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)

Substance abuse is a major public health problem in the United States today. Studies are showing increasing evidence of the serious medical and psychosocial consequences of drug use across all age groups. Of great concern are the problems of infants born to addicted mothers, the increased incidence of cardiovascular complications in young people due to cocaine use, and the extremely high risk of exposure to human immunodeficiency virus. There is no socioeconomic group that is left untouched by substance abuse. Yet, for various reasons this disease is probably the most ignored or underdiagnosed disease in the primary care setting. This article provides information about addiction and suggests key areas for history taking, physical exams, and collection of laboratory data that may help in primary care screening. When concrete information about the consequences of drug use is provided to addicts they may be motivated to seek treatment without feeling threatened.
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PMID:Primary care screening for substance abuse. 806 59

Considering the official figure on drug-related deaths in Austria, the problem of substance abuse has dramatically worsened over the last years. There is a distinct lack of comprehensive information concerning drug-related deaths in Austria, although deaths of drug users may be potentially important indicators of the extent of drug-related problems in the population. The results of examinations performed on 372 deceased substance abusers at the Institute of Forensic Medicine in Vienna between 1985 and 1992 are presented. Drug-related deaths are defined according to the official definition issued by the Austrian Federal Ministry of Internal Affairs. A distinction was made between injecting drug users and non-injecting drug users with respect to infectious diseases transmitted by sharing of paraphernalia. Between 1985 and 1992 there was a distinct increase in drug-related deaths. In approximately 30% an accidental single substance intoxication, mainly due to morphine, was found. A connection with a better quality of street drugs is assumed but not proven. In 207 corpses more than one drug, including alcohol, was detected. During the investigation there was an evident trend towards multi-substance abuse patterns. Furthermore, blood alcohol concentration, an additional risk factor for narcotic overdose, was strongly associated with higher age. The small number of examined drug injectors found positive for the human immunodeficiency virus type-1 (HIV-1) makes it difficult to draw any kind of conclusion regarding the HIV-I seroprevalence among injecting drug users in Vienna.
Addiction 1994 Jul
PMID:Drug-related deaths between 1985 and 1992 examined at the Institute of Forensic Medicine in Vienna, Austria. 808 Nov 83

Methadone maintenance therapy is advocated as a major preventive strategy for the spread of the human immunodeficiency virus (HIV) and other blood-borne infectious agents among injecting drug users (IDUs) because of its effects in decreasing the frequency of injecting and presumably sharing of equipment. As an opioid agonist, methadone may share the direct and indirect immunoregulatory effects of other opioids, and thus affect susceptibility to, and the natural history of, HIV infection. Available evidence pertaining to methadone and immune function is reviewed. The long-term immunosuppression observed in heroin injectors on present (incomplete) evidence appears to be caused by factors associated with a drug-using lifestyle rather than by a direct action of heroin. Although data are conflicting, it is most likely that methadone does not significantly impair immune function and is safe for HIV-infected IDUs, possibly even allowing some improvement of immune function to occur. The increasing reliance placed on methadone maintenance to control the epidemic of HIV infection in IDUs requires that remaining uncertainties regarding methadone and immune function are clarified urgently.
Addiction 1993 Feb
PMID:The effects of methadone on immune function among injecting drug users: a review. 822 63

