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 risk of acquiring a sexually transmitted disease as a result of rape is not known, in part because it is difficult to ascertain whether infections were present before the assault or acquired during it. To investigate this question, we examined female victims of rape within 72 hours of the assault and again at least one week after the assault. Of the 204 girls and women initially examined within 72 hours of the rape, 88 (43 percent) were found to have at least one sexually transmitted disease. These diseases included infections caused by Neisseria gonorrhoeae (6 percent of those tested), cytomegalovirus (8 percent), Chlamydia trachomatis (10 percent), Trichomonas vaginalis (15 percent), herpes simplex virus (2 percent), Treponema pallidum (1 percent), and the human immunodeficiency virus type 1 (HIV-1; 1 percent) and bacterial vaginosis (34 percent). Among the 109 patients (53 percent) who returned for at least one follow-up visit (excluding those who were found to be infected at the first visit or who were treated prophylactically), the incidence of new disease was as follows: gonorrhea, 4 percent (3 of 71); chlamydial infection, 2 percent (1 of 65); trichomoniasis, 12 percent (10 of 81); and bacterial vaginosis, 19 percent (15 of 77). There were no new infections with herpes simplex virus, cytomegalovirus, Trep. pallidum, or HIV-1, but follow-up serologic testing was performed in only 26 percent of the patients. On the basis of our assumptions that most venereal infections present within 72 hours of a rape were preexisting and that new infections identified 1 to 20 weeks later were acquired during the assault, we conclude that the prevalence of preexisting sexually transmitted diseases is high in victims of rape and that they have a lower but substantial additional risk of acquiring such diseases as a result of the assault.
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PMID:Sexually transmitted diseases in victims of rape. 221 85

From 1 January 1986 to 1 September 1989 124 women presented to the Ambrose King Centre (the department of genitourinary medicine of the London Hospital) alleging rape. Sexually transmitted diseases were found in 36 (29%) women (excluding candidosis and bacterial vaginosis). The commonest organisms detected were Neisseria gonorrhoeae and Trichomonas vaginalis, each being present in 15 patients. Eleven women had genital warts. Chlamydia trachomatis was isolated in six patients, two had herpes simplex virus infection and one patient had pediculosis pubis. Serological evidence of past hepatitis B infection was detected in five women and one patient had antibodies to human immunodeficiency virus. Eighteen of the 36 women (50%) had multiple infections. Six women had abnormal cervical cytology smears, three being suggestive of cervical intraepithelial neoplasia grades II-III. Although it is rarely possible to attribute infection to an assailant, these patients require further counselling, treatment and review. Rape victims are thus a population at risk of having sexually transmitted diseases and screening should be offered.
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PMID:Sexually transmitted diseases in rape victims. 207 Nov 37

The most common spermicidal compound in use in North America is nonoxynol-9. Barrier methods of contraception used in combination with a spermicidal product help prevent a variety of sexually transmitted diseases. In 1991 the Centers for Disease Control reported a total of 620,478 cases of gonorrhea, 128,569 of syphilis, and 43,672 of acquired immunodeficiency syndrome (AIDS). The evidence for antimicrobial activity of spermicides against sexually transmitted disease pathogens has been accumulated during the last 20 years from in vitro and in vivo studies on Neisseria gonorrhea, Treponema pallidum, Chlamydia trachomatis, Trichomonas vaginalis, Herpes simplex viruses 1 and 2, and the human immunodeficiency virus. Uropathogenic bacteria, including E. coli, Proteus mirabilis, Enterococcus faecalis and Staphylococcus species, have been found to grow in concentrations of 25% or greater of nonoxynol-9. Less well known is the effect of nonoxynol-9 on the growth of lactobacilli, the predominant organisms colonizing the vagina of most healthy postpubertal and premenopausal women, which according to in vitro studies could inhibit the colonization and ascending infection of the bladder by E. coli and as E. faecalis. The organisms associated with bacterial vaginosis have been found to be inhibited by low concentrations of nonoxynol-9 (0.0019-0.5%). However, spermicide use does not appear to have any effect on the development of bacterial vaginosis. Clinical studies to date, with one exception, have shown no significant differences in bacterial vaginosis infection rates among users of diaphragms, contraceptive sponges and condoms and other contraceptive methods that do not involve exposure to spermicides. A history of nonoxynol-9 use as well as the use of antimicrobial agents should be considered in recurrent urogenital infections, since both can potentially disrupt the urogenital microbial flora. The physician must weigh the risk of exposure to sexually transmitted diseases or an unwanted pregnancy against the prevention of urinary tract infection or vaginal candidiasis before advising the patient to discontinue the use of nonoxynol-9-containing spermicides.
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PMID:The influence of nonoxynol-9-containing spermicides on urogenital infection. 805 30

