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

The roles of Mycoplasma genitalium and Ureaplasma urealyticum in nongonococcal urethritis are not yet well established. The aim of this study was to determine the presence of these microorganisms in the urethral tracts of 187 human immunodeficiency virus type 1 (HIV-1)-infected male patients with no clinical signs of urethritis. The results indicate that the prevalence of M. genitalium and U. urealyticum was higher in AIDS patients than in asymptomatic, HIV-1-infected patients and in healthy individuals. The high rate of mycoplasmas and ureaplasmas detected in AIDS patients, in the absence of urethritis, argues against major roles in causing disease at the urethral mucosal level for these microorganisms.
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PMID:Increased frequency of detection of Ureaplasma urealyticum and Mycoplasma genitalium in AIDS patients without urethral symptoms. 1032 75

To determine the effect of circumcision status on acquisition of human immunodeficiency virus (HIV) type 1 and other sexually transmitted diseases, a prospective cohort study of 746 HIV-1-seronegative trucking company employees was conducted in Mombasa, Kenya. During the course of follow-up, 43 men acquired HIV-1 antibodies, yielding an annual incidence of 3.0%. The annual incidences of genital ulcers and urethritis were 4.2% and 15.5%, respectively. In multivariate analysis, after controlling for demographic and behavioral variables, uncircumcised status was an independent risk factor for HIV-1 infection (hazard rate ratio [HRR=4.0; 95% confidence interval [CI], 1.9-8.3) and genital ulcer disease (HRR=2.5; 95% CI, 1.1-5.3). Circumcision status had no effect on the acquisition of urethral infections and genital warts. In this prospective cohort of trucking company employees, uncircumcised status was associated with increased risk of HIV-1 infection and genital ulcer disease, and these effects remained after controlling for potential confounders.
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PMID:Effect of circumcision on incidence of human immunodeficiency virus type 1 and other sexually transmitted diseases: a prospective cohort study of trucking company employees in Kenya. 1082 7

Human immunodeficiency virus (HIV) infection risk behavior was evaluated in a cross-sectional survey of 400 male active-duty US Army personnel who presented at a sexually transmitted disease (STD) clinic with symptoms of acute urethritis. High-risk partners were common, and nearly one-quarter of the sample had previously had STDs. Logistic regression models examined correlates of HIV exposure risk, of inconsistent condom use, and of having partners with increased risk of HIV infection. Frequent partner turnover, sex "binging," negative attitudes toward condom use, and engaging in sex during military leaves were important correlates of risk. Individuals with HIV infection risk behavior generally were cognizant of their risk for HIV infection. Implications for intervention are discussed.
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PMID:Correlates of human immunodeficiency virus infection risk behavior in male attendees of a clinic for sexually transmitted disease. 1077 Jul 35

We have examined cell-free viral populations in the blood plasma and seminal plasma compartments of men infected with subtype C human immunodeficiency virus type 1 (HIV-1) using the V3-specific heteroduplex tracking assay (V3-HTA). We studied two cohorts of subjects who had visited either a sexually transmitted disease (STD) clinic for genital tract inflammation in the form of urethritis (n = 43) or a dermatology clinic (controls, n = 14) in Malawi. We have previously shown that the presence of urethritis is associated with an eightfold increase in virus load in the seminal plasma compartment (M. S. Cohen et al., Lancet 349:1868-1873, 1997). The purpose of this study was to determine whether genital tract inflammation and its treatment caused genetic instability in cell-free HIV-1 populations. In a cross-sectional analysis at study entry, three-fourths of the STD and control subjects had multiple V3 populations in their blood while 60% of the STD subjects and 79% of the control subjects had multiple V3 populations in their semen. Overall, one-fourth of all of the subjects showed discordance between results with blood and semen specimens when samples were compared for the presence and absence of subpopulations. When differences in the relative levels of abundance of bands were also taken into account, two-fifths of all of the subjects showed discordance between the compartments. Among the subset of subjects in whom multiple virus populations could be detected, half showed discordance between the compartments. There were no differences between STD and control cohorts for these comparisons of the compartments in this cross-sectional analysis at study entry. Longitudinal analysis of the viral populations from two separate clinic visits over 1 to 4 weeks showed that the complexity of each V3 population as measured by Shannon entropy was different in blood and semen at the two time points, indicating that the blood and semen constitute different compartments for HIV-1. The seminal plasma compartment was more dynamic than the blood plasma compartment for the STD subjects who were treated for urethritis, with changes being noted in the presence or absence of V3-HTA bands in the semen of 29% of these subjects but in the blood of only 9% of these subjects. However, the changes were generally small. Overall, our results suggest that 40% of male subjects show discordance between seminal and blood viral populations and that the complexity of each V3 population was different between the two compartments. Both of these results point to the partial independence of the seminal compartment as a viral niche within the body.
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PMID:Effects of genital tract inflammation on human immunodeficiency virus type 1 V3 populations in blood and semen. 1098 38

