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)

Sexually transmitted diseases (STD) cause lower genital tract infections (cervicitis, vaginitis) or ascending infections of the fallopian tubes, and, possibly, pelvic inflammatory disease (PID). The syphilis bacterium, human immunodeficiency virus (HIV), and the hepatitis virus cause systematic disease. Although oral contraceptives (OCs) are the most reliable contraceptive method, they have limited anti-STD properties and their relationship with STDs remain unclear. Various mechanisms explain a protective role of OCs against STDs; however, in no way can OCs be considered a safe anti-STD contraceptive method, when compared to specific barrier methods, which provide both contraception and anti-STD protection. The above has been confirmed by a recent study performed in our institution where 10.3% and 6.9% of OC users presented a prevalence of Chlamydia trachomatis and Mycoplasma, respectively, when compared to 0% and 4.5% infection rates found among condom users. It is concluded that although OCs possess some anti-STD properties, mainly in the prevention of PID, they should be used in combination with a barrier method.
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PMID:Sexually transmitted diseases and oral contraceptive use during adolescence. 923 95

We offered standardized gynecologic examinations to consecutive women admitted to an AIDS-designated inpatient medical service; 65 (97%) of 67 women consented to the examination. The median CD4+ T lymphocyte count was 54/mm3. Only 9% of the women were admitted for primary gynecologic or genitourinary diagnoses; however, on evaluation, 83% of these women had gynecologic disease. The overall prevalences of vaginitis, cervical dysplasia, genital condylomata, genital herpes, and pelvic inflammatory disease were 51%, 45%, 23%, 20%, and 5%, respectively. Unexpected findings included adenovirus infection and foscarnet-associated genital ulcerations (two cases each). For predicting disease, gynecologic symptoms had a sensitivity of 76% and a positive predictive value of 95% but a negative predictive value of only 41%. Our results document the high prevalence of comorbid gynecologic disease among women infected with human immunodeficiency virus (HIV). Because of the inability to fully predict disease by symptom history, it is imperative that comprehensive gynecologic evaluation be offered routinely to all HIV-infected women hospitalized for acute medical illnesses.
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PMID:High prevalence of gynecologic disease among hospitalized women with human immunodeficiency virus infection. 931 65

A prospective observational study over a 6-month period on women presenting with infertility was conducted at King Edward VIII Hospital (KEH), South Africa. The aim of the study was to establish the patient profile and investigations performed on women presenting with infertility. One hundred women were recruited. The mean age of the women was 31 years and 60% had secondary infertility. The mean duration of infertility was 7.2 years; 61% had histories suggestive of pelvic inflammatory disease and approximately half (49%), had had previous infertility investigations; 16% of the women were HIV (human immunodeficiency virus) antibody positive and 16% had positive syphilis serology. Tubal factors were identifiable in 77%, ovulatory factors in 21% and uterine factors in 21%. Male factor infertility was present in 21%. The study confirms that in developing countries, tubal factors are the commonest cause of infertility.
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PMID:Infertility profile at King Edward VIII Hospital, Durban, South Africa. 970 Feb 83

To determine the effect of human immunodeficiency virus type 1 (HIV-1) infection upon pelvic inflammatory disease (PID), a laparoscopic study of acute PID was conducted in Nairobi, Kenya. Subjects underwent diagnostic laparoscopy, HIV-1 serology, and testing for sexually transmitted diseases. Of the 133 women with laparoscopically verified salpingitis, 52 (39%) were HIV-1-seropositive. Tubo-ovarian abscesses (TOA) were found in 33% of HIV-1-infected and 15% of HIV-1-uninfected women (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.2-6.5). Among seropositive women, TOA was found in 55% of those with CD4 cell percent <14% vs. 28% with CD4 cell percent>14% (OR 3.1, 95% CI 0.6-15.3). Neisseria gonorrhoeae was detected in 37 women (28%) and Chlamydia trachomatis in 12 (9%); neither was significantly related to HIV-1 seropositivity. Length of hospitalization was not affected by HIV-1 serostatus overall but was prolonged among HIV-1-infected women with CD4 cell percent <14%. Among patients with acute salpingitis, likelihood of TOA was related to HIV-1 infection and advanced immunosuppression. In general, HIV-1-seropositive women with acute salpingitis responded well to treatment.
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PMID:Effect of human immunodeficiency virus type 1 infection upon acute salpingitis: a laparoscopic study. 978 Feb 55

Recent evidence suggests that sexually transmitted diseases (STDs) enhance the transmission of human immunodeficiency virus (HIV) type 1. In 143 HIV-infected women enrolled in a university-based longitudinal HIV clinic over 16 months (mean), the STD point prevalence was examined at enrollment and the cumulative prevalence was calculated at follow-up. At enrollment, 35 women (25%) had > or = 1 STD. These included trichomoniasis in 16 women (11%); syphilis, 9 (6%); genital herpes, 8 (6%); gonorrhea, 5 (4%); chlamydia, 5 (4%); genital warts, 2 (1%); and pelvic inflammatory disease (PID), 1 (1%). STDs were found in 55 (42%) of the 125 patients who returned for at least one follow-up visit: trichomoniasis in 23 (18%); genital herpes, 20 (12%); gonorrhea, 9 (7%); syphilis, 7 (6%); genital warts, 7 (6%); chlamydia, 5 (4%); and PID, 4 (3%). Despite counseling at both enrollment and follow-up, these women had a very high cumulative prevalence of STDs, indicating persistent high-risk sexual behavior.
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PMID:Sexually transmitted disease acquisition among women infected with human immunodeficiency virus type 1. 980 54

