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)

A study was conducted to determine the prevalence rate and risk factors for sexually transmitted diseases (STDs) in Haiti's rural Artibonite Valley. Women attending antenatal services at Hospital Albert Schweitzer from October to December 1996 were tested for gonorrhea, chlamydia, trichomonas, syphilis, and human immunodeficiency virus (HIV). Of the 476 women tested, 121 (25.4%) had trichomonas, 11/475 (2.3%) had gonorrhea, 51/475 (10.7%) had chlamydia, 32/474 (6.8%) were seropositive for syphilis, 20/469 (4.3%) were seropositive for HIV, and 191 (40.1%) had at least one STD. Nearly 30% of the women reported having entered a sexual relationship out of economic necessity and had increased odds of HIV infection, Odds Ratio (OR) 6.3 (P < 0.001). We postulate that due to recent economic hardship in rural Haiti, women are entering into sexual relationships out of economic necessity and that this trend is contributing to the growing HIV epidemic. We recommend STD prevention and development programs that target young people and economically disadvantaged women.
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PMID:Economic hardship and sexually transmitted diseases in Haiti's rural Artibonite Valley. 1122 Jul 66

The Centers for Disease Control and Prevention recommends sexually transmitted disease (STD) screening among human immunodeficiency virus (HIV)-infected persons as a means of HIV prevention. HIV-infected persons in care may be an important target group in which to conduct regular STD screening to prevent enhanced transmission of HIV. We conducted STD screening for syphilis and two causes of urethritis, chlamydia, and gonorrhea, among 447 HIV-infected persons at two busy, urban clinics in San Francisco: a general HIV acquired immune deficiency syndrome (AIDS) care clinic and a methadone maintenance clinic. There were no new cases of syphilis identified and only two prevalent cases of chlamydia. While STD screening was feasible and acceptable in this population, the benefits of screening for asymptomatic gonococcal and chlamydial infection remain to be determined. Because these two pathogens only cause about 20% of urethritis, broader screening tests for urethritis, e.g., leukocyte esterase or urine microscopy, may be more useful. Finally, this study reaffirms the notion that local data should be used to evaluate national screening recommendations.
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PMID:STD screening among HIV-infected patients in care, San Francisco. 1122 32

To determine the prevalence of sexually transmitted diseases (STDs), we screened 107 human immunodeficiency virus-positive patients in Peru, where the virus is predominantly sexually transmitted. Patients had multiple risk factors for STDs, and 38% of women and 50% of men had at least 1 STD (gonorrhea, trichomoniasis, herpes simplex, anogenital warts, or syphilis seropositivity). No chlamydial infection was detected, even though infection rates in the general population are 5%-12%. Patients receiving trimethoprim-sulfamethoxazole(TMP-SMZ) for prophylaxis or treatment of respiratory infections were least likely to have cervicitis and/or urethritis (odds ratio, 0.37; 95% confidence interval, 0.15-0.89). Although not optimal treatment, administration of TMP-SMZ is effective against chlamydial infection. We speculate that the use of concomitant medications, such as TMP-SMZ, may be inadvertently preventing chlamydial infection in this population. Another finding was the presence of Trichomonas vaginalis in pharyngeal specimens of 3 men with histories of orogenital activity. This has not been previously reported and requires further study.
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PMID:Screening for sexually transmitted diseases in human immunodeficiency virus-positive patients in Peru reveals an absence of Chlamydia trachomatis and identifies Trichomonas vaginalis in pharyngeal specimens. 1122 50

Sexually transmitted diseases, despite vigorous efforts in prevention, are still existing and may provide portal of entry for human immunodeficiency virus transmission. Syphilis and gonococcal infection are decreasing but remain a problem in developing countries and their return cannot be excluded, despite active therapy. In industrial countries, viral infections are expanding. Herpes genitalis is the most common cause of genito-anal ulceration and anogenital warts have been steadily rising in the past decades. Some human papillomavirus genotypes are oncogenic. No treatment is able to eradicate them.
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PMID:[Sexually transmitted diseases of the anus]. 1123 96

