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

A young female patient with a long history of intravenous drug abuse died after a fulminant course of aplastic anemia. At postmortem examination, she was found to have multinucleate giant cells and immunocytochemical evidence of human immunodeficiency virus (HIV) infection of the central nervous system. This case raises the possibility that HIV infection contributed to the patient's aplastic anemia, and suggests that HIV-associated giant cells might be found retrospectively or prospectively within the brains of patients who die of conditions other than those narrowly defined as acquired immune deficiency syndrome (AIDS) or AIDS-related complex (ARC). It furthermore emphasizes that HIV infection of the nervous system is not necessarily accompanied by clinically apparent neurological disease.
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PMID:Evidence for human immunodeficiency virus (HIV) infection of the brain in a patient with aplastic anemia. 321 36

Two hundred fifty individuals from high risk categories were enrolled in a seroprevalence survey for human immunodeficiency virus (HIV) infections in Winnipeg. The overall seroprevalence in the Manitoba AIDS Virus Epidemiology Study (MAVES) was 5.2%. Of 2651 diagnostic and screening specimens in the province of Manitoba submitted over a similar period, 103 were positive (3.9%). HIV seropositivity in Manitoba was noted mainly in homosexual/bisexual males (especially those who were also intravenous drug abusers), hemophiliacs, and individuals from endemic regions of the world. Individuals whose only risk factor was intravenous drug abuse, those with sexually transmitted diseases, or those with high risk sex contacts have not demonstrated HIV seropositivity in Manitoba to date. Manitoba is currently a low seroprevalence region for HIV infection. Our study demonstrated that the awareness level of people at risk for HIV infections was low. In our study population, one-on-one counseling was demonstrated to be an effective way to improve short-term knowledge about HIV infections. Appropriate education approaches must be considered for Native/Metis peoples (26.4% of our MAVES study population), who were younger and had a lower educational and employment level compared to Caucasian/other racial groups.
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PMID:Seroprevalence and demographic information of patients at risk for human immunodeficiency virus (HIV) infection in Manitoba, Canada. 321

In order to evaluate the frequency of sexual transmission of human immunodeficiency virus (HIV) among promiscuous heterosexuals, we studied the prevalence of HIV infection among a group of predominantly Caucasian call girls and women working for escort services and massage parlors in New York City. In the 78 subjects studied, the mean age was 31.6 years and the mean duration of prostitution was 5.1 years. Study participants each had a median of 200 different sexual partners in the preceding year. Six women had a history of intravenous drug abuse and none had a history of any other recognized risk factor for HIV infection. Ninety percent of the women studied used condoms during intercourse with at least some of their partners. One of the six women with a history of drug abuse and none of the 72 non-drug-abusers were seropositive for HIV. This study indicates that despite their promiscuity, HIV infection is still uncommon in call girls in New York City.
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PMID:Prevalence of HIV infection in New York call girls. 321 2

Recent reports of the nonspecificity of the enzyme-linked immunosorbent assay (ELISA) test in African populations, significant genomic differences between simian T-cell lymphotropic virus and human immunodeficiency virus (HIV), and the early appearance of clinical acquired immunodeficiency syndroME (AIDS) in the US and Europe are powerful arguments against the assumption that AIDS originated in Africa. The authors postulate that HIV infection has been endemic in the Euro-American population at least since the beginning of the 20th century and that sociocultural changes led to the introduction of the virus into Africa. A search of the literature reveals 28 cases of disseminated Kaposi's sarcoma in the pre-epidemic 1902-66 period. In none of these cases are notations made on intravenous drug abuse, homosexuality, or other risk factors for AIDS. The majority of cases involved men, however. It is pointed out that, in a population where the incidence of a virus such as HIV is low, the number of sexual partners is limited, and intravenous drug abuse is nonexistent, an infection with as long a latency period as HIV may not only be expressed sporadically, but would probably not be recognized as a transmissible infection. On the other hand, the significant changes in these social factors that occurred as a result of the sexual revolution of the late 1960s and early 1970s would be expected to increase the spread of infection and clinical disease so that recognition would be achieved. During the past decade, there have been marked increases in the number of sexually transmitted infections in the homosexual male population. The efficiency of anal intercourse as a mode of transmission probably accounts for the fact that HIV infection first expressed itself in this population.
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PMID:Evidence for a Euro-American origin of human immunodeficiency virus (HIV). 331 73

Differences between the epidemiology of cases of acquired immunodeficiency syndrome (AIDS) in Africa compared to Western societies have prompted speculation that the risk factors may be unique to Africa. This difference is particularly apparent in terms of the male-to-female ratio of AIDS affectd individuals: 1:1 in Africa versus 19:1 in the US and Europe. Further suggestive of patterns of transmission that differ is the absence of the established risk factors of intravenous drug abuse and homosexuality from the African setting. Specific factors thought to influence AIDS transmission in Africa include: promiscuity, with a high prevalence of sexually transmitted diseases; sexual practices that have been associated with increased risk of human immunodeficiency virus (HIV) such as homosexuality and anal intercourse; and cultural practices, including female circumcision and infibulation. Other nonsexual cultural practices that may expose individuals to AIDS include: medicinal bloodletting, rituals establishing "blood brotherhood," ritual and medicinal enemas, and other practices resulting in exposure to blood; the use of shared instruments, such as in the injection of medicine, ritual scarification, group circumcision, genital tatooing, and shaving of body hair; and contact with nonhuman primates. Overall, however, sexual promiscuity seems to be the most important cultural factor contributing to the spread of AIDS in Africa.
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PMID:Cultural practices contributing to the transmission of human immunodeficiency virus in Africa. 332 61

