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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.
Int J STD AIDS
PMID:The role of maternal syphilis, gonorrhoea and HIV-1 infections in spontaneous abortion. 128 16

In the cases of medical patients with sexually transmitted diseases (particularly those with the human immunodeficiency virus), two distinct approaches exist to notifying sexual and/or needle-sharing partners of possible risk. Each approach has its own history (including unique practical problems of implementation) and provokes its own ethical dilemmas. The first approach--the moral "duty to warn"--arose out of clinical situations in which a physician knew the identity of a person deemed to be at risk. The second approach--that of contact tracing--emerged from sexually transmitted disease control programs in which the clinician typically did not know the identity of those who might have been exposed. Confusion between the two approaches has led many to mistake processes that are fundamentally voluntary as mandatory and those that respect confidentiality as invasive of privacy. In the context of the AIDS epidemic and the vicissitudes of the two approaches, we describe the complex problems of partner notification and underscore the ethical and political contexts within which policy decisions have been made.
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PMID:HIV prevention and the two faces of partner notification. 846 Jul 48

Adolescents and young adults are at risk for human immunodeficiency virus type 1 infection due to unprotected sexual intercourse and drug use. In 1988 and 1989, blinded surveys were conducted in 84 sexually transmitted disease clinics, 115 women's health clinics, and 19 drug treatment centers in 38 metropolitan areas. Blood specimens from 153,242 clients, aged 15 to 24 years, were tested for human immunodeficiency virus type 1 antibodies after all client identifiers were removed. In sexually transmitted disease clinics, the median rate was 0.4% among 15- to 19-year-olds, compared with 1.4% among 20- to 24-year-olds. Among heterosexual adolescents, rates in females were significantly higher than in males (Wilcoxon signed rank test). Rates in heterosexuals were highest in the northeastern and southeastern United States and in Puerto Rico. In 20- to 24-year-old male clients in sexually transmitted disease clinics who had sex with males, rates ranged from 9.7% to 55.6%. In drug treatment centers, the median rate among 20- to 24-year-old men and women was 8.3% (range, 0% to 33.3%). Rates in women's health clinics were much lower (median, 0.1%). The high rates of infection in certain groups of adolescents and young adults indicate the need for improved care, education, and outreach targeted toward those at high risk.
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PMID:Youth at risk. Sex, drugs, and human immunodeficiency virus. 131 May 67

Since 1989, 21 persons with unexplained CD4+ T-lymphocyte depletion, but without evident human immunodeficiency virus (HIV) infection, have been described (1-12). These reports included persons who have resided in the United States and six other countries and who sought medical care for conditions often associated with immune deficiency. Some of these cases were also described at the VII International Conference on AIDS/III STD World Congress in Amsterdam. In addition, CDC has received reports of five persons from three states who have had persistently low CD4+ T-cell levels but who have had no evidence of HIV infection or underlying disease processes or therapies known to be associated with T-cell depletion. In some of these five patients, opportunistic infections were diagnosed that frequently occur in persons with acquired immunodeficiency syndrome (AIDS). This report describes preliminary clinical and laboratory findings from an ongoing investigation by CDC of these five patients.
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PMID:Unexplained CD4+ T-lymphocyte depletion in persons without evident HIV infection--United States. 135 46

To identify the importance of heterosexual activity as a possible route for the transmission of the hepatitis C virus (HCV), a screening of antibodies against HCV (anti-HCV) was performed in 200 sexually transmitted disease patients with different risks for incurring genital infections as well as in 100 registered prostitutes. Out of all 300 persons tested, 14 cases of HCV infection were detected. Anti-HCV was present in 3 of the prostitutes and in 11 of the STD patients. Evaluating known risk factors, such as intravenous drug use or blood transfusion, 6 out of the 11 STD patients and all of the prostitutes in whom anti-HCV was present were intravenous drug users and exhibited highly promiscuous behavior. Intravenous drug use was the probable means of acquisition in 9 of the 14 subjects in whom anti-HCV was present, and homosexual promiscuous behavior was assumed to be the means of acquisition in another 2 subjects. In heterosexual patients engaging in high-risk behavior (high number of sexual partners and genital infections), the exclusion of intravenous drug use decreased the prevalence of anti-HCV from 12.1% to 4.1%, demonstrating no significant increase from the prevalence among low-risk persons. Most of the patients were screened for STDs, such as syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, human immunodeficiency virus (HIV), hepatitis B virus (HBV), trichomoniasis, and yeast infections. The highest rate of coinfection with anti-HCV was found in patients with serologic evidence of an HIV infection (50%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Seroepidemiologic study of hepatitis C virus in sexually transmitted disease risk groups. 138 51

A total of 236 clients attending human immunodeficiency virus (HIV) counseling and testing (C&T) centers and sexually transmitted disease (STD) clinics were interviewed to evaluate who is being reached by C&T services and if STD clients are being referred to HIV C&T centers. Respondents receiving HIV C&T reported significantly more sexual risk based on characteristics of their partners, whereas STD clinics respondents more frequently reported previous STD diagnoses and sex with prostitutes. Over 50% of the high-risk individuals attending STD clinics were not referred to HIV C&T centers. The differences in perceived risk of current and future infection between STD and HIV C&T centers and the low referral rates of high-risk individuals for HIV C&T indicate a need for increased education efforts, more effective risk-assessment policies in STD clinics, and a tightening of the link between STD clinics and HIV C&T centers.
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PMID:The link between sexually transmitted disease clinics and HIV counseling and testing centers: who is not getting referred? 138 81