These guidelines for the treatment of patients with sexually transmitted diseases (STDs) were developed by staff members of CDC after consultation with a group of invited experts who met in Atlanta on January 19-21, 1993. Included are new recommendations for single-dose oral therapy for gonococcal infections, chlamydial infections, and chancroid; new regimens for the treatment of bacterial vaginosis (BV) and outpatient management of pelvic inflammatory disease (PID); a new patient-applied medication for treatment of genital warts; and a revised approach to the management of victims of sexual assault. This report includes new sections on subclinical human papillomavirus (HPV) infections and cervical cancer screening for women who attend STD clinics or who have a history of STDs. These recommendations also include expanded sections on the management of patients with asymptomatic human immunodeficiency virus (HIV) infection; vulvovaginal candidiasis (VVC); STDs among patients coinfected with HIV; and STDs among infants, children, and pregnant women.
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PMID:1993 sexually transmitted diseases treatment guidelines. Centers for Disease Control and Prevention. 814 6

Intraamniotic infection is a common (2-4%) event in labor. The predictors of IAI include preterm labor or rupture of membranes, abnormal vaginal flora (e.g., GBS, sexually transmitted disease, bacterial vaginosis), obstetric manipulations (e.g., vaginal exams, internal fetal monitoring) in the presence of ruptured membranes, and diminished host response (due to smoking, drug abuse, obesity, immunodeficiency states, etc.). Group B Streptococcus and Enterobacteriaceae are the most important organisms associated with the polymicrobial infection. Anaerobes predict post-cesarean section complications. Neonatal pneumonia (2-5%) and early neonatal sepsis (1-4%) are the outcomes of the greatest concern and are caused by group B streptococcal or aerobic gram-negative rod infections. These outcomes are kept to a minimum if maternal antibiotic chemotherapy is started interpartum with agents that are safe, cross the placenta, and are active against GBS and Escherichia coli (e.g., ampicillin plus gentamicin). Anaerobic coverage should be added (clindamycin) if a cesarean section is performed. Antipyretics such as acetaminophen will reduce the hyperthermic stress on the fetus, and persistent fetal tachycardia after antipyretics may indicate fetal infection. Continuous electronic fetal monitoring is appropriate in cases of IAI, and providers should be prepared for neonatal resuscitation, early neonatal intravenous antibiotics, and respiratory support at delivery.
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PMID:Chorioamnionitis and intraamniotic infection. 829 82

Spermicides kill a wide range of bacteria and viruses causing sexually transmitted diseases (STDs), including the human immunodeficiency virus (HIV) in vitro, and protect in vivo from infection by gonorrhoea, chlamydia, and pelvic inflammatory disease (PID). In the UK and the US, the most commonly used compound in spermicidal agents is the neutral surfactant nonoxynol-9. Although spermicides reduce the incidence of reinfection by some STDs, an in vivo virucidal action is not supported by convincing data. Among barrier methods, latex condoms provide an impervious barrier in vitro to most STD pathogens, including HIV. Natural condoms made of sheep intestinal membrane can allow passage of hepatitis B viral particles but not HIV in vitro. Several studies have shown protection against cervical gonorrhoea and PID among diaphragm users; however, diaphragm use has been associated with an increased rate of urinary infection and also bacterial vaginosis. It is conceivable that women using oral contraceptives (OCs) do not develop as much tubal damage as women not using OCs because of a modified immunological reaction. A study carried out in Europe showed a statistically significant protective effect against PID of the levonorgestrel-containing IUD as compared with the copper-containing Nova-T. A case/control study of 1028 women in Chicago in 1970 noted admission for PID during the following 7 years of only 1 woman who had been sterilized compared to 9 controls. A case/control study examining risk factors for cervical intraepithelial neoplasia (CIN) in 103 women with biopsy-confirmed CIN II or III did not find an increased risk with either OC or IUD use after adjusting for other known risk factors. After adjustment for age and education, the odds ratio for diaphragm use was .3 and the odds ratio for condom use was .5. Thus, hormonal contraception and tubal ligation give protection to the upper genital tract but not to the cervix.
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PMID:Contraception and the prevention of sexually transmitted diseases. 832 7

