Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
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The AA. present a retrospective study on their experience with HIV positive patients, followed on the Infectious Diseases Department of the Hospital Curry Cabral, in Lisbon. This study was done in 90 patients seen since 1985 till March 1988. From the 90 patients, 81 were HIV--1 positive, 6 HIV--2 and 3 HIV1 + HIV2 positives. It is presented their distribution by sex (Male = 97.8%), age (mean--36.5 years), risk groups (homosexuals--64.4%, heterosexuals--21.1%, IVDA--7.7%, blood-related--5.6%), and their Walter Reed and CDC classifications. It is emphasised the increasing incidence of infected people along the years and an unexpected high rate of heterosexual males infected. It is also pointed the incidence of Kaposi (22%), Pneumocystis carinii pneumonia (55.6%), and Criptococosis (13.9%) in the WR6 group. The mortality rate was 31.3% for WR5 and 63.9% for WR6. We calculate some Relative Risks for clinical situations matched with risk groups and immunological status (meaning the T Helper lymphocitic count), and measured their statistical significance with the chi-square test. Besides the immunodeficiency, it was mentioned the associated lymphadenopathy and dermatological lesions, the HIV encephalopathy and the constitutional symptoms of the wasting syndrome.
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PMID:[Three years of AIDS. Experience of the Curry Cabral Hospital with HIV infections (1985-1988)]. 262 55

To date, the acquired immunodeficiency syndrome (AIDS) has been identified in over 50 children in the US, including those with associated hemophilia, high-risk environmental factors (Haitian background, parental intravenous drug abuse, or prostitution), and blood transfusions. The evaluation of an infant or young child in whom AIDS is suspected requires exclusion of congenital disorders of immune function. A specific test is not currently available, but inclusion criteria for childhood AIDS have been developed. The diseases accepted as indicative of underlying cellular immunodeficiency children are the same as those used in defining AIDS in adults, with the exclusion of congenital infections such as toxoplasmosis or herpes simplex virus infection in the 1st month of life or cytomegalovirus infection in the 1st 6 months of life. Specific conditions that must be excluded in children are primary immunodeficiency diseases (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome, ataxia-telangiectasia, neutrophil function abnormality) and secondary immuno-deficiency associated with immunosuppressive therapy, lymphoreticular malignancy, or starvation. Almost all young children with AIDS have hepatosplenomegaly, interstitial pneumonitis, and poor growth. The average age of 36 US child AIDS victims studied in detail was 5 months at presentation with findings suggestive of severe immunodeficiency. Mucocutaneous candidiasis was present in 75% of these 36 children, and Pneumocystis carinii and cytomegalovirus were each isolated from 30% of cases. Normal T4:T8 ratios occur in about 15% of pediatric AIDS cases. Laboratory evidence of polyclonal hypergammaglobulinemia generally supports the AIDS diagnosis. Recurrent infection and malnutrition are major problems in the clinical management of child AIDS patients.
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PMID:Acquired immune deficiency syndrome in childhood. 298 8

The causative agent of acquired immunodeficiency syndrome is a retrovirus, human T lymphotropic virus type III/lymphadenopathy-associated virus, now known as human immunodeficiency virus (HIV). Infection of children with HIV results in a wide spectrum of clinical manifestations, ranging from asymptomatic to symptomatic, with the severest disease forms including neurologic deterioration, opportunistic infections and malignancy. This virus infects preferentially T cells bearing the CD4 receptors and also seems to exhibit preference for the central nervous system. The predominant route of infection in children is transplacental, and most affected children are infected at the time of birth. For women who give birth to infants with congenital infection with HIV, the main risk factor is intravenous drug abuse; a smaller percentage of these women acquire the infection via sexual contact and a few are infected via blood transfusions. Estimates for the incidence of transmission of the virus from an infected mother to her offspring vary from about 20 to 70%. Infection in most children and adults is documented by serologic testing, inasmuch as almost all infected people are HIV antibody-positive. Mothers of congenitally affected children are always HIV antibody-positive and also frequently have immune abnormalities. Women who give birth to infected children may, however, be asymptomatic in 50% of instances or more. Because antibodies to HIV are predominantly of the IgG class, they cross the placenta. All infants born to infected women therefore acquire passively transferred antibodies to HIV irrespective of whether or not the infants are infected with the virus itself. These passively transferred antibodies may sometimes persist for as long as 15 months. Thus in infants and children under 15 months of age in the absence of symptoms, the only definitive way to establish diagnosis is by viral isolation or viral antigen detection. Clinically the HIV-infected children can be divided into two groups, symptomatic and asymptomatic. Among the symptomatic group the main diagnostic specific features are: (1) opportunistic infection, e.g. with Pneumocystis carinii pneumonia; (2) interstitial pneumonitis with respiratory distress resulting from lymphocytic interstitial pneumonitis; (3) microcephaly and other neurologic abnormalities; (4) recurrent bacterial infections.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Human immunodeficiency virus infection in children: nature of immunodeficiency, clinical spectrum and management. 304 60

