virus (HIV) risk behaviors of injection drug users who had received drug abuse treatment in the previous 5 years and those who had not received treatment. The National AIDS Demonstration Research Program database provided 2001 structured interviews, representing Cleveland, Columbus, Cincinnati, and Dayton, Ohio. About 43% of the subjects reported having received treatment in the previous 5 years. Length of involvement with drugs, more frequent injection, more legal problems, and higher levels of HIV risk behaviors were associated with a history of treatment. Incorporating HIV risk reduction education in drug abuse treatment is an urgent priority.
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PMID:Drug abuse treatment experience and HIV risk behaviors among active drug injectors in Ohio. 783 44

Variations in the drug use patterns of injection drug users (IDUs) can have important implications for public health efforts aimed at reducing drug abuse and the transmission of the human immunodeficiency virus. This article describes and compares the characteristics of IDUs living in four Ohio cities and compares African-American and White IDUs at a statewide level. Data from 2,001 IDUs who were recruited for the National AIDS Demonstration Research project between 1989 and 1991 in Columbus, Cleveland, Cincinnati, and Dayton were compared on a number of variables by city and by ethnicity using descriptive statistics and ANCOVA analysis. Significant differences among IDUs in the four cities exist for the use of alcohol, marijuana, cocaine, crack, heroin, speedball, other opioids, shooting gallery use, "safer" needle practices, treatment history, and self-help participation. Differences by ethnicity emerged on all variables except marijuana use, overall injection frequency, and incarceration experience. The results suggest that dramatic differences exist between African-American and White IDUs, and among IDUs in cities relatively close together, regardless of ethnicity. These findings should be considered when developing policy and programs for prevention and treatment activities targeting IDUs.
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PMID:Injection drug users in the Midwest: an epidemiologic comparison of drug use patterns in four Ohio cities. 784 56

Human immunodeficiency virus (HIV) infection among injecting drug users remains a major health problem. Traditional approaches to prevent parenteral transmission of HIV infection in this population include abstinence facilitated through treatment for drug abuse, HIV testing with education and counseling, disinfection of needles with bleach between uses, and needle exchange programs. While each of these strategies are important and contribute to risk reduction, high-risk behavior and transmission of HIV infection continues. The development and distribution of safe and effective HIV vaccines in this population is urgently needed.
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PMID:HIV vaccines for injection drug users in the context of a comprehensive prevention agenda. 786 24

This journal issue includes seven articles (six plus this introduction) from the "cocaine workgroup" of the National Institute on Drug Abuse (NIDA) treatment demonstration grants. In this introduction, results of the first attempts to compare data from seven disparate demonstration grant sites are summarized: Overall, rates of recent cocaine use were high in all locations, injection drug use was common, age of first drug use was between 14 and 17 years with age of first cocaine use between 20 and 25 years, arrests were common at all sites especially among cocaine injectors, and polydrug use was the norm. Interestingly, both gender and ethnic status were significantly associated with polydrug use and marijuana use among the cocaine users. These results indicated that it is possible to define variables precisely for analysis across sites and laid the groundwork for the next set of analyses in which the common theme of human immunodeficiency virus (HIV) risk behaviors among cocaine abusers was agreed upon. This next set of analyses are included in the following six papers. Overall, these reports confirm recent data about the association of cocaine use with HIV risk behaviors. They extend considerably the literature on the association of cocaine with HIV risk behaviors, and the report from New York in which therapeutic community treatment was shown to be feasible and possibly useful to methadone clients represents an interesting and new finding. In conclusion, cross-site collaborations can take different forms and this collection of papers represents one successful approach.
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PMID:Results of the NIDA treatment demonstration grants' cocaine workgroup: characteristics of cocaine users and HIV risk behaviors. 788 68

Since initial reports emerged of an association between recreational drug use and high-risk sexual behaviors in gay men, there has been interest in studying this relationship for its relevance to behavioral interventions. Reported here are the longitudinal patterns of alcohol and recreational drug use in the Chicago Multicenter AIDS Cohort Study (MACS)/Coping and Change Study (CCS) of gay men. A pattern of decreasing drug use over 6 years was observed that paralleled a decline in high-risk sexual behavior (i.e., unprotected anal intercourse). In contrast, alcohol consumption tended to be more stable over time, and to show no relationship to sexual behavior change. Men who combined volatile nitrite (popper) use with other recreational drugs were at highest risk both behaviorally and in terms of human immunodeficiency virus-1 (HIV) seroconversion throughout the study. Popper use also was associated independently with lapse from safer sexual behaviors (failure to use a condom during receptive anal sex). Use of other recreational substances showed no relationship to sexual behavior change patterns, and stopping popper use was unrelated to improvement in safer sexual behavior. When popper use and lapse from safer sex were reanalyzed, controlling for primary relationship status, popper use was associated with failure to use condoms during receptive anal sex among nonmonogamous men only. These findings suggest an association between popper use and high-risk sexual behavior among members of the Chicago MACS/CCS cohort that has relevance to HIV prevention intervention efforts.
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PMID:Recreational drugs and sexual behavior in the Chicago MACS/CCS cohort of homosexually active men. Chicago Multicenter AIDS Cohort Study (MACS)/Coping and Change Study. 791 May


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