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 possibility that an agent in addition to human immunodeficiency virus type 1 may be involved in the etiology of Kaposi's sarcoma in acquired immunodeficiency syndrome (AIDS) patients was investigated between 1984 and 1992 in this nested case-control analysis from the Multicenter AIDS Cohort Study (MACS) of homosexual and bisexual men. A total of 316 cases of Kaposi's sarcoma were identified and compared with 510 participants with AIDS and no evidence of cancer. More of the Kaposi's sarcoma cases were from Los Angeles and used a higher number of recreational drugs. The Kaposi's sarcoma cases were also more active sexually. There was a dose-response relation between Kaposi's sarcoma and the number of sexual partners, with an odds ratio of 2 between the most and least sexually active subgroups. The odds ratio for Kaposi's sarcoma increased to 4.18 (95% confidence interval 1.29-14.1) in the presence of a history of five infections. Hepatitis and gonorrhea contributed the most to this relation. The various observed odds ratios did not change after multivariate adjustment for the other risk factors. A model was developed combining all predictive associations into a composite risk score ranging from one to 12 and based on history of infections, sexual activity, use of poppers/nitrites, and having had sexual partners from the West Coast of the United States. The subgroup with the highest scores, compared to the subgroup with the lowest score, had an odds ratio of 8.93 (95% confidence interval 3.21-30.44) for Kaposi's sarcoma. A longitudinal proportional hazards analysis among all 2,190 human immunodeficiency virus type 1-seroprevalent men at study entry, based on this risk score and CD4 cells at baseline, confirmed these findings. Identifying these specific subgroups that are at high and low risk for Kaposi's sarcoma will help future investigations to be more focused in their search for an additional etiologic factor for Kaposi's sarcoma in AIDS.
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PMID:Composite risk score for Kaposi's sarcoma based on a case-control and longitudinal study in the Multicenter AIDS Cohort Study (MACS) population. 835 66

The authors separately studied the epidemiology (risk and risk factors) of Kaposi's sarcoma occurring as an initial acquired immunodeficiency syndrome (AIDS) outcome (early Kaposi's sarcoma) and later after a different initial AIDS outcome (later Kaposi's sarcoma) in a cohort of 2,591 human immunodeficiency virus type 1-infected gay men of the Multicenter AIDS Cohort Study between 1984 and 1992. Among 844 AIDS cases, 202 presented with early Kaposi's sarcoma, 101 subsequently developed later Kaposi's sarcoma, and 541 were not diagnosed with Kaposi's sarcoma. Overall, 37.4% of AIDS cases were diagnosed with Kaposi's sarcoma prior to death. Kaposi's sarcoma diagnosed on the skin was significantly more common with early Kaposi's sarcoma (77.3%) than with later Kaposi's sarcoma (65.1%). Men presenting with an AIDS outcome other than Kaposi's sarcoma were at high risk for later Kaposi's sarcoma. Later Kaposi's sarcoma onset in men with a previous AIDS outcome was associated with the following characteristics: 1) lower immune status prior to AIDS and 2) longer post-AIDS survival. A Kaposi's sarcoma diagnosis in a man with a previous AIDS illness approximately doubled the risk (hazard) for death. Histories of urethral gonorrhea and scabies prior to study entry were more common in early Kaposi's sarcoma cases than in later Kaposi's sarcoma cases. However, self-reported sexual activity at study entry and prior to AIDS onset was highest in the later Kaposi's sarcoma group. In this cohort, cigarette smoking had a protective association against all Kaposi's sarcoma in univariate and multivariate models. Only 21.0% of the later Kaposi's sarcoma and 25.0% of the early Kaposi's sarcoma men smoked at least one-half pack of cigarettes daily at study entry compared with 33.8% of non-Kaposi's sarcoma and 35.5% of seroprevalent men still AIDS free. The reasons for this surprising association are unclear. However, other evidence which documents that habitual smoking alters the immune system (and possibly cytokine levels) in ways that could perhaps influence Kaposi's sarcoma pathogenesis should be considered.
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PMID:Epidemiologic analysis of Kaposi's sarcoma as an early and later AIDS outcome in homosexual men. 835 67