The abuse of heroin and other opiates by intravenous injection is identified as the major risk for the spread of infection by the human immunodeficiency virus (HIV) and of acquired immunodeficiency syndrome (AIDS) to the population at large. From 1980 to 1992, 2,712 opiate-addicted intravenous drug users with severe complications and behavioural problems were treated at the Institute on Addictions, Belgrade; 2,090 of them were from the Belgrade area and 622 from other urban areas. All of them had used heroin by intravenous injection during a certain period of their addiction careers. A majority of the patients had started using heroin by the age of 20, and begun treatment after six or more years of addiction. An informal survey of heroin-addicted intravenous drug users newly admitted for treatment showed that every respondent knew from 10 to 20 other heroin users who had not sought treatment. It was estimated that a majority of intravenous drug users may not have been known to the authorities. Of 551 intravenous-opiate-addicted patients from the Belgrade area tested between 1987 and 1992, 43.7 per cent were HIV-seropositive, or 47.9 per cent of HIV-seropositive males and 32.9 per cent of females, while for the same period, of 366 tested patients from other urban areas, 4.6 per cent were HIV-seropositive, 5.2 per cent of them males and 1.8 per cent females. The distribution by sex of the intravenous-opiate-addicted patients indicated that the percentage of females who started using heroin earlier in their lives and the percentage of those who sought treatment late--after six or more years of addiction--were higher than the corresponding percentages of males. Also, female patients tended to become infected with HIV earlier in their lives than male patients.
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PMID:HIV infection among drug abusers in the Belgrade area. 830 3

This study examined the extent to which self-report of human immunodeficiency virus (HIV) risk behaviors might depend upon socially desirable response tendencies, and whether socially desirable responding might serve as a confounding variable in the study of risk behaviors and HIV serostatus. The subjects were 2885 intravenous drug users participating in the ALIVE study in Baltimore, Maryland. Participants completed an interview and were tested for HIV serostatus. The interview covered HIV risk behaviors, and included established scales to measure 'self-deception' and 'impression management', two separate dimensions of socially desirable responding. Seven items for each scale were scored true/false, with a summary score used for analysis. Scores on self-deception and impression management were inversely related to self-reports of sharing injection equipment, injecting at shooting galleries, and injecting more than once a day. Neither self-deception nor impression management was associated with cocaine use. Self-reported receptive anal intercourse was associated inversely with self-deception but not with impression management. HIV serostatus was not associated with social desirability, and statistically controlling for social desirability had a negligible impact on the magnitude of associations between risk behaviors and HIV serostatus. The results indicate that measures of social desirability may be used to ascertain sensitive areas of inquiry in interviews of intravenous drug users.
Addiction 1993 Apr
PMID:Socially desirable responding and self-reported HIV infection risk behaviors among intravenous drug users. 848 29

Opiate-induced immunosuppression has been implicated in the pathogenesis of infections caused by a variety of microorganisms, including human immunodeficiency virus (HIV). Although effects of opiates on lymphocyte function have been studied more extensively, morphine also has been shown to inhibit several functional activities of mononuclear phagocytes (e.g. chemotaxis, respiratory burst activity and phagocytosis). Opiate addiction has been identified as a risk factor for clinical tuberculosis prior to the HIV epidemic, and macrophages are a key cell in the pathogenesis of Mycobacterium tuberculosis. Thus, the hypothesis was tested in the present study that morphine would suppress phagocytosis of M. tuberculosis by human microglial cells, the resident macrophages of the brain. Contrary to this hypothesis, treatment of human fetal microglial cell cultures with morphine (10(-8) M) was found to stimulate phagocytosis of nonopsonized M. tuberculosis H37Rv. The stimulatory effect of morphine was blocked by naloxone and the mu opiate receptor selective antagonist beta-funaltrexamine. Also, morphine-induced increase in phagocytic activity was markedly inhibited by pertussis toxin and was unaffected by cholera toxin, suggesting the mechanism of morphine's stimulatory effect on microglial cell phagocytosis involves a Gi protein-coupled mu opiate receptor. The results of this in vitro study support the concept that exogenous and endogenous opioids play an immunomodulatory role within the central nervous system through their interaction with G protein-coupled receptors on microglial cells.
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PMID:Morphine stimulates phagocytosis of Mycobacterium tuberculosis by human microglial cells: involvement of a G protein-coupled opiate receptor. 874 73

