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)

In the US and globally women are contracting the human immunodeficiency virus (HIV) and developing the acquired immunodeficiency syndrome (AIDS) the fastest. Worldwide, HIV is transmitted primarily through heterosexual intercourse. In the US, the proportion of women who have contracted AIDS by heterosexual transmission has increased from 11% in 1984 to 34% in 1990. Women are at a greater risk than men for transmission by heterosexual intercourse as the ratio of women to men who acquire AIDS by heterosexual transmission is 3 to 1. Furthermore, 25% of AIDS cases caused by heterosexual transmission or iv drug use occurs in women. Although women often develop HIV-related serious gynecologic problems, including cervical cancer and refractory vaginal candidiasis, these conditions do not fall within the Centers for Disease Control definition of AIDS. Women who have gynecologic symptoms are not diagnosed as having AIDS, are not eligible for AIDS benefits, and live half as long as men do once they are diagnosed as being HIV infected. Little is known about the characteristics of HIV infection or AIDS in women. Sexually transmitted diseases (STDs) seem to act as cofactors for HIV infection. The human papilloma virus or genital warts, the herpes simplex virus, syphilis, chancroid, recurrent vaginal candidiasis, abnormal Pap smears, cervical neoplasias, and pelvic inflammatory disease have been associated with HIV infection in women. HIV infection should be considered in all women with symptoms of any of these disorders. Nurses must first become aware of the clinical manifestations of HIV infection specific to women. Nursing interventions should educate about safer-sex including condom use with nonoxynol 9, and the risks of sharing needles. Strategies must be developed that provide empowerment skills and are sensitive to the women's cultural, religious, and ethnic background, beliefs, and values.
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PMID:Issues concerning women and AIDS: sexuality. 140 53

The presence of antibodies to pili of Neisseria gonorrhoeae and Chlamydia trachomatis serovar L2 were assessed in women consecutively hospitalized in Zimbabwe with pelvic inflammatory disease (PID; n = 66), infertility (n = 227), and ectopic pregnancy (n = 60). Women delivering live full-term infants served as controls. Of the infertile women, 60% had secondary infertility; 59% had macroscopic evidence of a tubal abnormality. Women with PID, infertility and tubal disease, and ectopic pregnancy and tubal disease had significantly higher prevalences of antibodies against C. trachomatis and N. gonorrhoeae than did controls or women with infertility or ectopic pregnancy but no macroscopic tubal abnormalities (P less than .001 for all comparisons). The prevalence of antibody to chlamydia increased with age (P = .01), unlike the gonococcal antibody. Antibodies to C. trachomatis were associated with a history of PID, being single, a positive Treponema pallidum hemagglutination assay, and chlamydial antibody. None of the controls had human immunodeficiency virus, unlike 3.9%-7.6% of the other women. Tubal abnormalities were implicated in more than half of the cases of infertility.
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PMID:The role of Neisseria gonorrhoeae and Chlamydia trachomatis in pelvic inflammatory disease and its sequelae in Zimbabwe. 197 97

To assess the association of the human immunodeficiency virus (HIV) with other sexually transmitted diseases we undertook an anonymous HIV antibody serosurvey of all women admitted to the hospital with pelvic inflammatory disease. All the patients were given HIV risk reduction information and offered voluntary antibody testing. Thirty-one consecutive patients were evaluated; 30 specimens were suitable for anonymous testing. Five of the 30 (16.7%) were seropositive on both an enzyme-linked immunosorbent assay and Western blot test. The majority of the patients expressed concern about their HIV risk; 23 (74%) requested confidential testing. Of those tested, five (21.7%) were seropositive; three had traditional risk factors (intravenous drug abuse and/or sexual contacts at risk), and two denied traditional risk factors but reported nonintravenous cocaine use and multiple sexual partners. Of the seronegative women, 33% reported nonintravenous cocaine use (many with multiple sexual partners). Preventing the heterosexual spread of HIV into this vulnerable population is a formidable public health challenge.
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PMID:Seroprevalence of human immunodeficiency virus in women admitted to the hospital with pelvic inflammatory disease. 201 Aug 94

