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 prevalence of biologic false-positive (BFP) reactions for syphilis (reactive rapid plasma reagin [RPR] test, nonreactive fluorescent treponemal antibody absorption [FTA-ABS] test) among patients attending two sexually transmitted disease (STD) clinics was evaluated to assess relationships between BFP reactions and human immunodeficiency virus (HIV) infection. Among 4863 patients, 357 (7.3%) had serologic evidence of syphilis and 4.9% had HIV infection. Only 40 patients (0.8% of total patients, 11% of those with reactive RPR tests) had BFP serologic tests for syphilis. There were no demographic differences between true syphilis and BFP patients as to sex, age, or intravenous drug use. BFP patients tended to have lower RPR titers (less than or equal to 1:4) than did true syphilis patients. After excluding 317 patients with reactive FTA-ABS tests, BFP RPR tests were seen in 6 (4%) of 159 HIV-seropositive patients and 34 (0.8%) of 4387 HIV-seronegative patients (odds ratio, 5.0; 95% confidence interval, 1.9-12.7). Although more common among HIV-infected than HIV-uninfected patients, BFP reactions are relatively rare among STD clinic patients, and 89% of patients with reactive RPR or VDRL serologic tests for syphilis had current or prior syphilis infection. The RPR test remains useful for guiding decisions regarding therapy for syphilis.
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PMID:Association of biologic false-positive reactions for syphilis with human immunodeficiency virus infection. 158 32

Human immunodeficiency virus (HIV) infection among adolescents is causing increasing concern, and teenagers attending sexually transmitted disease (STD) clinics run a high risk of contracting it. To determine the status of HIV infection in a Mississippi adolescent population, we evaluated seroprevalence rates for adolescents attending Mississippi State Department of Health STD clinics from 1988 to 1990. During this 2-year period, 9855 adolescents (aged 13 to 20 years) attended STD clinics, and HIV antibody was confirmed in 39 (seroprevalence rate 4.0/1000; 95% confidence interval [CI] 2.7 to 5.2). Seropositive rates were almost equal for male and female subjects (4.1/1000 and 3.8/1000, respectively), suggesting predominantly heterosexual transmission. Rates among blacks were 3.5 times higher than among whites. Adolescents with HIV infection were identified throughout the state, irrespective of urban centers. Rates among the smallest counties (ie, population less than 25,000) were not significantly different from those of the largest counties (ie, population greater than 100,000). Mississippi's rank in the top 10 states for other STDs and the state's high teenage pregnancy rate make it an epicenter of the HIV epidemic among adolescents.
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PMID:Seroprevalence of human immunodeficiency virus among adolescent attendees of Mississippi sexually transmitted disease clinics: a rural epidemic. 158 96

An unlinked seroprevalence survey of human immunodeficiency virus (HIV) antibody was conducted using stored sera from all patients who attended the sexually transmitted disease (STD) clinic in Halifax, Nova Scotia between 1980 and 1986. None of the sera collected from 584 patients during 1980 were HIV positive. Of the 2867 patients who visited the clinic between 1981 and 1986, 27 (0.9%; 95% CI 0.6% to 1.2%) had the antibody. None of the 784 female patients were HIV seropositive. Of the 1,884 heterosexual men in the study, 5 (0.3%; 95% CI 0.1% to 0.5%) were HIV seropositive, and 22 (11.1%; 95% CI 6.7% to 15.5%) of the 199 homosexual men were HIV seropositive. There was a strong association between a history of syphilis and HIV antibody among heterosexual men (OR = 76.8; 95% CI 12.0 to 491.3; P = 0.001). Among homosexual men younger than 30 years of age, HIV infection was associated with a history of syphilis (OR = 18.2; 95% CI 5.1 to 64.7; P = 0.035) and a history of gonorrhea (OR = 8.2; 95% CI 4.2 to 16.0; P = 0.001). The association between a history of gonorrhea and HIV infection was strongest among homosexual men who had three or more sexual partners in the last month. These findings supplement existing evidence that STDs increase the likelihood of HIV transmission.
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PMID:Prevalence of human immunodeficiency virus in the patient population of a sexually transmitted disease clinic. Association with syphilis and gonorrhea. 159 13

