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)

Several studies have examined the prevalence of hepatitis B (HBV) and human immunodeficiency virus (HIV) in a trauma population. To our knowledge, no one has reported on the prevalence of hepatitis C (HCV). We prospectively studied the prevalence of HCV, as well as HBV, HIV, and syphilis in our adult regional level I trauma center population. Two hundred eighty-six consecutive trauma patients were tested for previous exposure to HCV using an anti-HCV mAb ELISA. Patients were also tested for exposure to HBV, HIV, and syphilis, and for illicit drug use. All rho values were calculated using Yates' corrected chi 2 or Student's t test. Twenty-two patients (7.7%) were found to have anti-HCV antibodies, five patients (1.7%) had active HBV, nine patients (3.2%) had HIV, and 16 patients (6%) were positive by RPR. Four (18%) of the patients seropositive for HCV tested positive for HBV, HIV, or syphilis as well. The HIV-positive patients were more likely than the HIV-negative patients to be HCV positive (rho = 0.018). Nine of the HCV seropositive patients (41%) tested positive for cocaine use. Cocaine users were more likely than nonusers to be HCV positive (rho = 0.0007). We have demonstrated the prevalence of HCV in our trauma population to be high (7.7%). It is well known that HCV has a high rate of chronicity, thus up to 90% of these patients are carriers and represent a substantial risk to health care workers. The two significant risk factors, HIV status and cocaine use, are difficult to elicit in the acute setting, reinforcing the need for adhering to universal precautions.
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PMID:The prevalence of hepatitis C in a regional level I trauma center population. 132 15

The association between human immunodeficiency virus (HIV) seropositivity and a history of sexually transmitted diseases (STDs), evidence of STDs on physical examination, and sexual and drug use practices was studied in a population of 2921 intravenous drug users (IVDUs) in Baltimore during 1988 and 1989. Overall, 24.1% were HIV-seropositive at baseline, and 60% reported a history of an STD. A significant association was found between HIV seropositivity and a history of syphilis (P = .04); both were more frequent among homosexual/bisexual men than among heterosexual IVDUs. In multivariate analysis, a history of syphilis was independently associated with HIV seroprevalence in homosexual/bisexual male IVDUs, of whom 90% reported a history of sexual intercourse with women. Cocaine injection was independently associated with HIV seropositivity but not a history of syphilis on multivariate analysis. STDs, indicative of unsafe sex practices, are common in this population; efforts are needed to prevent sexual transmission of HIV infection among IVDUs and their sex partners.
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PMID:Sexually transmitted diseases in a population of intravenous drug users: association with seropositivity to the human immunodeficiency virus (HIV). 186 36

To study the relationship of cocaine use to syphilis and human immunodeficiency virus infections a blinded urine and serum survey was performed among parturient women at an inner city hospital. Discarded urine samples of 1206 parturient women were saved and given code numbers that were also assigned to data sheets containing nonidentifying information, including prenatal care status and syphilis serologic results. In the latter part of the study blood remaining after syphilis serologic tests were performed (n = 480) were tested for human immunodeficiency virus antibodies. Overall 12.9% of urine samples had cocaine derivatives, 1.4% opiates, 1.5% marijuana, 0.0% benzodiazepine, and 0.3% methadone. The prevalence of positive rapid plasma reagin tests was 18.7% among patients with positive urine toxicologic tests for cocaine and 2.41% for patients with negative urine tests (odds ratio = 9.3, 95% confidence interval 5.2 to 16.5, p less than 0.001). Fluorescent treponemal antibodies were also significantly more frequent among patients with positive urine samples. Four of 53 (7.6%) patients with positive urine toxicologic screens were human immunodeficiency virus antibody positive compared with six of 427 (1.4%) women with negative screens (odds ratio = 5.7, 95% confidence interval = 1.4 to 21.5, p = 0.019). Cocaine patients with positive cocaine screens and with syphilis or human immunodeficiency virus had prenatal care in 6 of 21 (28.6%) and 0 of 4 (0%) cases, respectively, while patients with negative cocaine screens and syphilis or human immunodeficiency virus had prenatal care in 13 of 18 (72.2%) and 5 of 6 (83.3%) cases, respectively (p = 0.010 and p = 0.048). Cocaine use appears to be associated with both the acquisition of human immunodeficiency virus and syphilis and the failure of infected individuals to utilize prenatal services.
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PMID:The relationship of cocaine use to syphilis and human immunodeficiency virus infections among inner city parturient women. 238 37

