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)

To evaluate the role of parenteral and sexual transmission of human immunodeficiency virus, we studied seronegative intravenous drug users recruited from 25 drug dependence treatment centers in northern Italy. All attending intravenous drug users were asked for their consent and screened for antibodies to human immunodeficiency virus; those who were seronegative were enrolled, interviewed about their habits, and invited to follow-up visits. Between 1987 and 1989, 1,195 seronegative intravenous drug users were enrolled, 635 were followed up (mean duration, 11.9 months), and 35 seroconversions were observed. The incidence rate ratios were 3.3 (95% confidence interval (CI) 1.4-7.5) for subjects aged less than 20 years, 2.4 (95% CI 1.2-4.7) for less than 2 years of intravenous drug use, 2.2 (95% CI 0.9-5.5) for syringe sharing, and 1.0 for subjects with a sexual partner who had tested positive for human immunodeficiency virus. A case-control approach, using logistic regression and adjusting for sex, age, area, and prevalence, showed odds ratios of 13.2 (95% CI 3.1-56.8) for frequent syringe sharing and 4.0 (95% CI 1.5-10.4) for sexual contacts with seropositive partners; frequent use of condoms was associated with a reduction in risk that did not reach statistical significance. Parenteral transmission is the most important route of infection with the human immunodeficiency virus among intravenous drug users, and sexual transmission plays a relevant, additive role.
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PMID:Parenteral and sexual transmission of human immunodeficiency virus in intravenous drug users: a study of seroconversion. The Northern Italian Seronegative Drug Addicts (NISDA) Study. 131

We undertook an observational study of 1307 consecutive surgical procedures at San Francisco General Hospital to record descriptions of intraoperative exposures to blood and other body fluids, determine the factors predictive of these exposures, and identify interventions that might reduce their frequency. During a two-month period, circulating nurses took note of parenteral and cutaneous exposures to blood and recorded information about all procedures. In a follow-up validation study, 50 additional procedures were observed by the study investigators to determine the accuracy of the data collected by the nurses. A total of 960 gloves used by surgical personnel during the validation study were examined to determine the perforation rate. Accidental exposure to blood (parenteral or cutaneous) occurred during 84 procedures (6.4 percent; 95 percent confidence interval, 5.1 to 7.8 percent). Parenteral exposure occurred in 1.7 percent. The risk of exposure was highest when the procedures lasted more than three hours, when blood loss exceeded 300 ml, and when major vascular and intraabdominal gynecologic surgery was involved. Neither knowledge of diagnosed human immunodeficiency virus (HIV) infection nor awareness of a patient's high-risk status for such infection influenced the rate of exposure. Double gloving prevented perforations of the inner glove and cutaneous exposures of the hand. We conclude that all surgical personnel are at risk for intraoperative exposure to blood. Our data support the practice of double gloving and the increased use of water-proof garments and face shields to prevent mucocutaneous exposures to blood. No evidence was found to suggest that preoperative testing for HIV infection would reduce the frequency of accidental exposures to blood.
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PMID:Risk of exposure of surgical personnel to patients' blood during surgery at San Francisco General Hospital. 198 67

The gastrointestinal tract is a major target of the human immunodeficiency virus. Many AIDS patients have weight loss and/or diarrhea. Parenteral nutrition can be used to treat malnutrition associated with malabsorption. We reviewed retrospectively the clinical course of 22 patients with AIDS and weight loss greater than 10% who received home parenteral nutrition (HPN) for 56.2 patient-months. Mean weight loss was 21.4%, mean duration of HPN 2.55 months, mean age 37.4 years. Fifteen patients gained weight, six stabilized and two continued to lose weight. Nine patients returned to previous activity. Five died. The rates of catheter-related sepsis, complications, and metabolic disturbances were 0.12, 0.25, and 0.12/100 catheter days, respectively, results identical to those reported in other patient populations where HPN is commonly applied. We found that HPN induced weight gain and clinical improvement in most patients without higher risks of sepsis than in patients with malignancies.
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PMID:Risks and benefits of home parenteral nutrition in the acquired immunodeficiency syndrome. 190 Nov 11