Understanding the role of other sexually transmitted diseases (STDs) in the transmission of human immunodeficiency virus (HIV), the role of STDs in progression of HIV disease, and the role of HIV infection in alterations of natural history, diagnosis, or response to therapy of STDs is critical to the development of optimal strategies for HIV control. One hundred sixty-three studies on the interrelationships between HIV infection and other STDs were examined. Of 75 studies on the role of STDs in HIV transmission, the 15 analyses of examination or laboratory evidence of STDs adjusted for sexual behavior showed that both ulcerative and nonulcerative STDs increase the risk of HIV transmission approximately 3- to 5-fold. Due to limited data, the role of STDs in progression of disease remains unclear. Preliminary data from 83 reports on the impact of HIV infection on STDs suggest that, at a community level, HIV infection may increase the prevalence of some STDs (e.g., genital ulcers). If coinfection with HIV prolongs or augments the infectiousness of individuals with STDs, and if the same STDs facilitate transmission of HIV, these infections may greatly amplify one another. This "epidemiological synergy" may be responsible for the explosive growth of the HIV pandemic in some populations. Effective STD control programs will be essential to HIV prevention in these communities.
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PMID:Epidemiological synergy. Interrelationships between human immunodeficiency virus infection and other sexually transmitted diseases. 159 15

During the past decade, as the human immunodeficiency virus (HIV) has appeared, sexually transmitted diseases (STDs) have resurged to epidemic proportions, and STDs have been shown to facilitate transmission of HIV, the diagnosis and treatment of STDs have increased in importance for all clinicians. This article's recommendations for treatment of STDs that might more commonly be seen in a dermatology practice are based on the 1989 Sexually Transmitted Disease Treatment Guidelines of the Centers for Disease Control. Clinicians are encouraged to address actively prevention and treatment of sexual partners, a very important part of the management of STDs.
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PMID:Diagnosis and therapy for common sexually transmitted diseases. 160 71

Cryptococcus neoformans is an important opportunist pathogen in human immunodeficiency virus (HIV) infection. Cryptococcal meningitis (CM) 3rd after primary HIV neuropathy an Toxoplasma gondii among infectious neurological diseases in AIDS patients. Extrapulmonary infection due to C. neoformans has occurred in up to 13% of patients. 86% of the Cryptococcus spp isolates in the US, Canada, and Japan are serotype A. Thousands of infection due to var neoformans have been reported in AIDS patients but only 3 cases of var gattii. Cryptococcal pneumonia meningitis appears in 63-84% of AIDS patients with symptoms of fever, headache, meningism, and photophobia. 17-37% of AIDS patients with Cm die during therapy, and only 18-30% live over 12 months. Treatment in patients without immunodeficiency deficit is with a combination of .3 mg/kg/day of amphotericin B and 150 mg/kg/day of flucytosine for 4 weeks. A dose of .5-.8 mg/kg/day amphotericin was most effective although renal toxicity occurred in 80% of patients. Fluconazole has been used since 1987: cerebrospinal fluid concentrations reached 60-80% in serum. Treatment in 8 of 14 patients receiving 400 mg/day fluconazole failed while it did not in 6 patients treated with .7 mg/kg/day of amphotericin for 7 days and flucytosine 100 mg/kg/day. 200 mg/bid itraconazole was given to 32 patients with cryptococcosis (24 CM cases and 26 AIDS victims) and 65% of CM patients improved clinically with negative cultures. The relapse of 2 of 106 patients taking 200 mg/day fluconazole and 13 of 77 patients taking 1 mg/kg/week amphotericin B occurred in maintenance therapy. CM was suppressed in 10 of 15 patients with 400 mg/kg itrazonazole. Prophylactic use of azole drugs in AIDS does not protect completely from CM although it reduced systemic fungal infections such as cryptococcosis.
Int J STD AIDS
PMID:Cryptococcal infection in AIDS. 161 62

