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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role of the human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) as risk factor for spontaneous abortion was investigated in a case-control study in Nairobi, Kenya. Cases (n = 195) were women admitted with clinical signs and symptoms of spontaneous abortion, before 20 weeks of gestation. Patients with induced or clinically septic abortion were excluded. Controls were unselected pregnant women in their second or third trimester (n = 195). Spontaneous abortion was independently associated with maternal HIV-1 antibody (14.4% versus 6.2%; adjusted odds ratio, 2.3; 95% confidence interval, 1.1-4.8), with maternal syphilis seroreactivity (6.8% vs 2.1%, adjusted odds ratio, 4.3; 95% confidence interval 1.2-15.6), and with vaginal colonization with group B streptococci (15.6% vs 5.2%; adjusted odds ratio, 3.2; 95% confidence interval, 1.5-6.7). No significant association was found between maternal infections with gonococci and genital mycoplasmas, and spontaneous abortion.
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PMID:The role of maternal syphilis, gonorrhoea and HIV-1 infections in spontaneous abortion. 128 16

To evaluate the impact of human immunodeficiency virus (HIV) on human papillomavirus (HPV) and cervical intraepithelial neoplasia (CIN), a study was conducted of 147 HIV-seropositive and 51 HIV-seronegative prostitutes in Nairobi, Kenya. Among the women infected with HIV, 10 (7%) had signs or symptoms of significant HIV-related disease, and the remaining 93% were asymptomatic. The prevalence of cervical HPV DNA was 37% among HIV-seropositive women and 24% in HIV-seronegative women (odds ratio [OR] 1.7, 95% confidence intervals [CI] 0.8, 3.6, after adjusting for potential confounding factors). Genital warts, cervical HPV DNA, and cytologic findings consistent with CIN were all significantly associated with younger age and fewer years of prostitution, but were unrelated or weakly related to number of sexual partners per week or frequency of condom use. In a subset of 63 women with evaluable Papanicolaou smears, CIN was found in 50% of the women with HPV but only in 8% of those without HPV (adjusted OR 7.2, 95% CI 1.6, 32.1, P = 0.006). However, CIN was unrelated to HIV seropositivity (prevalence of 26% among HIV-seropositive women and 24% in HIV-seronegative women). Among women with cervical HPV DNA, HIV infection was not associated with an increased prevalence of CIN (47% prevalence among women with HIV versus 57% prevalence among women without HIV). Thus, in this population of HIV-seropositive women, most of whom had CDC Stage II or III infection, there was no demonstration of an adverse impact of HIV on CIN.
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PMID:Human immunodeficiency virus, human papillomavirus, and cervical intraepithelial neoplasia in Nairobi prostitutes. 131 92

Evidence from many countries suggests an association of human immunodeficiency virus (HIV) infection and tuberculosis of major public health significance. In order to begin assessing the impact of HIV on tuberculosis in Kenya, we have determined the HIV-1 seroprevalence among tuberculosis patients and compared the clinical characteristics of tuberculosis in HIV-positive and HIV-negative patients in two cross-sectional studies at the Infectious Disease Hospital (IDH) and the Ngaira Avenue Chest Clinic (NACC), Nairobi, Kenya. The diagnosis in 92% of all patients with pulmonary tuberculosis was confirmed by culture. The remainder were diagnosed on histological, clinical or radiological grounds. HIV seroprevalence among tuberculosis patients at IDH was 26.5% (52/196) compared to 9.2% (18/195) at NACC (P less than 0.001). There was no association between numbers of streptomycin injections in the previous 5 years and HIV infection. Positive sputum smear rates in HIV-positive patients were slightly lower than in HIV-negative patients at both study sites (71% vs 83% at IDH and 73% vs 82% at NACC) but the difference was not significant. Only Mycobacterium tuberculosis was isolated. Miliary disease was not associated with HIV infection. Persistent diarrhoea, oral candidiasis, generalized itchy rash, herpes zoster and generalized lymphadenopathy were all associated with HIV infection, but 46% (95% CI:38-54%) of all HIV-positive patients had none of the clinical features listed in the WHO Clinical Criteria for the Diagnosis of AIDS, apart from fever, cough and weight loss. Stevens-Johnson Syndrome was reported in 7/52 (13%) patients with HIV infection, and in 4/144 (3%) patients without (RR 4.85, 95% CI: 1.45-15.88).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cross-sectional survey of HIV infection among patients with tuberculosis in Nairobi, Kenya. 138 70

Chancroid is linked to the spread of human immunodeficiency virus type 1 (HIV-1) in East Africa. Effective, easily administered therapy is a priority for the control of Haemophilus ducreyi. The efficacy of a single oral dose of fleroxacin, 400 mg, was compared to a 3-day oral course of trimethoprim-sulfamethoxazole (TMP-SMZ), 160/800 mg, twice daily for the treatment of chancroid in 98 HIV-1-seronegative men in Nairobi, Kenya. No differences were noted between the two groups with respect to demographic characteristics, sexual behavior, and clinical characteristics. Culture-proven failure occurred in 1 (3%) of 36 fleroxacin-treated patients and in 11 (30%) of 37 TMP-SMZ-treated patients (P = .005). Fleroxacin, as a single oral dose, is an effective treatment for culture-proven chancroid in patients who are HIV-1 seronegative. TMP-SMZ is no longer predictably effective due to the recent emergence of resistance to both sulfonamides and to trimethoprim.
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PMID:A randomized, double-blind study of the efficacy of fleroxacin versus trimethoprim-sulfamethoxazole in men with culture-proven chancroid. 156 47

