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)

At Mulago Hospital in Kampala, Uganda, 270 consecutive patients at the dermatology and sexually transmitted disease (STD) clinic were enrolled in a study to evaluate the association of clinical STD syndromes and human immunodeficiency virus (HIV) infection. Female patients became sexually active earlier than male patients and were younger at marriage. Persons with a history of an STD during the preceding 5 years were more likely to be HIV infected (43%) than those without such a history (26%; OR 2.08, 95% C.I. 1.17, 3.73). Examination at the time of the visit demonstrated an association between genital ulcers and HIV infection in male and female patients (OR 2.21, 95% C.I. 1.08, 4.53, and OR 8.54, 95% C.I. 1.45, 87.55, respectively) but no association between HIV and urethritis or vaginal discharge. The etiologic fraction for HIV infection of genital ulcers was 0.218. Men with a history of contact with prostitutes were more likely to be HIV infected than those without contact (50% versus 28%, p less than 0.05), but once controlled for STDs, this relationship was no longer significant. This study confirms other studies from East Africa that have shown a relationship between genital ulcers and HIV infection. This finding, in the presence of no association between other STD syndromes and HIV infection, suggests that genital ulcers may be truly associated with HIV infection rather than a marker of high-risk activities.
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PMID:The association of genital ulcer disease and HIV infection at a dermatology-STD clinic in Uganda. 239 52

To identify epidemiologic and clinical patterns associated with human immunodeficiency virus (HIV) infection in sexually transmitted disease (STD) patients in Nigeria, serologic testing was performed on 581 men and women seen at Ibadan's Special Treatment Clinic during 1989-90. Of these, 37 (6.4%) were confirmed HIV-positive; 21 (3.6%) had HIV-1 antibodies and the remaining 16 (2.8%) had HIV-2 antibodies. Peak HIV incidence (24 cases, or 65%) was in the 21-30 year age group; the male to female ratio was 1.01 to 1.00. Presenting symptoms in HIV-positive cases included urethral discharge, vaginal discharge, dysuria, and genital ulcers. The prevalences of gonococcal infection, nonspecific urethritis and cervicitis, genital ulcer disease, and trichomoniasis were 27.0%, 18.9%, 16.2%, and 10.8%, respectively, among HIV-infected STD patients; none of the associations between specific STDs and HIV were statistically significant. Only 1 patient had developed clinical signs of acquired immunodeficiency syndrome (AIDS). The 6.4% prevalence rate detected among STD patients in this study was considered high since HIV is new to Nigeria (436 cases reported to date). Overall, these findings suggest that the AIDS epidemic is in an early stage in Nigeria and the major mode of HIV transmission is heterosexual sex. Routine HIV screening for high-risk groups in Nigeria, including STD patients, is recommended.
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PMID:Clinico-epidemiological patterns of HIV infection in STD patients in Ibadan. 888 45

The presence of human immunodeficiency virus type 1 (HIV-1) in genital secretions may be a determinant of vertical HIV-1 transmission. Cervical and vaginal secretions from HIV-1-seropositive pregnant women were evaluated to determine prevalence and correlates of HIV-1-infected cells in the genital tract. HIV-1 DNA was detected by polymerase chain reaction in 32% of 212 cervical and 10% of 215 vaginal specimens. Presence of HIV-1 DNA in the cervix was associated with cervical mucopus and a significantly lower absolute CD4 cell count (354 vs. 469, P < .001). An absolute CD4 cell count <200 was associated with a 9.6-fold increased odds of cervical HIV-1 DNA detection compared with a count > or = 500 (95% confidence interval, 2.8-34.2). Detection of vaginal HIV- 1 DNA was associated with abnormal vaginal discharge, lower absolute CD4 cell count, and severe vitamin A deficiency. Presence of HIV-1-infected cells in genital secretions was associated with immunosuppression and abnormal cervical or vaginal discharge.
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PMID:Genital shedding of human immunodeficiency virus type 1 DNA during pregnancy: association with immunosuppression, abnormal cervical or vaginal discharge, and severe vitamin A deficiency. 898 96