Behaviors that increase the risk of acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) among adolescents living in rural areas have been reported to be as frequent as those of lower socioeconomic minority youth living in large urban areas. Little is known, however, about whether rural adolescents possess adequate knowledge upon which to make responsible decisions to avoid exposure to HIV. In order to address this deficit, we administered the Centers for Disease Control (CDC) 1989 Secondary School Health Risk Survey to 294 sixth, seventh, and eighth grade students (30.2% sample) from a rural county with significant social problems including epidemic sexually transmitted diseases STDs, sex-for-drugs, poverty, and drug abuse. The sample was 65% African-American, 50% female, with a mean age of 12.9 +/- 1.3 years. Although 68% reported having received school-based AIDS education, a lower proportion (greater than or equal to 10%) the students were found to correctly answer 8 of 17 AIDS/HIV knowledge questions than those from a national comparison group. The mean was 12.8 +/- 3.1 of 17 items answered correct. Lower AIDS/HIV knowledge was associated with lower school grade (rho = 0.46, p less than or equal to 0.0001); being African-American, Hispanic, or Native American (p less than or equal to 0.043); and never receiving school-based AIDS/HIV education (p less than or equal to 0.0001). Based on multivariate analysis of variance (ANOVA), only school-based AIDS/HIV education was a significant predictor (p less than or equal to 0.0001) of knowledge.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:AIDS/HIV knowledge level and perceived chance of having HIV among rural adolescents. 139 Aug 17

Between June and December 1990, 806 prostitutes registered with the STD program in Singapore for regular screening for sexually transmitted diseases (STDs) were investigated for factors associated with STD incidence in the preceding year. The majority were foreigners (92.7% Malaysians and 3.1% Thais). Anal sex (0.4%) and iv drug use (0.9%) were rare. The overall STD incidence rate was 47.7/100. None was human immunodeficiency virus (HIV) positive. The crude and age-adjusted risk of STDs was found to increase significantly with client load. An inverse relationship between condom use and STD risk was also observed. Mean condom use among clients was reported as 56.1% for spontaneous use and estimated as 75.4% following negotiation for condom use by prostitutes. Although the prostitutes negotiated for condom use with the majority of clients (85.5%) who did not use condoms spontaneously, they were successful with only about 1/2 of them (54.4%). Health education should be aimed at those clients on the protective effects of condom use and at the prostitutes on skills in negotiating condom use.
Int J STD AIDS
PMID:Factors associated with sexually transmitted diseases among prostitutes in Singapore. 139 Oct 60

Human immunodeficiency virus infection has now reached epidemic proportions in both industrialized and nonindustrialized countries. Two preventive measures remain of questionable benefit: mandatory testing and partner notification. Sexually transmitted diseases and cervical ectopy may be risk factors for heterosexual transmission, now the most frequent mode of transmission of human immunodeficiency virus worldwide. Smokable freebase cocaine, the use of which is increasing in many cities in industrialized countries, is associated with acquisition of sexually transmitted diseases and human immunodeficiency virus infection. In addition to perinatal transmission of human immunodeficiency virus, postnatal transmission via breastfeeding has been demonstrated in association with a recent acquisition of human immunodeficiency virus by the mother. Intriguingly, in multiple pregnancies, first-born twins of human immunodeficiency virus-infected mothers could be at higher risk of infection than second-born twins. Nosocomial transmission of human immunodeficiency virus, both from infected patients to health professionals and from infected health professionals to patients, is a matter of concern and justifies preventive measures.
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PMID:The ever-evolving epidemiologic concepts of human immunodeficiency virus infections. 139 38

Acquired immunodeficiency syndrome (AIDS) is caused by infection with a pathogenic human retrovirus known as human immunodeficiency virus (HIV). Approximately 1 million people are currently infected with HIV in the United States, with 8 to 10 million infected individuals worldwide. The virus is transmitted predominantly through genital sexual contact, although orogenital spread has been rarely reported. Heterosexual transmission has been most common in the Third World, whereas male homosexual transmission has predominated in the United States and western Europe. Transmission through homosexual contact has been steadily declining over the past 5 years as transmission through illicit intravenous drug use and promiscuous unprotected heterosexual activity has increased. Sexually transmitted diseases that cause inflammatory or ulcerative lesions of the genital tract act as important cofactors in increasing the risk of transmission through sexual contact. Perinatal transmission of HIV occurs in approximately 30% of infants born to infected mothers. Transmission to infants through breast-feeding has also been documented. Health care workers have been infected with HIV through accidental high-risk percutaneous or mucous membrane exposures, albeit at a low transmission rate of 0.3%. Infection of patients by infected health care professionals is a rare event, having been reported only once in 10 years of the epidemic. Infection with HIV results in a chronic lifelong infection. The major targets for HIV are CD4+ T-helper lymphocytes and cells of monocyte/macrophage lineage. Infection of the T-helper lymphocyte ultimately results in the death of the cell. Over time (measured in years), a progressive destruction of the T-helper lymphocyte population occurs, which results in profound immune suppression. Infection of monocytes/macrophages is not cidal, but these cells do have functional alterations as a result of the infection, which may contribute to the immune deficiency. In addition, chronically infected tissue macrophages may act as an important reservoir for HIV, particularly in the central nervous system. Infection of the T-helper lymphocytes and monocytes/macrophages is mediated through attachment of HIV through a specific binding interaction between CD4 expressed in the plasma membrane of these cells and a surface glycoprotein on the virus, gp120. Once the virus nucleocapsid (core particle) enters the cytoplasm of the target cell, the viral RNA genome is reverse transcribed by a reverse transcriptase enzyme into proviral DNA. This proviral DNA migrates into the nucleus where it integrates into the host cellular genome, which results in a chronically infected cell.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:AIDS: Part I. 139 37


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