From July 1986 through June 1990, 33,199 sera from various risk groups were collected in Veterans General Hospital-Taipei for detection of antibody against human immunodeficiency virus, type 1 (HIV-1). Sixty-five samples were proved positive by Western blot analysis. Among individual high risk groups, hemophiliacs had the highest positive rate of 20/60 (29.41%), followed by homosexual/bisexual males (41/1,264, 3.24%). The overall positive rate was 65/33,199 (0.19%). Ten cases were recognized as acquired immunodeficiency syndrome (AIDS), 1 case had AIDS-related complex (ARC) and 4 case had other apparently symptomatic infections. Among these 15 cases, 7 expired, 1 lost of follow-up and 7 surviving cases are being treated with zidovudine (AZT). Most of symptomatic HIV-1 antibody positive cases had abnormal T4/T8 ratio of 0.39 +/- 0.54 as compared with the asymptomatic HIV-1 carriers at a ratio of 0.81 +/- 0.69. The opportunistic infections included Pneumocystis carinii pneumonia (PCP) in 6 case, disseminated cytomegalovirus infection in 6 cases, herpes zoster virus infection in 3 case, candidiasis in 4 cases, syphilis in 3 cases, pulmonary tuberculosis in 2 cases, and others with cryptococcosis, salmonellosis, Mycobacterium avium-intracellulare infection, gonorrhea, Staphylococcus aureus endocarditis and bacterial sepsis, etc. The natural history of HIV-1 infection to AIDS involved acute and persistent multiple infections. Although prevalence of HIV-1 infection was low in Taiwan, nationwide surveillance of HIV-1 infection in various risk groups is still needed.
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PMID:Five-year experience of human immunodeficiency virus type 1 national screening program implemented at Veterans General Hospital-Taipei. 840 70

The approximately 1.2 million inmates in U.S. correctional institutions have a high prevalence of communicable diseases, such as human immunodeficiency virus (HIV) infection, tuberculosis, hepatitis B virus infection, and gonorrhea. Before their incarceration, most inmates had limited access to health care, which, together with poor compliance because of lifestyle, made them difficult to identify and treat in the general community. Because of the high yearly turnover (approximately 800% and 50% in jails and prisons, respectively), the criminal justice system can play an important public health role both during incarceration and in the immediate postrelease period. A public policy agenda for criminal justice should include an epidemiologic orientation, as well as resources for education, counseling, early detection, and treatment. Taking advantage of the period of confinement would serve both the individual and society by controlling communicable diseases in large urban communities.
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PMID:Correctional health care: a public health opportunity. 849 74

To explore a possible association between bacterial vaginosis and human immunodeficiency virus (HIV) infection, 144 consecutively enrolled commercial sex workers from a sexually transmitted disease clinic (STD) in Chiang Mai, Thailand, were interviewed and underwent serologic testing and genital examination. 62 (43%) of sex workers were HIV-positive. A self-reported history of syphilis, chancroid, herpes, gonorrhea, or Chlamydia was significantly associated with HIV infection. Bacterial vaginosis, detected in 49 (34%), was also associated with HIV infection. Sex workers reporting 10-19 and 20 or more sexual encounters per week were 2.2 and 3.5 times, respectively, more likely to be infected with HIV than those reporting under 10 encounters. A clinically established diagnosis of bacterial vaginosis was independently associated with HIV seropositivity even when age, number of sexual encounters per week, current condom use, and past and current STD infection were controlled (odds ratio, 4.0; 95% confidence interval, 1.7-9.4). When the bacterial vaginosis diagnosis was based on Gram stain (score 7-10), however, the association with HIV seropositivity disappeared, but having abnormal vaginal flora (gram stain score 4-10) was related to HIV status. Further epidemiologic studies are recommended to investigate the possibility that bacterial vaginosis--the most prevalent genital infection in Thailand--acts as a cofactor for the heterosexual transmission of HIV.
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PMID:Bacterial vaginosis and HIV seroprevalence among female commercial sex workers in Chiang Mai, Thailand. 852 84

Infections due to pneumococci are frequent in patients infected with the human immunodeficiency virus (HIV), but joint infections are rare. We observed two cases of septic arthritis due to pneumococci in two non-haemophilic HIV seropositive patients. In the first case, a 31-year old drug addict who had undergone splenectomy, developed hip joint infection during an episode of meningitis due to pneumococci. The germ was moderately sensitive to ampicillin. The second case involved the knee joint in a 29-year-old woman who developed pneumococcal pneumonia after a trip to Zaire. In both cases, joint infection developed after antibiotics had been initiated, and in the first case, after the infection appear to be under control. This would be similar to "post-infectious" arthritis described in gonococcal and meningococcal infections. In HIV positive patients, joint infections are rare compared with other types of immunodepression, but can be observed in all stages of the disease. A total of 75 cases have been reported in the literature, including 8 cases due to pneumococci. These joint infections could be another argument in favour of anti-pneumococcal vaccination in HIV positive patients.
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PMID:[Pneumococcal septic arthritis in HIV infection]. 853 17