Previous research has suggested that frequent vaginal douching modifies vaginal flora and increases the risk of cervical infections -- a probable risk factor for human immunodeficiency virus (HIV). To assess the association between HIV infection and vaginal douching, 397 women attending a sexually transmitted disease clinic in Bangui, Central African Republic, during 1994-95 were interviewed regarding their sexual behavior and vaginal douching practices in the preceding 3 years. The overall HIV prevalence rate was 34%. Douching, primarily for hygiene or treatment of a vaginal discharge, was reported by 195 women (49%); its mean weekly frequency was 7 times. A commercial antiseptic was used by 140 women (72%); 48 (25%) used a noncommercial preparation (largely herbs) and 7 (3%) used water. The analysis was restricted to women who used commercial or noncommercial preparations at least once a week (104 and 32 women, respectively). 25 (21.7%) of the 115 HIV-positive women reported use of commercial antiseptics compared with 79 (35.4%) of seronegative women (odds ratio, 0.6; 95% confidence interval, 0.4-0.9 after adjustment for condom use, lifetime number of sexual partners, and marital status). Use of noncommercial preparations was reported by 17 (14.8%) seropositive and 15 (6.7%) seronegative women (adjusted odds ratio, 1.7; 95% confidence interval, l.0-3.0). Although these findings should be considered preliminary, it is speculated that the antifungal and bacteriostatic properties of commercial antiseptics used after sexual intercourse may reduce the inoculum of HIV through a flushing mechanism or reduce the frequency of sexually transmitted diseases that serve as co-factors for HIV infection. Moreover, the agents used in noncommercial preparations may irritate vaginal mucosa, enhancing HIV transmission.
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PMID:HIV infection and vaginal douching in central Africa. 911 82

To examine associations between method of contraception, sexually transmitted diseases (STDs), and incident human immunodeficiency virus type 1 (HIV-1) infection, a prospective observational cohort study was done among female sex workers attending a municipal STD clinic in Mombasa, Kenya. Demographic and behavioral factors significantly associated with HIV-1 infection included type of workplace, condom use, and parity. In multivariate models, vulvitis, genital ulcer disease, vaginal discharge, and Candida vaginitis were significantly associated with HIV-1 seroconversion. Women who used depo medroxyprogesterone acetate (DMPA) had an increased incidence of HIV-1 infection (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.4-3.4). In a multivariate model controlling for demographic and exposure variables and biologic covariates, the adjusted HR for HIV-1 infection among DMPA users was 2.0 (CI, 1.3-3.1). There was a trend for an association between use of high-dose oral contraceptive pills and HIV-1 acquisition (HR, 2.6; CI, 0.8-8.5).
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PMID:Hormonal contraception, sexually transmitted diseases, and risk of heterosexual transmission of human immunodeficiency virus type 1. 980 34

This review highlights some of the difficulties inherent in controlling sexually transmitted diseases (STDs) in developing countries--especially amongst women. Considerable efforts have been made to improve the syndromic approach to STD management but the poor performance of the algorithm for managing vaginal discharge limits the effectiveness of this strategy. The facilitating role of the human immunodeficiency virus (HIV) has been the main impetus to STD control rather than reduction of morbidity in women, especially pregnant women and their children. There are no easy solutions--but action on several fronts, with more attention to core groups, men and adolescents is indicated.
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PMID:Clinical management and prevention of sexually transmitted diseases: a review focusing on women. 1070 7

Vaginal discharge of mixed etiology occurs frequently, with abnormal vaginal flora being the most common condition. The interrelationships among the disturbance of the vaginal ecology, the presence of yeasts, and infection with Trichomonas vaginalis and human immunodeficiency virus type 1 (HIV-1) were investigated among women presenting to a sexually transmitted diseases service. Analysis was done for 598 women. Although the prevalence of HIV-1 infection increased linearly with increasing Nugent's score (bacterial vaginosis score of Gram stain), the prevalence of T. vaginalis increased suddenly, from 12% in patients with a Nugent's score of < or =3 to 33% in patients with a score of 4, and remained at this level at higher scores. Yeast colonization and vulvovaginal candidiasis were inversely related to Nugent's scores. T. vaginalis might be responsible for the change in normal vaginal flora and may, therefore, be one of the causes of bacterial vaginosis. This could lead to more effective HIV-1 acquisition.
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PMID:Interrelationships among human immunodeficiency virus type 1 infection, bacterial vaginosis, trichomoniasis, and the presence of yeasts. 1175 83