Parenteral drug abusers are the second largest group at risk for developing AIDS (25% of US cases) and a major risk group for infection with both hepatitis B virus (HBV) and the HBV-dependent RNA hepatitis delta virus (HDV). This study was conducted to determine the prevalence in 1984-1985 and relationships of HDV and HBV infections in 372 unselected parenteral drug abusers without AIDS or symptoms related to human immunodeficiency virus type 1 (HIV-1) infection (but 49% of whom were positive for HIV-1 antibodies) and in 53 drug abusers hospitalized with AIDS. The prevalence of HDV markers in the combined study groups was 20%; 81% of study subjects with hepatitis B surface antigenemia (HBsAg) had one marker for HDV infection. Significant differences were found between patients with and without AIDS with respect to the prevalence of hepatitis delta antigen (5.7% vs. 0.8%, P less than .05) and antibody (0 vs. 21.4%, P less than .01) and HBsAg (15.1% vs. 5.1%, P less than .05). The significantly higher prevalence of hepatitis delta antigen and HBsAg in subjects with AIDS suggests that persistence or reactivation of these viruses is significantly greater among parenteral drug abusers with AIDS than among those without AIDS. These findings, along with the absence of hepatitis delta antibodies in the drug abusers with AIDS, are probably related to the profound general immunosuppression that occurs in AIDS.
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PMID:Contrasting prevalence of delta hepatitis markers in parenteral drug abusers with and without AIDS. 237 77

To investigate whether the human immunodeficiency virus (HIV) infection or the abuse of narcotic drugs or other viral infections may be responsible for immunologic abnormalities in parenteral drug abusers, sera from 168 consecutive individual patients were collected from 1985 to 1986. The sera were tested for antibody to HIV (anti-HIV), and the clinical, immunologic, and serologic characteristics of 83 seropositive and 53 seronegative parenteral drug abusers were compared. The presence of anti-HIV was significantly associated with a decreased number of T helper lymphocytes (P less than .001), a reduced T helper/suppressor ratio (P less than .001). Of the 83 seropositive patients, 63 (76%) had generalized lymphadenopathy and 16 (18%) had AIDS-related complex. No patient had AIDS. Parenteral drug abusers with AIDS-related complex had significant reductions in the number of T helper cells (P less than .01) and the T helper/suppressor ratio (P less than .01) compared with patients with lymphadenopathy syndrome (LAS), suggesting that parenteral drug abusers with HIV infection develop a progressive immunodeficiency. IgG antibody to cytomegalovirus was found in 75% of anti-HIV-positive and 45% of anti-HIV-negative parenteral drug abusers (P less than .01), but significant associations between anti-HIV and markers for other viruses were not found. Our data confirm that HIV infection is the major cause of low T helper cells and reversed T helper/suppressor ratio in parenteral drug abusers.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:T lymphocyte subsets and viral infections in Sardinian parenteral drug abusers: relationship to HIV infection. 253 84

Parenteral drug users have a high prevalence of infection with human immunodeficiency virus (HIV), the etiologic agent of acquired immune deficiency syndrome (AIDS). New York City has had a prolonged and extensive epidemic of HIV infection and AIDS. In this study, we analyze, in relation to antibody to HIV (anti-HIV), available data from sera from parenteral drug users collected in New York City during 1978 through 1983 in the course of studies of liver disease. Among parenteral users of both heroin and cocaine, 30 (52%) of 58 had anti-HIV, compared with six (13%) of 48 injectors of heroin only (P less than 0.0001). Only two (11%) of 18 white patients were HIV-infected, compared with 34 (39%) of 88 black or Hispanic patients (P = 0.03). No other factors studied were linked to anti-HIV. In a multiple logistic regression, anti-HIV was significantly more common in parenteral users of both cocaine and heroin (P less than 0.0001), black patients (P = 0.02), and Hispanic patients (P = 0.049). We conclude that parenteral users of both cocaine and heroin as well as black and Hispanic patients were disproportionately HIV-infected during the early years of the HIV epidemic. Use of cocaine and heroin as well as ethnicity were independently linked to anti-HIV. Measures to prevent or treat drug use, HIV infection, and other medical problems while addressing the specific needs of cocaine users and black and Hispanic patients are urgently needed.
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PMID:Cocaine injection and ethnicity in parenteral drug users during the early years of the human immunodeficiency virus (HIV) epidemic in New York City. 261 98