Nonhormonal methods of contraception--including condoms, spermicides, withdrawal, the diaphragm, periodic abstinence, and the IUD--are again increasing in popularity and accounted for 42% of contraceptive use in 1987. Most dramatic have been increases in condom and spermicide use due to the ability of these methods to serve as physical and chemical barriers to the transmission of the human immunodeficiency virus and other sexually transmitted diseases. The cervical cap, approved for distribution in the US in 1988, offers several advantages over the vaginal diaphragm, including a wear time of up to 48 hours, reduction in the amount of spermicide required, and small size. Although acceptance of periodic abstinence has not kept pace with recent increases in contraceptive prevalence, more than 10% of married women in some developing countries adhere to natural family planning. Moreover, new technologies identifying the fertile period have made this method more reliable and thus more acceptable. The Copper T-380A IUD, with a pregnancy rate of less than 1 per 100 women the 1st year of use, is expected to attract growing numbers of acceptors, especially given recent research findings of a lack of effect on pelvic inflammatory disease incidence and subsequent fertility. In fact, the World Health Organization has cited the IUD as the single most effective reversible method of fertility control. Contributing to increased prevalence rates for barrier methods is the trend toward a dual method of contraception (i.e., oral contraceptive is association with condoms) among women at risk of sexually transmitted diseases.
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PMID:Contraception: barriers and spermicides, periodic abstinence, and intrauterine devices. 213 Sep 48

Both human immunodeficiency virus infections and pelvic inflammatory diseases are sexually acquired illnesses of great consequence to women. This study was undertaken to determine if women hospitalized with pelvic inflammatory disease, in a community endemic for human immunodeficiency virus, were at high risk to be infected with human immunodeficiency virus and if human immunodeficiency virus infections altered their hospital course. One hundred ten women hospitalized with pelvic inflammatory disease in Brooklyn (in a hospital in which 2% of parturients are human immunodeficiency virus seropositive) agreed to human immunodeficiency virus testing; 15 (13.6%) were found to be seropositive. Seropositive women were significantly more likely to have an admission white blood cell count less than 10,000/mm3 (p = 0.001). Human immunodeficiency virus seropositivity was not associated with a higher frequency of other sexually transmitted diseases although there was a trend toward more cases of syphilis among human immunodeficiency virus-infected women. Similarly, although there was no significant difference in rates of operative intervention (26.6% among seropositive and 8.4% among seronegative; p = 0.058), there was a trend toward more surgery among those who were human immunodeficiency virus infected. Women hospitalized with pelvic inflammatory disease, in a community endemic for human immunodeficiency virus, are at high risk for human immunodeficiency virus infection. More research is needed to verify a trend toward more refractory infections among human immunodeficiency virus-infected women.
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PMID:Sexually transmitted diseases and human immunodeficiency virus infection among women with pelvic inflammatory disease. 222 Sep 17

Both acquired immunodeficiency syndrome (AIDS) surveillance data and surveys on the seroprevalence of human immunodeficiency virus (HIV) indicate that HIV infection through heterosexual transmission is showing a trend of dramatic increase among US women. In women, especially pregnant women, AIDS has a more fulminant course than in men and there is a shorter survival time from diagnosis to death. Gynecologists may be the first source of medical contact among asymptomatic HIV-positive women, and primary care providers should aware of unusual gynecologic manifestations of HIV infection. Protracted herpes infection, refractory vaginal candidiasis, and widespread condylomata often represent early warning signs of an underlying immunocompromised state. Women with impaired cellular immunity are at greater risk of genital papillomavirus and neoplasia. Deficient cellular immunity also facilitates activation of latent infections such as cytomegalovirus, herpes simplex, and papillomavirus. Pelvic inflammatory disease is found in a disproportionately high number of HIV-infected women, although it is unknown whether the inflammation is secondary to the AIDS virus or a co-factor. Genital ulcers both increase the risk of HIV seroconversion and enhance the infectiousness of women already HIV-positive. Herpes simplex and other gynecologic conditions are likely to be more fulminant in presentation, more protracted in course, and resistant to conventional therapy in HIV-infected patients. To facilitate the early identification and treatment of these conditions, Pap smears should be taken every 4-6 months in infected women and there should be liberal use of colposcopy. Oral contraceptive users should be advised to switch to condom/nonoxynol-9 use to reduce the potential for disease transmission and accelerated progression.
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PMID:Primary care of women infected with the human immunodeficiency virus. 224 90