In Kenya, the median incubation time to AIDS in seroconverting sex workers is 4 years; this incubation time is specific to female sex workers. We studied the influence of acute sexually transmitted infections (STIs) on several immunologic parameters in 32 human immunodeficiency virus type 1 (HIV-1)-positive and 10 HIV-1-negative women sex workers who were followed for 1-5 months. Plasma cytokines, soluble cytokine receptors, CD4 and CD8 T cell counts, and HIV-1 plasma viremia were quantitated before, during, and after episodes of STI. Increases in interleukin (IL)-4, IL-6, IL-10, soluble tumor necrosis factor (TNF)-alpha, and viremia and a decline in CD4(+) T cell counts occurred during gonococcal cervicitis and returned to baseline after treatment. Increases in viremia correlated with increased IL-4 and decreased IL-6 concentrations. Similar changes were seen among women with acute pelvic inflammatory disease. Acute bacterial STI resulted in increased HIV-1 viremia. This may be mediated through increased inflammatory cytokines or through modulation of immune responses that control HIV-1 viremia.
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PMID:Acute sexually transmitted infections increase human immunodeficiency virus type 1 plasma viremia, increase plasma type 2 cytokines, and decrease CD4 cell counts. 1091 76

Neisseria gonorrhoeae infections are a major cause of pelvic inflammatory disease, infertility, and ectopic pregnancy in women and facilitate the transmission of human immunodeficiency virus (1). To characterize the epidemiology of gonorrhea in the United States, CDC examined national surveillance data on gonorrhea cases reported to CDC through state health departments in 1998 and surveyed selected states with increases and decreases in gonorrhea rates since 1996. This report summarizes the results of this analysis, which indicate that following a 13-year decline, the number of gonorrhea cases in 1998 increased by 9% compared with 1997. Although changes in gonorrhea screening and surveillance practices may have contributed to the higher reported rates, reports from states suggest that true increases in gonorrhea cases also occurred in some populations.
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PMID:Gonorrhea--United States, 1998. 1092 55

Bacterial vaginosis is characterized by a shift from the predominant lactobacillus vaginal flora to an overgrowth of anaerobic bacteria. Bacterial vaginosis is associated with an increased risk of gynecologic complications, including pelvic inflammatory disease, postoperative infection, cervicitis, human immunodeficiency virus (HIV), and possibly cervical intraepithelial neoplasia (CIN). The obstetrical risks associated with bacterial vaginosis include premature rupture of membranes, preterm labor and delivery, chorioamnionitis and postpartum endometritis. Despite the health risks associated with bacterial vaginosis and its high prevalence in women of childbearing age, bacterial vaginosis continues to be largely ignored by clinicians, particularly in asymptomatic women.
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PMID:Gynecologic conditions and bacterial vaginosis: implications for the non-pregnant patient. 1096 4

In 1999, 360,076 cases of gonorrhea were reported in the United States (1). Gonorrhea is a major cause of pelvic inflammatory disease, often leading to ectopic pregnancy and infertility, and it can facilitate human immunodeficiency virus (HIV) transmission (2). During the 1980s, resistance to penicillin and tetracycline among gonococcal isolates became widespread; as a result, CDC recommended that other antimicrobial agents be used to treat gonorrhea. This report summarizes investigations of an increase in fluoroquinolone-resistant Neisseria gonorrhoeae in Hawaii and of a cluster of N. gonorrhoeae infections with decreased susceptibility to azithromycin in Missouri.
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PMID:Fluoroquinolone-resistance in Neisseria gonorrhoeae, Hawaii, 1999, and decreased susceptibility to azithromycin in N. gonorrhoeae, Missouri, 1999. 1101 33

Epidemiologic, animal, and in vitro models suggest an important role for interferon (IFN)-gamma in the clearance of Chlamydia trachomatis infection. IFN-gamma in the supernatants of in vitro-stimulated peripheral blood mononuclear cells (PBMC) from 22 human immunodeficiency virus type 1 (HIV-1)-infected and 73 uninfected women at high risk for C. trachomatis acute pelvic inflammatory disease (PID) was studied. PBMC were stimulated with C. trachomatis purified major outer membrane protein (MOMP) and whole elementary bodies (EBs) from the 4 predominant serovars (E, F, K, and L2) that circulate in Nairobi. PBMC IFN-gamma secretion after stimulation with C. trachomatis EBs was significantly decreased in HIV-1-infected women. Among HIV-1-infected women, CD4 T cell depletion was associated with lower IFN-gamma secretion from PBMC stimulated with either C. trachomatis MOMP or EB antigen. Decreased antigen-specific IFN-gamma production may enhance the susceptibility of HIV-1-infected women to C. trachomatis PID.
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PMID:Human immunodeficiency virus type 1-infected women exhibit reduced interferon-gamma secretion after Chlamydia trachomatis stimulation of peripheral blood lymphocytes. 1106 39


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