We assessed the association between the causative agents of vaginal discharge and pelvic inflammatory disease (PID) among women attending a rural sexually transmitted disease clinic in South Africa; the role played by coinfection with human immunodeficiency virus type 1 (HIV-1) was studied. Vaginal and cervical specimens were obtained to detect Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, and bacterial vaginosis. HIV-1 infection was established by use of serum antibody tests. A total of 696 women with vaginal discharge were recruited, 119 of whom had clinical PID. Patients with trichomoniasis had a significantly higher risk of PID than did women without trichomoniasis (P=.03). PID was not associated with any of the other pathogens. When the patients were stratified according to HIV-1 status, the risk of PID in HIV-1-infected patients with T. vaginalis increased significantly (P=.002); no association was found in patients without HIV-1. T. vaginalis infection of the lower genital tract is associated with a clinical diagnosis of PID in HIV-1-infected women.
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PMID:Trichomonas vaginalis is associated with pelvic inflammatory disease in women infected with human immunodeficiency virus. 1179 80

Patients with sexually transmitted diseases (STDs) in developing countries are often untreated for long periods of time or receive ineffective treatment, producing complications that can lead to infertility, blindness, and even death. In addition, there is growing research evidence that people with bacterial or viral STDs are more likely to acquire--and perhaps transmit--the human immunodeficiency virus (HIV). STD control programs in developing countries must be reorganized to include: 1) good management of patients with STDs and their contacts, 2) case finding for syphilis in the antenatal population, 3) screenings and case findings for gonorrhea in high-risk groups, and 4) systematic prophylaxis for ophthalmia neonatorum in newborns. Since diagnosis before treatment is problematic in rural areas, the World Health Organization recommends simple treatment protocols based on the most common STD symptoms--urethral discharge; gynecological complaints such as vaginal discharge, low abdominal pain, or dysuria; genital ulceration; and inguinal bubo, a swelling of the lymph nodes in the groin. Other components of this approach include standardized treatment, contact tracing and treatment, health education targeted at high-risk groups, follow-up and case referral where necessary, and the collection of simple statistics on treatment efficacy and STD epidemiology. The incidence of STDs in developing countries is steadily increasing as a result of urbanization, increased numbers of young people, and delayed age at marriage. However, this situation can be combatted through application of treatment protocols, technological advances, improvements in the health care delivery system, and awareness on the part of policy makers of the seriousness of the STD problem.
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PMID:Management of sexually transmitted diseases. 1234 18

This study focuses on the identification of aetiological agents of vaginitis in Nigerian women. Study subjects are drawn from patients presenting with lower abdominal pain, vaginal discharge and itching at the gynaecology clinic of Lagos University Teaching Hospital and at the Clinical Centre of the Nigerian Institute of Medical Research, Yaba, Lagos, between January 2001 and July 2002. A total of 250 patients gave informed consent to participate in the study. The patients also had pre- and post-test human immunodeficiency virus (HIV) counselling. Each patient completed a questionnaire in order to provide biographical data, past clinical history and socio-economic background information. A cervical swab (CS) and a high-vaginal swab (HVS) were obtained from each patient. Swab samples were examined for pH and under light microscopy by Gram's stain and as wet preparations in 10% potassium hydroxide. Subsequently, samples were cultured on appropriate media at optimal conditions and a drug sensitivity profile for all isolates was determined by standard methods. Blood samples were screened and confirmed for HIV antibodies. Bacterial, fungal and parasitic pathogens were identified or isolated in samples from 241 (96.4%) of the women. Bacterial agents (Neisseria, Streptococcus and Staphylococcus species) were predominant in 128 (51.2%) patients, followed by fungi in 108 (43.2%) and parasites (Trichomonas vaginalis) in five (2.0%). Sensitivity to ciprofloxacin was seen in 40% of Staphylococcus species and in 90% of Neisseria species. Positive HIV serology was seen in 25 (10%) of the 250 women studied, 20 (80%) of which had concurrent microbial infections. Overall, a broad spectrum of microbial agents were shown to be responsible for vaginitis in the group of patients studied.
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PMID:Aetiological agents of vaginitis in Nigerian women. 1564 8


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