The vulnerability of injecting drug users to human immunodeficiency virus (HIV) was confirmed in a survey of 171 consecutive women 14-50 years of age (median age, 31 years) court-ordered to the Female Drug Rehabilitation Center in Malaysia's Kelantan State. The median duration of drug use in this sample was 7.4 years (range, 1-27 years). Involvement in commercial sex work was reported by 82 women (48%); condoms were not used in 60.1% of all sexual encounters. Overall, 24 (14%) of these rehabilitation center patients were HIV-positive; however, of the 75 women with a history of intravenous drug use, 21 (28%) were seropositive, and such a history was present in 20 (83%) of the 24 HIV-positive respondents. 36 (48%) of the intravenous drug users were sharing injecting equipment, reportedly because of an inadequate supply of needles and syringes, and only 16 (44%) of needle-sharers were using the correct method for cleaning. HIV infection was significantly associated with age 31-40 years, low educational status, a history of at least one prison term, syphilis infection, intravenous drug use, and sharing of injecting equipment; however, only the latter two factors retained significance in the analysis of variance. Women-oriented programs aimed at preventing drug injection, or at least decreasing needle sharing, are needed to curtail the spread of HIV infection in Malaysia.
Addiction 1996 Mar
PMID:HIV infection in females dependent on drugs. 886 6

Harm reduction strategies for the prevention of transmission of human immunodeficiency virus (HIV) transmission among injecting drug users (IDUs) have been widely implemented in Australia and are seen to have been effective in preventing the spread of HIV. A major strategy has been increasing the availability of and accessibility to methadone maintenance therapy (MMT) programmes. We have reviewed the experience of a major MMT general practice with hepatitis C virus (HCV) infection from 1991 to 1995. Of 1741 individuals tested for HCV antibodies at least once 66.7% were positive. Of 73 IDUs who were initially seronegative and were retested at least once, 19 were subsequently seropositive. Seroconverters to HCV were younger than non-seroconverters, and were more likely to have evidence of previous hepatitis B infection. The overall HCV incidence rate was 22 cases per 100 person-years, and this did not differ between those on MMT programs (continuous or interrupted) between HCV tests and those not on MMT. These findings suggest that the role of MMT in the control of the spread of HCV infection among IDUs needs further assessment, and that control of the current epidemic of HCV infection among IDUs in Australia will be very difficult.
Addiction 1997 Aug
PMID:Methadone maintenance and hepatitis C virus infection among injecting drug users. 937 82

The Maryland Dentist's Well-Being Committee was formed in 1980 as a standing committee of the Maryland State Dental Association. The committee has assisted many dentists over the years with problems such as stress, alcoholism, drug dependence, psychiatric disorders, medical problems, HIV (human immunodeficiency virus) disease, neurological disorders, and other illnesses that cause impairment. Key elements of the committee include confidentiality, a good working relationship with the Maryland State Board of Dental Examiners, advocacy efforts, and a paid clinical coordinator with special expertise in mental health and addiction treatment.
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PMID:The Dentists' Well-Being Committee of Maryland. 956 76

This study aimed to estimate excess mortality among tuberculosis patients in The Netherlands and identify risk factors for tuberculosis-associated mortality. The national tuberculosis register provided data on patients diagnosed in the period 1993-1995. Excess mortality in tuberculosis cases, according to age and sex, was determined by comparison with national mortality rates. Risk factors were identified and adjustment for confounders was carried out using Cox's proportional hazard analysis. Of 4,340 patients alive at diagnosis, 258 died within 1 yr while on treatment. The Kaplan-Meier survival probability after 1 yr was 93%. Tuberculosis patients had a standardized mortality ratio of 8.3. Independent risk factors for mortality were: gender; age; presence of a malignancy or human immunodeficiency virus (HIV) infection; addiction to alcohol or drugs; localization of tuberculosis; and the type of medical officer having made the diagnosis. Of all deaths, 83% occurred in two risk groups comprising 21% of tuberculosis patients: those aged > or =65 yrs and those having HIV infection or a malignancy. Tuberculosis patients in The Netherlands are at a considerably increased risk of death. However, the prognosis is very good for those aged less than 65 yrs and without human immunodeficiency virus infection or a malignancy.
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PMID:Mortality among tuberculosis patients in The Netherlands in the period 1993-1995. 962 82


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