Increasing use of cocaine among pregnant women has been reported. This study was conducted to determine the prevalence of positive urine toxicologic screens for cocaine and other substances of patients admitted to the Sloane Hospital for Women. Urine samples were obtained from 509 women admitted to the delivery suite. The overall prevalence of cocaine was 10% (n = 51). Cocaine use was 10 times more prevalent in the clinic population (14%) than in the private population, (1.4%). In addition, women whose urine samples were positive for cocaine were more likely to have no prenatal care, previous induced abortions, to be human immunodeficiency virus-positive, and admitted previous use of cigarettes, alcohol, cocaine, and other drugs. Amphetamines were detected in 13% (n = 65) of patients. However, the screens did not distinguish between metabolites of amphetamines and other drugs such as cold medications. The medical history alone predicted only 37% (n = 19) of the cocaine-positive screens and none of the amphetamine-positive screens.
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PMID:Prevalence of use of cocaine and other substances in an obstetric population. 240 58

A retrospective chart review of 1120 antepartum admissions revealed the prevalence of antepartum pneumonia rose to 1 per 367 deliveries. A total of 26 cases in 9560 deliveries were identified with criteria of fever greater than 39 degrees C, productive cough, and radiologic findings of infiltrates or consolidation. Pregnancy-related outcome variables studied were prevalence of preterm labor or birth, birth weight, and trimester of occurrence. Pneumonia characteristics studied were rate and type of organisms recovered, seasonality, and severity of the illness and radiologic findings. Exposure variables relating to the development of pneumonia studied were underlying medical conditions, hematocrit, human immunodeficiency virus status, and drug use. Birth weight, hematocrit, human immunodeficiency virus status, and drug use were compared with a randomly selected sample of women drawn from the general population delivered of infants during the study time period. One patient experienced preterm delivery, which occurred 1 month after cure of pneumonia. Birth weight was significantly lower in the study group (2770 +/- 224 gm versus 3173 +/- 99 gm, p less than 0.01). The most common organism recovered was Streptococcus pneumoniae. A total of 42% of patients had multilobar involvement and two required intubation. Cocaine use (52% in the study group versus 10% in the general population, p less than 0.01) and human immunodeficiency virus positivity (24% in the study group versus 2% in the general population, p less than 0.01) were significant risk factors for antepartum pneumonia.
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PMID:Risk factors associated with the increasing prevalence of pneumonia during pregnancy. 240 78

A discriminant function analysis was performed with data from 409 high-risk heroin addicts at intake into a methadone maintenance treatment program to determine the characteristics of cocaine users. Cocaine users presented a higher-risk profile for human immunodeficiency virus (HIV), engaged in a wider variety of criminal activities, were more likely to be African-American, reported more alcohol use, and showed more signs of psychological disturbance. A second discriminant function analysis determined that crack smokers differed from non-crack cocaine users in ethnicity, alcohol use, criminal activity, needle use, and marital status. Heroin addicts who use cocaine, in particular crack, represent a sub-group at higher risk and in need of targeted treatment planning and monitoring.
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PMID:Cocaine and crack use and HIV risk behaviors among high-risk methadone maintenance clients. 788 69

The association between cocaine use (crack and injection cocaine) and risky behaviors for human immunodeficiency virus (HIV) infection was investigated among participants in a multi-site study at drug treatment and non-drug treatment sites in Worcester, Massachusetts. Cocaine use was more prevalent among young, African-American men. Compared to heroin injectors cocaine injectors had higher risk injection and sexual behaviors. Among non-injectors, crack users were more likely to have multiple partners and receive money or drugs for sex. Cocaine use, either injected or smoked as crack, should be considered a high risk behavior for HIV infection.
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PMID:Cocaine use and risky injection and sexual behaviors. 788 75

