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)

Herpes simplex infection of the genitals is a common condition, more often due to herpes simplex virus (HSV) type 2 than to type 1 virus. There is a severe first attack followed by mild recurrences which are more common and more frequent after HSV-2 than after HSV-1 genital infection. Clinical features with prodrome, vesicles and erosions may be characteristic allowing rapid clinical diagnosis. When possible laboratory confirmation should be attempted. General management includes simple hygiene, avoidance of sexual transmission, use of condoms, and notifying partners. Oral acyclovir (Zovirax, Wellcome) is the drug of choice for initial attacks and should be considered for all women with this diagnosis. Intravenous acyclovir may be used for very severe attacks. Men with initial attacks may be treated with oral acyclovir but mild disease affecting only skin may be treated with 5% acyclovir cream. Recurrences are short so acyclovir has less effect. Frequent recurrences can be troublesome and may be suppressed by continuous oral acyclovir, or individual attacks may be aborted with intermittent therapy. Various systemic complications may occur; an important but rare problem is primary herpes in late pregnancy. Acyclovir is effective in the treatment of the troublesome herpes simplex disease associated with human immunodeficiency infection. Acyclovir is one of the more expensive treatments for sexually transmitted diseases. At present in many countries costs are being examined, and application of the principles outlined here should help to minimize cost and maximize care.
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PMID:Management of genital herpes simplex infection. 195 14

A total of 489 patients who had blood tests for antibodies to the human immunodeficiency virus (HIV) were given medical advice for sexually transmitted disease (STD) screening. Of 378 patients who had STD screening, STDs were found to be present in 47%. Among various STDs, non-specific urethritis (NSU) in men and chlamydial genital infection in women were found to be common. When the prevalence of these two diseases were compared with those of a control group the difference was significant.
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PMID:Sexually transmitted diseases among patients seeking HIV antibody test for AIDS. 208 96

To explore a possible association between bacterial vaginosis and human immunodeficiency virus (HIV) infection, 144 consecutively enrolled commercial sex workers from a sexually transmitted disease clinic (STD) in Chiang Mai, Thailand, were interviewed and underwent serologic testing and genital examination. 62 (43%) of sex workers were HIV-positive. A self-reported history of syphilis, chancroid, herpes, gonorrhea, or Chlamydia was significantly associated with HIV infection. Bacterial vaginosis, detected in 49 (34%), was also associated with HIV infection. Sex workers reporting 10-19 and 20 or more sexual encounters per week were 2.2 and 3.5 times, respectively, more likely to be infected with HIV than those reporting under 10 encounters. A clinically established diagnosis of bacterial vaginosis was independently associated with HIV seropositivity even when age, number of sexual encounters per week, current condom use, and past and current STD infection were controlled (odds ratio, 4.0; 95% confidence interval, 1.7-9.4). When the bacterial vaginosis diagnosis was based on Gram stain (score 7-10), however, the association with HIV seropositivity disappeared, but having abnormal vaginal flora (gram stain score 4-10) was related to HIV status. Further epidemiologic studies are recommended to investigate the possibility that bacterial vaginosis--the most prevalent genital infection in Thailand--acts as a cofactor for the heterosexual transmission of HIV.
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PMID:Bacterial vaginosis and HIV seroprevalence among female commercial sex workers in Chiang Mai, Thailand. 852 84