Pediatric acquired immunodeficiency syndrome (PAIDS) results from infection with human immunodeficiency virus (HIV). The majority of infants with AIDS are infected in utero. In most instances, mothers are infected from intravenous drug abuse or bisexual partners. Infected individuals, both mothers and infants, may be asymptomatic for prolonged periods of time. Initially viral replication may be limited and the virus integrated into immune cells. Activation of the virus may result from several factors including infection with other viral agents, such as cytomegalovirus and Epstein-Barr virus. Variable progression of disease may be related to dose of virus, the degree of pre-existing immunodeficiency, and the presence of other infectious agents. Recent evidence suggests that individual HIV isolates vary in their capacity to infect cells. This may explain differences in clinical presentation and progression. A diagnosis of HIV infection may be difficult in infants who have persistence of maternal antibody. Viral isolation is often difficult and unreliable, even in infants who have clinical features of AIDS. Currently only azidothymidine has been shown to reduce viral replication and improve prognosis. However, azidothymidine does not eradicate HIV and patients require repeated or chronic therapy. The drug is not yet approved for use in children, although studies are being performed at several medical centers. Prevention of HIV infection is the single most important approach to controlling its rapid spread in infants. Screening of all blood products by using HIV antibody testing is essential. Increased effort in preventing drug abuse and in reducing pregnancy rates among infected women should be a priority of health care workers.
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PMID:Immunopathogenesis of pediatric acquired immunodeficiency syndrome. 305 42

Intravenous drug abusers constitute 25 per cent of the cases of the acquired immunodeficiency syndrome (AIDS) in adults in the United States of America and 21 per cent of such cases in Europe. The potential for the rapid spread of the human immunodeficiency virus (HIV) among intravenous drug abusers exists because such drug abusers commonly share drug injection equipment. The heterosexual and perinatal spread of AIDS is also largely associated with intravenous drug abusers, and drug abusers have been identified as a major vector for the spread of the AIDS epidemic as it is associated with intravenous drug abuse. As long as intravenous drug abusers are addicted, they will continue to be at risk of contracting AIDS. Thus, the primary AIDS prevention strategy must be to help addicts to stop using drugs. It is suggested that drug abuse treatment resources should be expanded and outreach programmes developed to encourage more intravenous drug abusers to enter treatment. AIDS risk-reduction counseling must also be provided to intravenous drug abusers who continue injecting drugs, and to addicts and their sexual partners to prevent the sexual spread of HIV. Vigorous AIDS prevention initiatives must be undertaken now, using the most promising intervention strategies, while simultaneously evaluating and refining these strategies.
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PMID:The acquired immunodeficiency syndrome and intravenous drug abuse. 306 41

The importance of female prostitutes to the transmission of human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) varies worldwide, with the greatest problem currently existing in Africa. Prevalence rates for STDs are consistently higher among prostitutes than the general population, regardless of region, and up to 40% of prostitutes are positive for syphilis. Non-intravenous-drug- abusing prostitutes in major European and US cities have been found to have relatively low rates of HIV infection (under 8%) ; however, in African countries such as Rwanda and Kenya, 85-88% of prostitutes have antibodies to HIV. The major risk factors for African prostitutes appear to be the number of clients, length of time in prostitution, and a history of other STDs, especially genital ulcers. Although females prostitutes are not at present playing a major role in the transmission of HIV infection among the heterosexual population in the US and Europe, the potential clearly exists. Thus, there is a need in all world regions for health education campaigns aimed at prostitutes and their clients. Condom use and avoidance of intravenous drug abuse are the most effective preventive measures. In Africa, there is a need for operations research on the optimal methods for encouraging condom use among prostitutes. Pilot programs have indicated that the most effective such programs are those that utilize existing networks to train prostitutes as acquired immunodeficiency syndrome (AIDS) educators for both their peers and their clients.
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PMID:Prostitutes: a high risk group for HIV infection? 306 58

We report here the results of a survey of 308 intravenous drug abusers recruited from hospital-based methadone maintenance or drug detoxification programmes located in Manhattan, New York City. Complete interviews and serological analyses for antibodies to human immunodeficiency virus (HIV) using both enzyme-linked immunosorbent and Western blot assays were obtained from 290 (94%) of the subjects. HIV antibodies were found by both assays in 147 (50.7%) of the tested subjects; conflicting results were found in three (1%) of the subjects; and negative results on both tests were found in 140 (48.3%) of the subjects. Logistic regression analysis identified significant relative risks for HIV infection associated with the frequency of drug injection and the proportion of injections in 'shooting galleries'. Additional risk among men was associated with a history of homosexual relations. Traditional efforts taken by subjects to clean syringes between uses, such as washing with water or alcohol, showed no evidence of being protective. Programmes aimed at prevention of HIV infection should focus on reducing use of shooting galleries and sharing of needles and syringes as well as reducing intravenous drug abuse generally.
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PMID:Risk factors for infection with human immunodeficiency virus among intravenous drug abusers in New York City. 312 88