Previous studies have shown that cocaine consumption alters the normal immune functions of animals. Several epidemiologic studies have indicated an association between cocaine consumption and an increased risk for AIDS. In the present studies, unstimulated peripheral blood mononuclear cells (PBMC) isolated from 8 healthy, human immunodeficiency virus (HIV) type 1-seronegative volunteers were exposed to cocaine or one of its by-products, in vitro, at concentrations compatible with blood levels found during clinical abuse of cocaine. PBMC treated with cocaine had significantly increased levels of HIV-1 replication after infection in vitro compared with untreated PBMC. The major cocaine by-product, benzoylecgonine, did not appear to exert any significant potentiating effect on HIV-1 replication. Cocaine or its by-product did not significantly increase HIV-1 replication in persistently HIV-1-infected T lymphocytic or monocytoid cell lines. These data indicate that exposure of PBMC but not chronically HIV-1-infected cell lines to cocaine can result in increased HIV-1 replication.
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PMID:Human immunodeficiency virus type 1 replication in peripheral blood mononuclear cells in the presence of cocaine. 822 49

The number of children infected by the human immunodeficiency virus type-1 (HIV-1) who develop the acquired immunodeficiency syndrome (AIDS) continues to increase. While some children become infected after birth and others at the time of parturition, a significant percentage are infected during gestation and there is a positive correlation between maternal illicit intravenous drug use and fetal HIV-1 infection. Drugs can contribute in, at least, four ways to vertical transmission of HIV-1. These four ways are divisible into 2 main categories that are comprised of both direct and indirect mechanisms. For example, drugs of abuse can have a direct effect on the maternal-fetal interface. Cocaine is associated with vasculitis. If this occurs as a placentitis or chorioamnionitis, it can alter the permeability of these barriers to maternal blood and increase the number of potentially infected inflammatory cells in this tissue and as a result in the fetus. Another direct mechanism wherein drugs of abuse can increase the probability that a fetus will become infected is via an inflammatory reaction such as a vasculitis in the fetus rendering it more susceptible to viral infection. Drugs can also affect the course of HIV-1 infection via indirect mechanisms. An example of this may be by modulating the female immune system. This effect can exacerbate the woman's immunodeficiency and accelerate opportunistic infections. For example, cytomegalovirus infection resulting in placentitis might facilitate fetal HIV-1 infection. Lastly, a similar type of indirect mechanism can be postulated for the fetus wherein its developing immune system can be adversely effected.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Perinatal AIDS: drugs of abuse and transplacental infection. 823 98

Cocaine abuse is a common clinical problem among opioid-dependent patients who are in methadone maintenance treatment. In an open prospective study, 16 DSM-III-R, cocaine-dependent, methadone maintenance treatment patients were treated with fluoxetine, at a mean dose of 45 mg/day for 9 weeks. Eleven subjects (69%) were infected with the human immunodeficiency virus. Cocaine use was significantly reduced by the end of treatment, although most subjects did not achieve abstinence. Comparison of intake to week 9 showed a significant decrease in self-reported cocaine use, craving, and quality of high. Actual cocaine use was measured by a quantitative analysis of cocaine and benzoylecgonine (BE) concentrations in plasma and urine. Median BE and cocaine concentrations in urine decreased significantly from intake to week 9 of fluoxetine treatment. This decrease would not have been detected if BE had been measured only qualitatively, as present or absent in the urine. Fluoxetine was well tolerated in combination with methadone and did not appear to alter methadone concentrations in plasma. Few adverse effects were noted. No subjects had to discontinue fluoxetine. Fluoxetine may be a promising treatment approach for cocaine abuse in methadone maintenance patients. Quantitative determination of exact cocaine and BE concentrations in biofluids may be a more accurate method of measuring cocaine use outcome than qualitative urinalysis.
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PMID:Fluoxetine for cocaine dependence in methadone maintenance: quantitative plasma and urine cocaine/benzoylecgonine concentrations. 780 96


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