Sexually transmitted diseases (STDs) are now the most common group of identifiable infectious diseases in many countries, especially among those ages 15-50 and in infants. Their control is important considering the high incidence of acute infections, complications and sequelae, their socioeconomic impact, and their role in increasing transmission of the human immunodeficiency virus (HIV). THe worldwide incidence of major bacterial and viral STDs is estimated to be over 125 million cases yearly. STDs are hyperendemic in many developing countries. However, in industrialized countries, the bacterial STDs such as syphilis, gonorrhea, chancroid declined from their peak during WW II until the late 1950s, increased during the 1960s and early 1970s, and have again decreased since that time. In the industrialized world, diseases due to Chlamydia trachomatis, genital herpes virus, human papillomaviruses, and HIV are now more significant than the classical bacterial ones; both groups remain major health problems in most developing countries. Infection rates are similar in both men and women, but women and infants bear the major burden of complications and serious sequelae. Infertility and ectopic pregnancy are often a result of pelvic inflammatory disease and are preventable. STDs in pregnant women can result in prematurity, stillbirth, and neonatal infections. In many areas, 1-5% of newborns are at risk of gonococcal ophthalmia neonatorum, a disease that blinds and congenital syphilis causes up to 25% of perinatal mortality. Genital and anal cancers (especially cervical cancer) are associated with viral STDs (genital human papillomavirus and herpes virus infections). Urethral stricture and infertility are frequent sequelae in men. (author's modified)
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PMID:Epidemiology of sexually transmitted diseases: the global picture. 228

As the number of women with acquired immunodeficiency syndrome (AIDS) continues to rise in the United States, it becomes important to target preventive interventions as effectively as possible toward those groups at highest risk of acquiring human immunodeficiency virus (HIV) infection. We analyzed the prevalence of serum antibody to HIV in 333 women admitted to the Gynecology Service at San Francisco General Hospital with acute pelvic inflammatory disease in the years 1985-1988. The proportion of women with HIV infection in our sample rose incrementally over this 4-year period, from 0 to 6.7%. A history of intravenous (IV) drug use conferred a 23-fold risk of HIV seropositivity. In contrast, markers of the level of sexual activity did not correlate significantly with the presence of HIV infection, although the power to detect such an association was limited by the small sample size. An intensification of educational efforts directed at IV drug-using women in San Francisco is necessary to prevent further increases in the rate of HIV infection and further spread into the heterosexual population.
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PMID:Seroprevalence and epidemiologic correlates of human immunodeficiency virus infection in women with acute pelvic inflammatory disease. 231 85

The prevalence of sexually transmitted pathogens in two groups of women was studied: 50 women with clinical diagnoses of acute pelvic inflammatory disease (PID) and 50 asymptomatic women attending a family planning clinic (FPC). Genital specimens, collected by non-invasive procedures, were examined. Endocervical Neisseria gonorrhoeae was present in 62% of the PID group and 10% of the FPC group (P less than 0.0001). One-third of N. gonorrhoeae isolates were penicillinase-producing strains. Chlamydia trachomatis was isolated from the endocervix in 30% of the PID group and 26% of the FPC group (P = 0.8240 NS). Mycoplasma hominis was more prevalent in the vaginas and endocervices of the PID group than the FPC group (84% and 72% v. 50% and 42%; P = 0.0006 and 0.0047 respectively). Trichomonas vaginalis was present in 56% of the PID group and 20% of the FPC group (P = 0.0004). Syphilis serology was positive in 34% of the PID group and 10% of the FPC group (P = 0.0026). In the PID group of patients, 8% were positive for HBsAg. Antibody to the human immunodeficiency virus was not detected in any of the 100 women. The high prevalence of recognised sexually transmitted pathogens underlines the need for appropriate antimicrobial agent(s) active against N. gonorrhoeae, C. trachomatis and M. hominis in patients with PID. In view of the high prevalence of penicillinase-producing strains of N. gonorrhoeae, routine use of an antibiotic active against such strains is desirable.
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PMID:Sexually transmitted pathogens in acute pelvic inflammatory disease. 250 53

IUDs have assumed increasing importance as contraceptives. Better design and use of new materials has increased their safety and reduced their side effects. However, pathological problems are constantly reported in literature. They include menstrual alterations (menometrorrhagia), pelvic infection, ectopic pregnancies, and perforation of the uterus. Results of research conducted at the Gynecology and Obstetrics Clinic at the University of Pavia are reported. The pathogenesis and etiology of cervico-vaginitis, actinomyces infections, PID and septic abortion in patients using IUDs were examined. It is concluded that the use of the spiral IUD is contraindicated for women affected by immunodeficiency and for patients with diseases that require therapy with anti-inflammatory agents. Special attention should be given to nulliparous patients with cardiovalvular problems and to patients during the immediate postpartum period. The importance of performing a bacteriological cervico-vaginal examination before the insertion of the IUD is stressed. Aside from common aerobic germs, the patient should be examined for anaerobic germs and agents of sexually transmitted diseases. Any form of cervico-vaginitis should be treated prior to insertion. A bacteriological checkup should be performed continually in order to prevent possible phlogistic as well as asymptomatic or minor symptomatic complications. The IUD should be replaced within 2 years of insertion. If infections occur, the device must be removed and an antibiotic therapy initiated.
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PMID:[IUD and gynecological infections]. 357 47


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