To explore a possible association between bacterial vaginosis and human immunodeficiency virus (HIV) infection, 144 consecutively enrolled commercial sex workers from a sexually transmitted disease clinic (STD) in Chiang Mai, Thailand, were interviewed and underwent serologic testing and genital examination. 62 (43%) of sex workers were HIV-positive. A self-reported history of syphilis, chancroid, herpes, gonorrhea, or Chlamydia was significantly associated with HIV infection. Bacterial vaginosis, detected in 49 (34%), was also associated with HIV infection. Sex workers reporting 10-19 and 20 or more sexual encounters per week were 2.2 and 3.5 times, respectively, more likely to be infected with HIV than those reporting under 10 encounters. A clinically established diagnosis of bacterial vaginosis was independently associated with HIV seropositivity even when age, number of sexual encounters per week, current condom use, and past and current STD infection were controlled (odds ratio, 4.0; 95% confidence interval, 1.7-9.4). When the bacterial vaginosis diagnosis was based on Gram stain (score 7-10), however, the association with HIV seropositivity disappeared, but having abnormal vaginal flora (gram stain score 4-10) was related to HIV status. Further epidemiologic studies are recommended to investigate the possibility that bacterial vaginosis--the most prevalent genital infection in Thailand--acts as a cofactor for the heterosexual transmission of HIV.
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PMID:Bacterial vaginosis and HIV seroprevalence among female commercial sex workers in Chiang Mai, Thailand. 852 84

Women constitute the fastest growing segment of adults with acquired immunodeficiency syndrome (AIDS), representing 18% of all cases in the United States in 1994. Heterosexual transmission is now the dominant route by which women are infected. Recent reports indicate that although certain manifestations may be different in women than in men, the rate of clinical progression is similar when they receive comparable medical treatment. Antiretroviral therapy is equally as effective in women as in men. As in men, Pneumocystis carinii pneumonia is the most frequent AIDS-defining diagnosis in women. Candida esophagitis and ulcers secondary to herpes simplex virus are more common in women. Kaposi's sarcoma is rare. The prevalence of humanpapilloma virus infection and cervical neoplasia is increased in HIV-seropositive women. Vaginitis due to candida, trichomonas, and bacterial vaginosis are common findings among human immunodeficiency virus seropositive women. The clinical course and response to therapy in certain sexually transmitted diseases (syphilis and herpes) may be altered. The use of zidovudine during pregnancy and delivery has been associated with a 67.5% reduction in vertical transmission.
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PMID:Human immunodeficiency virus infection and acquired immunodeficiency syndrome among North American women. 887 94

Bacterial vaginosis (BV) is associated with an increased rate of sexual transmission of human immunodeficiency virus (HIV) type 1, and Gardnerella vaginalis is frequently isolated from the genital tracts of women with BV. G. vaginalis lysates were found to significantly stimulate HIV expression in monocytoid cells. Stimulation was significantly higher when lysates were heated at 100 degrees C for 5 min but was reduced by treatment with lysozyme or protease. G. vaginalis lysates also activated HIV expression in certain T cell lines. G. vaginalis lysates activated HIV long-terminal repeat transcription in HIV-infected cells and increased NF-kappaB binding activity, indicating an effect by G. vaginalis on HIV transcription. The activation of HIV production by G. vaginalis suggests that genital tract infection with G. vaginalis increases the risk of HIV transmission by increasing HIV expression in the genital tract. This may explain, at least in part, the increased rate of HIV transmission in women with BV.
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PMID:Activation of human immunodeficiency virus type 1 expression by Gardnerella vaginalis. 1006 88

This study was undertaken to assess whether the prevalence of lower genital tract infections among human immunodeficiency virus (HIV)-seropositive women was higher than among high-risk HIV-seronegative women at their baseline visit for the HIV Epidemiology Research Study. Results were available for 851 HIV-seropositive and 434 HIV-seronegative women. Human papilloma virus (HPV) infection was more prevalent among HIV-seropositive women (64% vs. 28%). Bacterial vaginosis was common (35% vs. 33%), followed by trichomoniasis (12% vs. 10%), syphilis (8% vs. 6%), Chlamydia trachomatis infection (4% vs. 5%), candidal vaginitis (3% vs. 2%), and Neisseria gonorrhoeae infection (0.8% vs. 0.3%). Alcohol use (odds ratio [OR], 1.8; 95% confidence interval [CI], 1. 3-2.4) and smoking (OR, 1.8; 95% CI, 1.3-2.5) were associated with bacterial vaginosis. Bacterial vaginosis (OR, 2.3; 95% CI, 1.5-3.4), trichomoniasis (OR, 2.3; 95% CI, 1.1-4.7), and syphilis (OR, 3.1; 95% CI, 1.3-7.4) were found to be more prevalent among black women. Our study showed no statistically significant difference in the prevalence of lower genital tract infections except for HPV between HIV-infected and demographically and behaviorally similar HIV-uninfected high-risk women.
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PMID:Prevalence of lower genital tract infections among human immunodeficiency virus (HIV)-seropositive and high-risk HIV-seronegative women. HIV Epidemiology Research Study Group. 1052 55


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