Sexually transmitted diseases (STDs), grouped together are one of the most common medical complications of pregnancy. They can have serious adverse effects on the health of both the pregnant mother and her baby. The increasing prevalence of many STDs and the advent of human immunodeficiency virus (HIV)-related problems emphasize the need for STD awareness in the care of pregnant women.
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PMID:Sexually transmitted diseases in pregnancy. 161 40

We analysed the correlation between ophthalmic and systemic findings in 125 subjects with AIDS and 50 subjects with AIDS-related complex (ARC). Positive eye findings were defined as the presence of cotton-wool spots (CWS) or cytomegalovirus (CMV) retinitis. The presence of positive eye findings was significantly more frequent in AIDS than in ARC (P = 0.0001). Both lowest haematocrit and lowest T-helper cell count were significantly lower in AIDS than in ARC, and also lower in subjects with positive eye findings than in those with negative eye findings. No association was found between ocular findings and the following: risk factors for human immunodeficiency virus (HIV) transmission; positive titres for CMV, herpes simplex, Epstein-Barr virus (EBV), and toxoplasmosis; systemic infections; and intake of azidothymidine (AZT). Patients with AIDS and CWS were similar to patients with AIDS and CMV retinitis in viral serology, haematocrit, T-helper count, and survival. Positive eye findings, low haematocrit, and low T-helper count are poor prognostic signs for survival in AIDS.
Int J STD AIDS
PMID:Ocular-systemic interrelationships in acquired immunodeficiency syndrome. 164 4

The Centers for Disease Control is conducting two investigations of the outcomes of HIV counselling and testing services offered persons at high risk for infection with the human immunodeficiency virus (HIV). One investigation is a trial conducted at sexually transmitted disease clinics where an enhanced version of HIV counseling and testing is compared with a standard version. The other investigation is a longitudinal study of the effects of HIV counseling and testing in drug treatment programs that use methadone therapy. In the evaluation, comparisons are being made of different ways of offering HIV counseling and testing and of the effectiveness of the program among persons who know their HIV serostatus and those who do not. The outcome variables include self-reported sexual and drug-using behaviors, together with corroborating laboratory tests, drug treatment compliance, mental health effects, and services utilization. Methodological, practical, and sociopolitical challenges were encountered in the evaluations. Possible solutions to the problems are described. The authors conclude that the designs of the evaluations were appropriate, but that considerable resources are required to carry them out. In settings with low levels of resources, thorough evaluation of the process and an assessment of the immediate outcomes may be the most appropriate evaluation strategy. As HIV counseling and testing are of fundamental importance to national and international HIV prevention efforts, their evaluation is a critical issue.
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PMID:Evaluating the CDC program for HIV counseling and testing. 165 20

A seroprevalence study was carried out on 1757 outpatients consecutively seen in a sexually transmitted disease (STD) clinic in order to evaluate the sexual transmission of hepatitis C virus (HCV). A total of 1442 consenting patients were tested for hepatitis C, hepatitis B and human immunodeficiency virus type 1 (HCV, HBV, HIV-1) antibodies. The relations between anti-HCV, anti-HBc and anti-HIV-1 were studied. Of 73 anti-HCV positive reactions, 45 (61.6%) were confirmed by the recombinant immunoblot assay (RIBA). The proportion of individuals with anti-HCV was higher in outpatients with a history of sexually transmitted disease than without. It was 2.8% in non drug user heterosexuals and 2.9% in non drug user homosexuals. Intravenous drug users (IDU) had higher anti-HCV prevalence when a history of STD was taken into account (42.3% in subjects with STD versus 36.7% in subjects without STD). Among non drug user heterosexuals an association was found between anti-HCV and anti-HBc. These data suggest that sexual transmission of HCV occurs, although it seems to be less efficient than other parenteral modes of transmission. When a more sensitive and specific marker of HCV infection become available, a more accurate estimate of the frequency and efficiency of the sexual transmission will be possible.
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PMID:Heterosexual and homosexual transmission of hepatitis C virus: relation with hepatitis B virus and human immunodeficiency virus type 1. 166 Dec 41


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