This is a case report of a 35-year-old woman infected with the human immunodeficiency virus who presented with acute bacterial sepsis that proved to be secondary to Neisseria gonorrhoeae. Typical skin and joint findings developed only after the acute sepsis had resolved. Patients with disseminated gonococcal infection rarely have signs of acute bacterial sepsis. This case raises the question of whether HIV-infected patients are at an increased risk of contracting severe gonococcal disease.
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PMID:Acute gonococcal sepsis in an HIV-infected woman. 857 12

Female sex workers in Nairobi were prospectively evaluated for risk factors of incident Chlamydia trachomatis infection. Independent risk factors included cervical ectopy (P=.007), gonococcal infection (P=.002), human immunodeficiency virus (HIV) seropositivity (P=.003), HIV seroconversion (P=.001), and duration of prostitution (P=.002). Eighteen different C. trachomatis outer membrane protein (omp1) genotypes were identified, with the allelic composition of the C. trachomatis population changing significantly over time (P=.005). Seventeen of 19 reinfections > or = 6 months apart were with different C. trachomatis omp1 genotypes. Women with HIV infection had an increased proportion of visits with C. trachomatis infection (P=.001) and an increased risk of reinfection (P=.008). Overall, the data demonstrate significant fluctuations in the genotype composition of the C. trachomatis population and a reduced rate of same-genotype reinfection consistent with the occurrence of strain-specific immunity.
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PMID:The epidemiology of Chlamydia trachomatis within a sexually transmitted diseases core group. 860 76

To identify epidemiologic and clinical patterns associated with human immunodeficiency virus (HIV) infection in sexually transmitted disease (STD) patients in Nigeria, serologic testing was performed on 581 men and women seen at Ibadan's Special Treatment Clinic during 1989-90. Of these, 37 (6.4%) were confirmed HIV-positive; 21 (3.6%) had HIV-1 antibodies and the remaining 16 (2.8%) had HIV-2 antibodies. Peak HIV incidence (24 cases, or 65%) was in the 21-30 year age group; the male to female ratio was 1.01 to 1.00. Presenting symptoms in HIV-positive cases included urethral discharge, vaginal discharge, dysuria, and genital ulcers. The prevalences of gonococcal infection, nonspecific urethritis and cervicitis, genital ulcer disease, and trichomoniasis were 27.0%, 18.9%, 16.2%, and 10.8%, respectively, among HIV-infected STD patients; none of the associations between specific STDs and HIV were statistically significant. Only 1 patient had developed clinical signs of acquired immunodeficiency syndrome (AIDS). The 6.4% prevalence rate detected among STD patients in this study was considered high since HIV is new to Nigeria (436 cases reported to date). Overall, these findings suggest that the AIDS epidemic is in an early stage in Nigeria and the major mode of HIV transmission is heterosexual sex. Routine HIV screening for high-risk groups in Nigeria, including STD patients, is recommended.
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PMID:Clinico-epidemiological patterns of HIV infection in STD patients in Ibadan. 888 45

Human immunodeficiency virus (HIV)-seronegative high-risk homosexual men were enrolled in a vaccine feasibility study in three US cities. HIV seroincidence was 2.3/100 person-years (95% confidence interval [CI], 1.7-2.9) over 18 months in 1975 men. After receiving an explanation of HIV vaccine trial design, 37% stated they were "definitely" willing to participate in future trials; seroincidence was 3.7/100 person-years (95% CI, 2.5-4.9) in this subgroup. An additional 57% "might be" or were "probably" willing. Independent predictors of HIV seroconversion in multivariable pooled logistic regression analysis were having a known HIV-seropositive sex partner (odds ratio [OR], 4.5; 95% CI, 2.6-7.8), injection drug use (OR, 3.6; 95% CI, 1.2-10.7), unprotected receptive anal sex (OR, 2.4; 95% CI, 1.4-4.2), condom failure (OR, 2.4; 95% CI, 1.4-4.1), gonococcal/nongonococcal urethritis (OR, 2.3; 95% CI, 1.1-4.7), and age < 25 years (OR, 2.2; 95% CI, 1.2-4.2). Interest in vaccine trials and seroincidence in high-risk homosexual men are sufficiently high to initiate efficacy trials once a suitable candidate vaccine is identified. Risk factors for seroconversion highlight important area for development of ancillary intervention strategies.
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PMID:Feasibility of human immunodeficiency virus vaccine trials in homosexual men in the United States: risk behavior, seroincidence, and willingness to participate. 889 95


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