The incidence of gonorrhoea is again rising in developed countries and a high disease rate has been maintained in less developed regions for a number of years. The need not only for treatment of the individual but also for control of gonorrhoea at a community level has increased significantly following recognition of its role in the amplification of human immunodeficiency virus (HIV) transmission. A sustainable decrease in the incidence of gonorrhoea and other sexually transmitted diseases (STDs) requires an integrated approach combining improved prevention, better diagnosis and optimal treatment. Effective antibiotic treatment is an essential element of this approach. However, antibiotic treatment of gonorrhoea has been severely hampered by the development of antibiotic resistance in Neisseria gonorrhoeae, to the extent that many therapies are no longer effective. Those treatments that retain acceptable efficacy are often unaffordable where they are most needed. Penicillins and tetracyclines should no longer be used in gonococcal disease, there are limitations on the effectiveness of newer macrolides and spectinomycin and in many parts of the world quinolones have been withdrawn from schedules for the treatment of gonorrhoea. Of all the current agents used to treat all forms of gonococcal disease, only the third generation cephalosporins (most notably ceftriaxone) have retained their efficacy; however, decreased susceptibility to these antibiotics has also appeared. Continuing reliance on antibiotic treatment for controlling gonorrhoea in the absence of other necessary approaches will see a further deterioration in the situation. In these circumstances the possibility that gonorrhoea will be untreatable becomes more real.
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PMID:Current concepts in the management of gonorrhoea. 1182 28

Host cell infection by sexually transmitted disease (STD)-causing microbes and fertilization by spermatozoa may have some mechanisms in common. If so, certain noncytotoxic agents could inhibit the functional activity of both organisms. High molecular mass poly(sodium 4-styrenesulfonate) (T-PSS) may be one of these compounds. T-PSS alone (1 mg/ml) or in a gel (2% or 5% T-PSS) completely prevented conception in the rabbit. Contraception was not due to sperm cytotoxicity or to an effect on sperm migration. However, T-PSS inhibited sperm hyaluronidase (IC(50) = 5.3 microg/ml) and acrosin (IC(50) = 0.3 microg/ml) and caused the loss of acrosomes from spermatozoa (85% maximal loss by 0.5 microg/ml). T-PSS (5% in gel) also reduced sperm penetration into bovine cervical mucus (73% inhibition by 1 mg gel/ml). T-PSS (5% in gel) inhibited human immunodeficiency virus (HIV; IC(50)= 16 microg gel/ml) and herpes simplex viruses (HSV-1 and HSV-2; IC(50) = 1.3 and 1.0 microg gel/ml, respectively). The drug showed high efficacy against a number of clinical isolates and laboratory strains. T-PSS (5% in gel) also inhibited Neisseria gonorrhea (IC(50) < 1.0 gel/ml) and Chlamydia trachomatis (IC(50) = 1.2 microg gel/ml) but had no effect on lactobacilli. These results imply that T-PSS is an effective functional inhibitor of both spermatozoa and certain STD-causing microbes. The noncytotoxic nature should make T-PSS safe for vaginal use. T-PSS was nonmutagenic in vitro and possessed an acute oral toxicity of >5 g/kg (rat). Gel with 10% T-PSS did not irritate the skin or penile mucosa (rabbit) and caused no dermal sensitization (guinea pig). Vaginal administration of the 5% T-PSS gel to the rabbit for 14 consecutive days caused no systemic toxicity and only mild (acceptable) vaginal irritation. T-PSS in gel form is worthy of clinical evaluation as a vaginal contraceptive HIV/STD preventative.
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PMID:Efficacy and safety of a new vaginal contraceptive antimicrobial formulation containing high molecular weight poly(sodium 4-styrenesulfonate). 1190 5

Around 70% of female infertility in developing countries is caused by sexually transmitted diseases (STDs) that can be traced back to husbands or partners. STDs and reproductive tract infections cause 750,000 deaths and 75 million illnesses among women each year worldwide, and these deaths may more than double by the year 2000. Death rates are rising fastest in Africa, followed by Asia and Latin America. About 450,000 cases of potentially fatal reproductive tract cancers are diagnosed annually: an estimated 354,000 occur in Third World women, virtually all of whom die. Worldwide, roughly 250 million new infections of chlamydia, gonorrhea, and the human papillomavirus are sexually transmitted each year. Chlamydia and the human papillomavirus account for 50 million and 30 million new cases per year, respectively. The human immunodeficiency virus (HIV) infected 1 million people worldwide between April and December 1991, according to the World Health Organization. A study in the Indian state of Maharashtra revealed that 92% of the 650 rural women examined had an average of 3.6 infections of gynecological type or sexually transmitted type per women. Another study in 2 rural Egyptian villages found that half of 509 nonpregnant women aged 20 to 60 years had infections. Only 2 facilities for the diagnosis and treatment of STDs exist in all of Kenya. In Ibadan, Nigeria, with a population of 2 million, there is only 1 recognized STD clinic. The physical consequences of several STDs have been linked to increased risks of AIDS transmission. Early recognition and treatment of STDs in pregnant women would cut infant mortality. Maternal infections with chlamydia, gonorrhea, or herpes are transferred to infants at birth 25% to 50% of the time. In Africa, infant blindness caused by gonorrhea infection is 50 times more common than in industrial countries. The International Women's Health Coalition's March 1992 meeting of more than 50 Third World scientists, health advocates, and policymakers made suggestions to make universally available simple, inexpensive, rapid diagnostic tests for STDs and to develop vaginal microbicides that protect women against STDs.
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PMID:The other epidemics. Sexually transmitted diseases. 1215 77