The pattern of cases of AIDS in Belgium suggests that Europeans infected with human immunodeficiency virus (HIV) acquired the infection in Africa. The prevalence of infection was assessed in Belgian advisers and European expatriates and risk factors for infection defined in a case-control study of expatriate men. Fifteen (1.1%) of 1401 Belgian advisers working in Africa and 41 (0.9%) of 4564 European expatriates living in Africa, were positive for antibody to HIV in a voluntary screening programme in Belgium. Among subjects with antibody to HIV the ratio of men to women was 3:1. These subjects did not have a history of intravenous drug abuse or blood transfusion and only one was homosexual. In a case-control study of 33 expatriate men who had antibody to HIV and 119 controls the men with antibody reported significantly more female sexual partners, who were more commonly local; and significantly more sexual contact with prostitutes in Africa. They had a significantly higher prevalence of history of sexually transmitted disease and had received significantly more injections by unqualified staff in Africa during the previous five years. No specific sexual practices were associated with having antibody to HIV. After multivariate analysis sexual contact with local women (adjusted odds ratio 14.7; 95% confidence interval 2.81 to 76.9), sexual contact with prostitutes (adjusted odds ratio 10.8 (1.6 to 71.9), and injections by unqualified staff (adjusted odds ratio 13.5 (3.7 to 49.8) remained independent risk factors for infection. European expatriates in Africa were at increased risk from infection with HIV and were a means of introducing HIV into the heterosexual population in Europe. Transmission from women to men by vaginal intercourse seemed to be the most probable route of infection.
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PMID:Risk factors for infection with human immmunodeficiency virus among European expatriates in Africa. 313 19

Techniques adapted from population and community ecology, quantitative geography, and epidemiology are applied to ecosystem and environmental index data on the Bronx in an attempt to understand the origins and potential impacts of rampant spread of human immunodeficiency virus (HIV) and its sequelae of acquired immunodeficiency syndrome (AIDS) in that borough: Recent work by Drucker and Vermund (1987), ("Estimating Prevalence of Human Immunodeficiency Virus Infection in Urban Areas with High Rates of Intravenous Drug Abuse: A Model of the Bronx in 1987," Poster presented at the Third International Conference on AIDS, June 2, 1987) estimates HIV seroprevalence levels of from 8 to 21% among men of age 25-44 in the south Bronx, at this writing, comparable to the cities of Central Africa. It is found that the "South Bronx" process of fulminating, contagious urban decay which devastated the region in the 1970s, and its associated forced population migrations, spread intravenous drug abuse, the principal HIV vector in the Bronx, from a geographically contained center in the South-Central Bronx to a virtually borough-wide phenomenon. This has significantly complicated attempts to contain HIV infection, both by shredding the social networks which are the natural vehicles for education, and by vastly enlarging the area requiring intensive targeting. Since the "planned shrinkage" municipal service cuts which triggered the "South Bronx" burnout persist, and since levels of housing overcrowding now approach those of the early 1970s in the Bronx, it is expected that a new outbreak of contagious urban decay will occur, likely again dispersing population and seriously compromising any in-place HIV control strategies. If overt AIDS itself becomes a contributor to urban deterioration in overcrowded neighborhoods susceptible to "South Bronx" process, we could then see a nonlinear ecosystem coupling between AIDS, contagious urban decay, and population shift. Elementary mathematical models are provided. Thus, in striking contrast to the middle-class male homosexual community, successful control of HIV infection in the Bronx, and by inference in other devastated ghetto communities, seems predicated on quick reestablishment of demographic stability: The tools to make the tools for control must first be reconstructed. Necessary elements of any program toward this end are briefly outlined. AIDS in the Bronx and similar areas, like tuberculosis, seems increasingly a marker disease of extreme poverty, and again like tuberculosis, seems increasingly a marker disease of extreme poverty, and again like tuberculosis, may well form an important reservoir for further spread or resurg
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PMID:A synergism of plagues: "planned shrinkage," contagious housing destruction, and AIDS in the Bronx. 316 63

A random, stratified sample of 2601 adult Australians from all states and territories was interviewed about knowledge of the acquired immunodeficiency syndrome (AIDS). After the interview, an anonymous questionnaire on the prevalence of practices that are associated with risk of human immunodeficiency virus (HIV) infection was left with the respondents; 60.2% of these questionnaires were returned. Data from this survey suggest that the prevalences of male homosexual behaviour, prostitute contact and lesbian contact are substantially lower than were estimated previously. Men with homosexual experience were significantly more prevalent in the more populous states, but the majority of other risk factors--intravenous drug abuse, male respondents' contact with prostitutes, transfusion of blood or blood products during 1980-1985 and heterosexual contact--showed few significant associations with geographical, occupational or marital status. Intravenous drug abusers were significantly younger, and heterosexual contact was associated with age for both male and female respondents. No significant differences were found in the prevalence of homosexual contact among single, married and previously-married men, although the prevalence of homosexual contact was lower in married men. The results of the study are discussed in terms of targeting preventive campaigns and assessing the future potential for the spread of HIV infection.
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PMID:Prevalence of risk factors for human immunodeficiency virus infection in the Australian population. 317 93


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