A 35-year-old Black male with a long history of intravenous drug abuse developed clinical manifestations of Reiter's syndrome, with significant joint and psoriasiform skin involvement. In addition, he had signs and symptoms compatible with human immunodeficiency virus (HIV) infection and had a positive HIV antibody test confirmed with Western blot testing. Although many dermatologic manifestations of HIV infection have been described, this is the first time that an association with Reiter's syndrome has been reported. Recently, the development of psoriasis in other patients with HIV infection has been described. Taken together, these occurrences suggest that the purported retroviral relationship with psoriasis and related dermatoses may warrant further examination.
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PMID:Reiter's syndrome and human immunodeficiency virus infection. 333 1

Thrombocytopenia is a relatively frequent hematological complication of HIV (human immunodeficiency virus) infection. The incidence of thrombocytopenia in a cohort of 359 homo- or bisexual men with HIV infection was 3%, while it was 9% in a cohort of 321 HIV positive persons with a history of intravenous drug abuse. We followed 42 thrombocytopenic patients prospectively to study the clinical significance of thrombocytopenia in these patients. Thrombocytopenia was significantly more severe in intravenous drug abusers than in homo- or bisexual men: 52% of the drug abusers had thrombocyte counts below 10,000/mm3, compared with only 9% of the homo- or bisexual men. Symptoms of bleeding, almost always harmless skin or mucosal bleeding, were found in 45% of patients with a history of intravenous drug abuse and in 18% of the homo- or bisexual men. Life-threatening bleeding episodes did not occur during a median observation period of approximately one year. Prednisone was the most commonly used drug in symptomatic thrombocytopenia and had demonstrable effect only while being administered. After medication was stopped the thrombocyte counts usually fell to pretreatment values. Our findings suggest that therapy of HIV-associated thrombocytopenia should be reserved for severely symptomatic patients, particularly since this symptom of HIV infection rarely causes serious complications and we do not know the influence of drugs such as corticosteroids on the progression rate of HIV-infection.
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PMID:[HIV-associated thrombocytopenia]. 336 12

The debate over the provision of sterile injection equipment to intravenous drug users, as a means of preventing the spread of the AIDS epidemic, has a number of political, ethical, and clinical implications. The issue has in some respects been inappropriately dichotomized as a conflict between public health agendas and the traditional priorities of drug treatment. The relevant issues include: (1) the existence of evidence for needle-sharing as a route of transmission of human immunodeficiency virus among intravenous drug users; (2) the role of needle scarcity as a factor promoting needle-sharing behavior, and evidence for the ability of drug users to change such behavior; (3) the possibility of increased needle availability leading to increased prevalence of intravenous drug abuse; (4) the possibility that the provision of sterile needles would compromise treatment efforts among drug abusers currently or potentially engaged in the treatment system. These issues are discussed in light of relevant existing data; a multilevel strategy for AIDS prevention among drug users is suggested, addressing both the availability of sterile injection equipment and the promotion of drug treatment goals.
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PMID:Sterile needles and the epidemic of acquired immunodeficiency syndrome: issues for drug abuse treatment and public health. 344 96

AIDS is a transmissible immunodeficiency syndrome which has first been observed less than a decade ago and since that time has spread in an epidemic manner. Usually it manifests itself by opportunistic infections and/or neoplasias. After courses of a few years, approximately 100% of cases have a lethal outcome. Sometimes, neuropsychiatric disturbances are the presenting symptoms and signs of AIDS. One of the first important observations was, that certain behavioural patterns such as homosexuality and intravenous drug abuse were apparently associated with a high risk for acquiring AIDS. The occurrence of AIDS in a number of haemophiliacs and recipients of blood transfusions suggested an important role of the haematogenous route of transmission. Not more than two years after the first clinical reports on AIDS a retrovirus was identified as the etiological agent. On the basis of different criteria this retrovirus can be classified as a slow virus. Subsequently, virological tests were developed which allowed an early diagnosis of this viral infection, even prior to the evolution of clinical symptoms. Immunological features of this new syndrome include disturbances of cellular as well as humoral immune functions. As we have no effective chemotherapy for AIDS and the successful development of a vaccine is delayed by a number of virological problems, it is of special importance to prevent transmission of the disease.
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PMID:[Acquired immunologic deficiency syndrome (AIDS). I. Biologic principles]. 347 43

To determine the prevalence of unsuspected human immunodeficiency virus (HIV) infection in critically ill emergency patients, we examined the anonymous serum samples of 203 critically ill or severely injured patients with no history of HIV infection. We found that six (3%) were seropositive for HIV antibody by both enzyme-linked immunoassay and Western blot analysis. All seropositives were trauma victims between the ages of 25 and 34 years, representing 16% of the trauma patients in that age group (n = 37). All seropositives were actively bleeding, and all required multiple invasive procedures. History of intravenous drug abuse was not discriminating in identifying potential seropositives. We conclude that infection-control precautions are indicated for both emergency department personnel and prehospital care providers (such as paramedics, police officers, and fire fighters) when caring for bleeding patients, whether or not previous suspicion of HIV infection exists.
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PMID:Unsuspected human immunodeficiency virus in critically ill emergency patients. 357 58


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