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

This paper presents a socioeconomic profile and the prevalence of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), among 341 female commercial sex workers (CSWs) in Kathmandu Valley. Most of the CSWs are from outside the valley, but from within Nepal. Over 50% of the CSWs have a secondary or higher level of education. The average age of the CSWs is 21 years. The average age of first sexual intercourse was 16 years; and, at entering the sex trade, 18 years. The most frequently reported type of sexual activity is vaginal intercourse followed by anal intercourse. Although a large proportion of CSWs are aware of condoms, only one-fifth of them reported using condoms most of the time they had intercourse. The majority of the CSWs are aware of general types of STDs. Slightly over 60% are aware of AIDS, and the majority of them know of at least one mode of AIDS transmission. Gynecological examination based on symptoms revealed that 72% of the CSWs were infected with some type of STD. About 47% had vaginal discharges, 36% had pelvic inflammatory disease, 24% had ulcerative disease, and 4% had urethritis. Blood tests of the CSWs revealed that 28% had VDRL (a test for syphilis), hepatitis B, or HIV. The prevalence of VDRL was the most common, followed by hepatitis B. Of the 341 CSWs, 3 (0.9%) were HIV-positive.
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PMID:Commercial sex workers in Kathmandu Valley: profile and prevalence of sexually transmitted diseases. 1215 41

Due to the fact that an overwhelming majority of patients with Acquired Immune Deficiency Syndrome (AIDS) acquired the infection through sexual contact, it comes as no surprise that the same populations who are at increased risk for various sexually transmitted diseases (STDs) also experience high rates of human immunodeficiency virus (HIV) infection. There is increasing evidence that some STDs may enhance the efficiency of sexual transmissions of HIV. Genital ulcers are among the genital syndromes most convincingly implicated as cofactors for potential sexual transmission of HIV. Several cross-sectional studies among heterosexual men and women in Africa originally revealed that both a history of and the presence of genital ulcers was correlated with HIV infection. These findings are complemented by those of a study of HIV infection in homosexual men in the US. This study reports a strong association between HIV antibodies and a history of syphilis and of oral or anogenital herpes. The association between HIV antibodies and genital ulcers remained after controlling for the level of sexual activity. A prospective study conducted in Nairobi provided evidence that genital ulcers, particularly chancroid, increase the susceptibility to HIV infection among women. Another prospective study in Nairobi of men who acquired an STD from a group of prostitutes known to have a very high rate of HIV infection found that men who acquired genital ulcers had 5 times the rate of HIV infection as men who acquired urethritis. In the same cohort of prostitutes, "chlamydia trachomatis" infection also increased the risk of acquisition of HIV. Effective and inexpensive antimicrobial therapy is available for most bacterial STDs. Programs for the diagnosis and treatment of STDs should be integrated into AIDS control programs. The AIDS epidemic should not become a reason for decreasing support for STD control programs but rather an incentive to initiate or strengthen such programs.
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PMID:AIDS: the impact of other sexually transmitted diseases. 1228 Sep 52

Sexually transmitted diseases (STDs) affect the physiology of male/female reproduction. Chronic bacterial infection of semen is uncommon, but may be a cause of male infertility. Antibacterial treatment results in improvement in sperm quality, once the infection is eradicated. Little is known about how infection with Mycoplasma hominis affects semen quality, but treatment with antibiotics improves motility and decreases the percentage of coiled tails. Chlamydia trachomatis is not frequently isolated from the urethral cultures of normal men, but is a major cause of nongonococcal urethritis and epididymitis. Chlamydia is an important cause of epididymal and oviductal obstruction. Trichomonas vaginalis most frequently colonizes the vagina and cervix of women and the anterior urethra of the male sexual partners. The highest prevalence is in sexually active men and women and Trichomoniasis may well be the most common STD. Syphilis may be an important cofactor in facilitating transmission of the human immunodeficiency virus (HIV). A history of syphilis or a positive serologic test for syphilis is associated with HIV seropositivity in men. In South Africa, the seropositivity in pregnant black women ranges from 11-20%. Ga-Rankuwa Hospital is the referral center for 40 peripheral hospitals and over 4 million people. Since the inception of the Andrology Laboratory in June 1985, more than 5300 semen analyses have been performed on 2000 patients.
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PMID:Sexually transmitted diseases (STD) in infertile males attending the andrology clinic at Ga-Rankuwa Hospital. 1228 85

Given strong evidence that sexually transmitted diseases (STDs) are co-factors for human immunodeficiency virus (HIV) acquisition, integration of STD prevention programs is an essential aspect of acquired immunodeficiency syndrome (AIDS) control. The interaction between STDs and HIV is bidirectional and synergistic. HIV-infected persons with a concomitant untreated STD may have enhanced shedding of the virus, thereby increasing transmission efficiency. Moreover, the impaired immunity in HIV-infected persons with an STD is associated with more severe clinical manifestations of that STD and a compromised treatment response. According to numerous prospective studies, the presence of a concurrent STD at the time of unprotected intercourse is associated with an up to five-fold increased risk of HIV infection. The presence of a genital ulcer and either urethritis or cervicitis are highly predictive of seroconversion. Cervical entropy and lack of circumcision further increase the risk of HIV transmission. Preliminary research findings from Thailand and Tanzania suggest that an aggressive AIDS educational campaign, in conjunction with condom distribution and a large-scale STD diagnosis and treatment program, has the potential to slow the rate of HIV seroconversion.
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PMID:STDs as cofactors for the acquisition of HIV infection. 1232 Feb 80


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