Genital infection with human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Genital or anal infection with oncogenic types of HPV, particularly types 16 and 18, can cause precancerous lesions of the squamous epithelium. Infection with human immunodeficiency virus (HIV) increases the risk for HPV-associated genital neoplasias in both women and men. Detectable cervical and anal HPV infection is more prevalent among women and men with HIV infection than among those who are HIV-seronegative, and the magnitude of the increase in prevalence is proportionate to the severity of immunosuppression. Coinfection with HIV and HPV increases the risk for genital intraepithelial neoplasia, and the increase in this risk also reflects the severity of immunosuppression. One difficulty complicating elucidation of the association between HIV and HPV infections is that the risk factors for acquisition and transmission of the two viruses are similar. The strength of this association represents a burgeoning health problem, yet there are no treatment guidelines aimed specifically at HIV-infected individuals with HPV-associated genital neoplasias. Treatment of HPV-associated cervical disease in HIV-infected women may be further complicated by a greater risk of treatment failure and recurrence than exists among HIV-seronegative women; it is not known whether dysplasia progresses to invasive disease more rapidly in women infected with HIV. A thorough understanding of the associations among HIV, HPV, and HPV-associated disease is essential to the development of effective strategies for intervention and prevention.
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PMID:Human papillomavirus infection and associated disease in persons infected with human immunodeficiency virus. 854 1

Simian immunodeficiency virus (SIV) can cross the intact vaginal epithelium to establish a systemic infection in macaques (mac). Using this SIVmac model, we found that subcutaneous progesterone implants, which could mimic hormonally based contraceptives, thinned the vaginal epithelium and enhanced SIV vaginal transmission 7.7-fold over that observed in macaques treated with placebo implants and exposed to SIV in the follicular phase of the menstrual cycle. Progesterone treatment also increased the number of SIV DNA-positive cells in the vaginal lamina propria as detected by in situ polymerase chain reaction analysis. Moreover, plasma viral RNA was elevated for the first three months in macaques with progesterone implants, and three of the progesterone-treated macaques developed relatively rapid disease courses. This study shows that SIV genital infection and disease course are enhanced by subcutaneous implants containing progesterone when compared with the rate of vaginal transmission in the follicular phase.
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PMID:Progesterone implants enhance SIV vaginal transmission and early virus load. 901 20

Research related to maternal-child transmission of human immunodeficiency virus (HIV) has been advanced by standardization of case definitions and transmission rate calculation methodologies as well as enhanced diagnostic options for detecting infant HIV-1 infection. Standardization guidelines have yielded vertical transmission rate estimates of 25-30% in developing countries and 14-25% in developed countries. Mathematical modeling suggests that 95% of infant infections occur later than the last 2 months before delivery. Serial polymerase chain reaction evaluation has identified a 7.7% risk of in utero transmission, a 17.6% risk of combined in utero and intrapartum transmission, and a 4.9% incidence of late postnatal transmission. The risk of transmission through breast feeding has been estimated at 14%, with increases with longer durations. Advanced maternal clinical HIV status, primary infection, decreased maternal cell-mediated immunity, placentitis, ascending genital infection during the peripartum period, and syncytium-inducing HIV-1 strains have been associated with higher rates of maternal-child transmission. Prematurity, lack of cellular immunity, and vitamin A deficiency may be infant risk factors. The finding in an AIDS Clinical Trial Group that zidovudine (AZT) treatment was associated with a 67.5% reduction in risk has prompted widespread use of this regimen in developed countries; however, AZT is expensive and logistically difficult to administer in most developing country contexts. Randomized clinical trials currently underway are assessing the benefits of cesarean section delivery, postpartum HIV-specific immunoglobulin administration to infants, avoidance of breast feeding or early weaning, and antenatal maternal vitamin A administration. Selected intervention strategies should be regionally designed to take into account variations in viral, host, and obstetric factors.
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PMID:Mother-to-child transmission of human immunodeficiency virus type 1. 902 9

Genital chlamydial infection is the most commonly reported infectious disease in the United States, and the prevalence of Chlamydia trachomatis genital infections in sexually active adolescents is 5%-15%, regardless of socioeconomic status. Although chlamydial infections frequently are asymptomatic in women, untreated infections can cause extensive inflammation and scarring of the female reproductive tract. In addition, chlamydial infections may facilitate human immunodeficiency virus transmission. Because of the risks and complications associated with this infection, CDC and the U.S. Preventive Services Task Force have recommended that all sexually active adolescent women undergoing a pelvic examination receive routine screening for chlamydia. To characterize the chlamydia screening practices of primary-care providers in Wake County, North Carolina, a county with high reported rates of chlamydial genital infection, the Wake County Human Services Public Health Center conducted a survey of primary-care providers during August-October 1996. This report summarizes the results of that survey, which document missed opportunities for the detection of chlamydia infection by health-care providers in both public and private practices.
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PMID:Chlamydia screening practices of primary-care providers -- Wake County, North Carolina, 1996. 931 Feb 15