A cross-sectional study was conducted among women attending a sexually transmitted diseases clinic in Nairobi, kenya, to determine the prevalence of and associated risk factors for human immunodeficiency virus (HIV) type 1 infection. HIV-1 antibody was detected in 13.8% of 600 women. This virus was found most frequently in prostitutes (odds ratio [OR], 7.2), in women reporting a history of genital ulcers (OR, 2.3), and in those with a current diagnosis of genital ulcers (OR, 5.1). Lifetime duration of oral contraceptive use was significantly greater in HIV-1-positive women. Multivariate analysis revealed an association between genital ulcers and HIV-1 infection (OR, 3.8). The strongest association for HIV-1 infection, however, occurred with genital ulcers in combination with the use of oral contraceptives (OR, 25.7).
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PMID:Human immunodeficiency virus type 1 infection in women attending a sexually transmitted diseases clinic in Kenya. 848 67

To identify risk factors involved in heterosexual transmission of human immunodeficiency virus (HIV), a cross-sectional study of HIV-seropositive men and their spouses was conducted in Nairobi, Kenya. Of 70 spouses, 40 (57%) were seropositive and 30 (43%) were seronegative for HIV. In univariate analysis, the presence of cervical ectopy (odds ratio, 4.7; P = .006) was the only statistically significant variable associated with HIV infection in women. After controlling for possible confounding variables using multivariate logistic regression analysis, the presence of cervical ectopy (odds ratio, 5.0; P = .007) remained the only independent predictor of HIV seropositivity. These findings suggest that cervical ectopy may be a newly identified risk factor for heterosexual transmission of HIV.
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PMID:Association of cervical ectopy with heterosexual transmission of human immunodeficiency virus: results of a study of couples in Nairobi, Kenya. 186 44

Human immunodeficiency virus (HIV) infection and cervical neoplasia intimately share several epidemiologic factors, the most important being the role of sexuality in their prevalence. Recent reports have suggested a strong association between the two conditions. In Africa HIV transmission is predominantly heterosexual and there is no significant sex preference. The prevalence of cervical cancer is also high in Africa and may be rising. Two hundred African patients with cervical carcinoma in Nairobi, Kenya, were screened for HIV seropositivity by both ELISA and Western blot. A seroprevalence rate of only 1.5% was obtained. This was comparable to the 2% found in the general population but much lower than the 18-59% recorded in recognized high-risk groups. The background to these surprising results and their implications are discussed.
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PMID:Human immunodeficiency virus seroprevalence among cervical cancer patients. 232 19

The literature relating to the social context of sexual relations in East and Central Africa has several implications for the heterosexual transmission of human immunodeficiency virus (HIV). Colonially created cities in the region still discriminate economically and socially against women. Rapid urbanization is occurring, but migrants maintain strong ties with rural areas. Traditional attitudes towards marriage and sexuality affect urban behavior in the extent of marital stability, the frequency of polygyny, and the emotional bond between spouses. Ethnic groups in Kampala and Nairobi exemplify the cultural foundations of two forms of sexual relations found in the region, one characterized by prostitution and the other by small circles of interchanging lovers. The first results in a more rapid spread of HIV through the urban population and outwards into rural areas. Each pattern exerts unique constraints on behavioral change and requires different prevention campaigns.
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PMID:Social context of human immunodeficiency virus transmission in Africa: historical and cultural bases of east and central African sexual relations. 268 46

Recent epidemiologic studies have implicated genital/anorectal ulcer disease as an important cofactor for acquisition and transmission of human immunodeficiency virus (HIV) during sexual intercourse. To better understand the mechanism for the association between genital ulcers and HIV, exudates from 62 genital ulcers of 56 HIV-seropositive prostitutes in Nairobi (Kenya) were cultured for HIV. Twenty-six ulcer cultures could not be evaluated for the presence of HIV because of bacterial or fungal contamination. HIV was isolated from 4 (11%) of the 36 remaining uncontaminated ulcer cultures (2 introital, 1 vaginal, and 1 cervical) from 4 separate women. HIV was isolated from the cervical os from only 2 of the 4 women. HIV p24 antigen was detected in exudate from 1 of the 4 culture-positive ulcers and 0 of 32 culture-negative ulcers. Genital ulcers in seropositive patients should be regarded as potential sources of HIV, which could be important in transmission of HIV during intercourse. Public health measures aimed at controlling sexually transmitted genital ulcer diseases should be an integral part of acquired immunodeficiency syndrome (AIDS) prevention programs.
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PMID:Isolation of human immunodeficiency virus from genital ulcers in Nairobi prostitutes. 276 Apr 95

A malformation syndrome has been proposed in infants with acquired immunodeficiency syndrome or acquired immunodeficiency syndrome-related complex secondary to congenital infection with human immunodeficiency virus (HIV) in the United States and Europe. To determine whether embryopathy is detectable in HIV-exposed African infants, 85 infants of HIV-seropositive mothers and 98 infants of HIV-seronegative mothers in Nairobi, Kenya, were examined for minor and major anomalous features shortly after birth. No mother used intravenous drugs. With the exception of growth failure no anomalous feature was associated with in utero HIV exposure. No increase in the number of anomalous features per infant was correlated with HIV, nor did any infant have the reported malformation syndrome. Thus in this population of African infants examination for anomalous features during the neonatal period failed to identify those infants with fetal exposure to HIV.
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PMID:Lack of correlation of maternal human immunodeficiency virus infection with neonatal malformations. 281 15


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