The serologic testing algorithm for recent human immunodeficiency virus (HIV) seroconversion (STARHS) distinguishes between recent acquisition of HIV infection (seroconversion, on average, in the past 129 days) or long-standing infection. STARHS was offered to sexually transmitted disease clinic patients to estimate HIV incidence and determine correlates of recent infection from October 1998 through December 1999. Of the 5227 patients tested, 116 (2.1%) were HIV infected, and 28 had recent infections. The incidence was highest among homosexual men (5.3%/year; 95% confidence interval [CI], 2.6%-10.0%), those who had HIV-infected partners (8.6%/year; 95% CI, 2.9%-21.1%), and those who had gonorrhea (6.7%/year; 95% CI, 1.5%-20.3%). Among homosexual men, African American (odds ratio [OR], 3.61; 95% CI, 1.13-11.55) or Latino (OR, 3.08; 95% CI, 1.11-8.55) race/ethnicity, and having unprotected anal intercourse (OR, 2.98; 95% CL, 1.20-7.45) or gonorrhea (OR, 3.03 95% CI, 1.07-8.63) predicted the predominance of a recent seroconversion. HIV infections in San Francisco may be shifting from white men who have sex with men to men of color who have sex with men.
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PMID:Characterization of sexually transmitted disease clinic patients with recent human immunodeficiency virus infection. 1223 44

In 1993, Zimbabwe's blood service revised its notification system to protect the confidentiality of blood donors found to be positive for human immunodeficiency virus (HIV) or another sexually transmitted disease (STD). In the past, such donors were referred back to their physicians, many of whom were unable or unwilling to discuss STDs; other donors had no personal physician. Now, donors who test positive for HIV, syphilis, or gonorrhea are informed by mail they have an unspecified infection and offered follow-up and counseling services from an organization or doctor (who also receive letters) of their choice. However, some nongovernmental organizations to which infected donors are referred report that less than half present for counseling. Common reasons include a reluctance to go to a site perceived as an AIDS center, fears of an HIV diagnosis, concerns about encountering a counselor they know personally, difficulties related to travel or limited clinic hours, and problems with the postal service. Still in need of clarification is Zimbabwe's policy toward young blood donors. Many countries seek out school-age donors because of their presumed lower risk of infection; however, when these young people test positive, ethical dilemmas emerge about parental notification and consent for counseling. Finally, to reduce the misuse of blood donation services for HIV testing, measures are needed to improve the availability of HIV screening.
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PMID:Testing positive. Counselling blood donors. 1229 30

Two recent US Food and Drug Administration (FDA) hearings have focused on barrier contraceptive methods. In the first action, FDA's Obstetrics and Gynecology Devices Panel voted 7 to 1 against approval of Lea's Shield, a device similar to the cervical cap that does not require custom fitting, on the grounds that adequate clinical research on effectiveness was lacking. Only 1 clinical trial, involving 55 women over a 6-month period, was conducted. The panel urged that additional research on effectiveness also investigate whether the device confers protection against sexually transmitted diseases. During another hearing, FDA advisory committees voted 18 to 1 that spermicidal gels and foams containing nonoxynol-9 appear to provide women with some protection against gonorrhea and chlamydia. At the same time, the committees urged FDA to relabel existing spermicides to inform consumers that their effectiveness in preventing pregnancy has not been established. In addition, panelists voted 11 to 8 that spermicides have been proven safe, although concerns were expressed about spermicide-associated vaginal irritation, which may enhance women's susceptibility to human immunodeficiency virus (HIV) infection.
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PMID:FDA panels probe efficacy of barrier contraceptives. 1229 83


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