We studied natural killer (NK) activity and lymphocyte subsets in 11 active parenteral heroin abusers, 11 long-term methadone-maintained former heroin abusers and 11 apparently healthy individuals. All subjects were males aged 23 to 49 and none had active infectious or inflammatory diseases. All current or former heroin abusers were seronegative for antibody to human immunodeficiency virus. The methadone maintenance patients were socially rehabilitated and had not abused drugs parenterally for at least 10 years. NK activity was determined by a standard Cr-release cytotoxicity assay using K562 cells as targets, and lymphocyte subsets were determined by direct immunofluorescence using flow cytometry. At all three effector-target ratios (100:1, 50:1 and 25:1), NK activity was reduced significantly (P less than .01) in parenteral heroin abusers compared with methadone maintenance patients and apparently healthy individuals. The latter two groups did not differ from each other. Parenteral heroin abusers also had higher absolute numbers of CD2, CD3, CD4 and CD8-positive cells. These data support our hypothesis that significant abnormalities of cellular immunity in parenteral heroin abusers can be normalized by successful long-term methadone treatment.
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PMID:Natural killer cell activity and lymphocyte subsets in parenteral heroin abusers and long-term methadone maintenance patients. 278 18

Parenteral drug abusers are at risk for acquired immunodeficiency syndrome (AIDS), which is caused by human immunodeficiency virus (HIV). We tested stored sera for antibody to HIV (anti-HIV) using two enzyme-linked immunosorbent assay (ELISA) methods and Western blot. The patients were parenteral drug abusers who had undergone percutaneous liver biopsy for chronic liver disease. Current or former alcohol abuse was noted in 88 (80%) of the 110 patients. The sensitivities of the two ELISA tests in comparison with Western blot, the more specific test for HIV, were 100 and 94%, respectively; the specificities were 94 and 99%. Western blot was positive in 36 (33%) of 110 patients. False-positive ELISA reactions for anti-HIV were seen in five (7%) of 70 patients with negative Western blot analyses. Compared to true-negatives, false-positives had significantly more years of alcohol abuse, younger ages of onset of alcohol abuse, greater frequencies of jaundice and edema, higher levels of alkaline phosphatase, total billirubin, total protein, and globulins, and lower levels of serum albumin. In a stepwise logistic regression, only hyperglobulinemia was significantly associated with a false-positive anti-HIV. We conclude that: (a) ELISA tests for anti-HIV are useful for screening abusers of alcohol and parenteral drugs with chronic liver disease for HIV infection, but positive results must be confirmed with more specific tests such as Western blot; (b) false-positive ELISA reactions in this population are associated with hyperglobulinemia; and (c) studies of HIV testing are needed in other populations of patients with alcoholism or liver disease.
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PMID:Specificity of antibody tests for human immunodeficiency virus in alcohol and parenteral drug abusers with chronic liver disease. 306 17

Progressive lymphadenopathy in a previously healthy female adult with homozygous sickle cell disease (SCD) was found to be due to infection with the human immunodeficiency virus (HIV). Detailed questioning identified several risk factors for HIV in this apparently low-risk patient. Parenteral therapy and heterosexual relationships while abroad may place such SCD patients at risk of HIV infection and its sequelae. The additional risk due to the underlying immunological abnormalities which have been identified in SCD patients is unclear in the absence of prospective studies or reported cases.
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PMID:Unexplained lymphadenopathy in sickle cell disease. 334 28

Other therapeutic agents used in foals for specific diseases are discussed elsewhere. The marked effect of species, age, and degree of maturity on drug metabolism in the neonate reinforces the danger of interspecies extrapolation of pharmacology, the need for information specific for the foal, and the necessity for monitoring drug levels in the individual. Suggested antimicrobial doses are listed in Tables 3, 4, and 6. Recommended doses of anticonvulsants and sedatives are listed in Table 8 and in the article "Intensive Care of the Neonatal Foal." The following are recommendations for drug therapy in the neonate: Avoid unnecessary administration of drug to the dam at parturition because of possible placental transfer of the drug with subsequent effects on the neonate. If possible, avoid unnecessary drug therapy in foals under 30 days of age. Select a drug that undergoes minimal biotransformation (hepatic metabolism) and is not highly protein bound. Owing to probable immunodeficiency in the neonate, broad-spectrum, bactericidal drugs are preferred for treatment of life-threatening infections. Every attempt should be made to identify the etiologic agent so that drug therapy can be based on cultures and sensitivity test results to maximize the benefit-risk ratio. Parenteral (intramuscular or intravenous) drug administration is preferable to oral. Avoid drugs that are known oxidants, which may produce hemolysis or methemoglobinemia. In general, the same or a slightly higher initial dose should be employed in the neonate, but it should be given less frequently than in the adult if it has a high potential to cause toxicity. When possible, individual monitoring of serum levels of potentially toxic drugs should be employed in premature and newborn foals unless specific drug pharmacokinetics are known for that age group.
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PMID:Aspects of pharmacology in the neonatal foal. 390 67


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