In 101 healthy pregnant women and 132 pregnant women with genital infection (colpitis, endocervicitis, cervicitis) the characteristics of the anti-infectious protection of cervical mucus were studied. In pregnant women with inflammatory diseases of the vagina and cervix uteri disturbances in the local immunity of the sex system were detected. The study showed that in genital infections local immunodeficiency depended to a greater extent on the localization and spread of the process rather than on the etiological factor of the disease.
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PMID:[The local immunity of the genital system in pregnant women with a genital infection]. 1080 85

Since the advent of the antimicrobial era, single-dose therapy has been a valuable tool in the management of genital infection. Most of the common sexually transmitted infections (STIs) such as gonorrhoea, syphilis, trichomoniasis and chancroid can be treated in this way, as can genital infections which are not sexually transmitted such as bacterial vaginosis and genital tract candidiasis. Until recently, treatment for Chlamydia trachomatis infection required a multi-dose regimen, but single-dose azithromycin has now been shown to be an effective and acceptable alternative to this. Unfortunately, eradicative therapy has proven to be elusive for the viral STIs such as genital herpes simplex infection, human papilloma virus infection and human immunodeficiency virus (HIV) infection. The main advantage of single-dose therapy lies in its convenience and in its ability to ensure virtually 100% compliance. This addresses the problems of reduced clinical efficacy and the difficulties in assessing the response to therapy which complicates poor treatment compliance. However, some single-dose regimens for STIs do have drawbacks, particularly in certain situations. This may be with respect to efficacy, for example in syphilis with single-dose benzathine penicillin therapy, particularly for pregnant women and individuals infected with HI. Alternatively, it may involve toxicity, for example with single-dose metronidazole therapy for trichomoniasis or bacterial vaginosis where a higher rate of gastrointestinal adverse effects may be expected than if a lower multi-dose regimen is used. In addition, single-dose therapy, for example with nevirapine, given to the mother in labour and to the baby after delivery significantly reduces the risk of mother to child HIV transmission, but resistance mutations are frequently detected in the viral genome after the brief exposure to the drug, which could jeopardise its future use. Single-dose therapy clearly has both advantages and disadvantages. We have reviewed a range of these in a variety of situations, focussing on their applications, effectiveness, compliance and toxicity, highlighting how single-dose therapy may be a double-edged sword.
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PMID:Treatment of sexually transmitted infections with single-dose therapy: a double-edged sword. 1192 35

Vaccines capable of protecting against sexually transmitted infections, such as human immunodeficiency virus (HIV), will depend on the induction of potent long-lasting mucosal immune responses in the genital tract. We evaluated vaginal and systemic immune responses and protection from vaginal challenge elicited after intranasal immunization of mice with inactivated glycoprotien 120-depleted HIV-1 immunogen alone or in combination with immunostimulatory CpG oligodeoxynucleotides (ODNs). Mice immunized with HIV-1 immunogen plus CpG ODN had significantly enhanced levels of anti-protein 24 immunoglobulin (Ig) G and IgA antibodies in serum and vaginal washes and increased production of beta-chemokines and interferon-gamma, compared with mice immunized with HIV-1 immunogen alone or with control ODN. Furthermore, mice intranasally immunized with HIV-1 immunogen plus CpG were protected against intravaginal challenge with a recombinant vaccinia virus expressing HIV-1 gag. These results indicate that mucosal immunization with whole-killed HIV-1 plus CpG ODN may be an effective means of inducing local immunity and protection against genital infection.
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PMID:Mucosal immunization with inactivated human immunodeficiency virus plus CpG oligodeoxynucleotides induces genital immune responses and protection against intravaginal challenge. 1235 60


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