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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seventy-five doctors working in an academic paediatric department each completed an anonymous self-administered questionnaire. Questions were posed relating to the need for consent before human immunodeficiency virus (HIV) testing and the informing of sexual partners of HIV-infected mothers. Only 9% of the doctors thought that the sexual partner of an HIV-infected mother should never be informed if the mother refused to do so. Sixty-one per cent of the doctors thought that pre-test consent was never necessary when screening hospital admissions. This opinion conflicts with the view of the South African Medical and Dental Council that pre-test consent is mandatory.
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PMID:HIV-related practices and ethics--survey of opinions in a paediatric department. 202 7

From September 1988 to August 1989, in a university hospital in Newark, NJ, 3529 serum and plasma specimens from patients with admitting conditions presumably not associated with human immunodeficiency virus (HIV) infection (Centers for Disease Control, Atlanta, Ga, Sentinel Hospital Surveillance System criteria) were tested anonymously for the presence of type 1 HIV (HIV-1) antibody. Of these specimens, 269 (7.6%) were confirmed HIV-1 seropositive. Overall, 10.3% of male patients and 4.8% of female patients were seropositive. Persons 25 to 44 years old had the highest HIV-1 seroprevalence- 20.9% for male and 7.5% for female patients. Based on this anonymous testing, the number of HIV-infected hospitalized patients discharged in 1988 was estimated. Data on hospital-confirmed HIV-infected patients tested on the basis of clinical suspicion suggest that only 40% of HIV-infected patients were actually tested for HIV-1 infection as part of their medical care in this hospital. These data demonstrate a high prevalence of HIV infection in this patient population and suggest that hospitals serving populations with a high HIV seroprevalence offer routine screening for HIV infection as part of good medical care.
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PMID:Anonymous human immunodeficiency virus surveillance and clinically directed testing in a Newark, NJ, hospital. 202 45

The U.S. sentinel hospital surveillance system for human immunodeficiency virus (HIV) infection includes approximately 40 short-stay hospitals located in 31 metropolitan areas in the United States and Puerto Rico. Several hospitals began testing in late 1986, and additional sentinel hospitals have since been recruited. At each sentinel hospital, anonymous, unlinked testing for antibody to HIV is conducted monthly on 300 blood specimens, selected systematically and stratified by age of the patient. Specimens are excluded from patients whose reason for hospital visit on that occasion was for a medical condition associated with HIV infection or with risk factors for HIV infection, in order to limit the expected overrepresentation of HIV-infected persons among hospital patients compared with the general catchment population of the hospital. The incidence of acquired immunodeficiency syndrome (AIDS) in metropolitan areas with sentinel hospitals has been approximately twice the incidence of AIDS in the entire United States. However, while absolute levels of HIV seroprevalence should therefore be interpreted with caution, trends in the age-, sex-, and race-specific HIV seroprevalence at sentinel hospitals likely reflect trends in the communities served by the hospitals. Although concentrated in areas disproportionately affected by AIDS, sentinel hospitals will contribute seroprevalence data over time that reflect the impact of HIV infection across all age and behavioral risk groups. Sentinel hospitals will also constitute a key surveillance system to help integrate the age group-specific and risk group-specific findings from other activities in the CDC family of seroprevalence surveys.
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PMID:Methods of surveillance for HIV infection at U.S. sentinel hospitals. 210 59

An association between past exposure to tuberculosis (TB) and infection with human immunodeficiency virus type 1 (HIV-1) was investigated using a case-control design among a 6-week sample of 698 male inmates consecutively admitted to the Maryland State prison system. Based on Mantoux testing and measurement of anti-HIV-1, we found a positive but not significant association between HIV-1 and TB infection (odds ratio 2.4, 95 percent confidence interval 0.9-6.3). The power of the study to detect an association of this magnitude was 0.57. Of the entire intake sample, 1.3 percent were found to be coinfected with TB and HIV-1. Some misclassification may have been present due to anergy or latent HIV-1 infection. The elevated risk of TB in coinfected inmates, coupled with the study results, suggest that the inmate screening process on entry to the prison should be modified to improve identification of coinfected people. Specifically, anergy testing should be added to the admission screening procedure, and appropriate voluntary anonymous HIV-1 antibody testing should be more widely available to inmates.
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PMID:Coinfection with tuberculosis and HIV-1 in male prison inmates. 211 91

Seroprevalence surveys of incoming inmates provide useful sentinel information on human immunodeficiency virus (HIV) infection rates among groups that practice HIV-associated high-risk behaviors. In addition, such data are beneficial to corrections officials in the formulation of institutional policies to prevent HIV infection. Inmates entering the Michigan corrections system from December 1987 to March 1988 participated in blind, anonymous serosurveys for HIV infection. Eight of 802 entering inmates (1.0 percent) were seropositive; most seropositive persons reported intravenous drug use. The most common risk behaviors reported by study participants were intravenous drug use (20.0 percent), multiple sexual partners (37.1 percent), and infrequent (that is, never or seldom) use of condoms (82.6 percent). Women reported the highest rates of intravenous drug use (35.1 percent) and needle-sharing (19.4 percent). Results from this study indicate that in spite of wide-spread HIV-associated risk behaviors, the extent of HIV-seropositivity among incoming inmates in Michigan is relatively low. Such data suggest that there is still time to impact the course of the AIDS epidemic among high-risk groups in States where the prevalence of HIV infection is relatively low. The data also indicate that the potential for HIV spread in correctional facilities is noteworthy and that HIV prevention education and substance abuse treatment services are needed in corrections facilities.
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PMID:Sentinel surveillance of HIV infection among new inmates and implications for policies of corrections facilities. 212 Jul 29

The presence of antibody to human immunodeficiency virus (HIV) in post-partum women may be inferred by screening the blood of their newborn babies, since maternal IgG antibodies freely cross the placenta. We tested a sample of 10,217 newborns from 10 hospitals covering three areas in Sydney and other metropolitan centres in New South Wales from April to July, 1989. None of the specimens gave a positive test for antibody to HIV. Thus, the prevalence of HIV positive serology in this sample of newborns was found to be zero. It was estimated that the seroprevalence of antibody to HIV among all neonates in the study area was between zero and 0.045% (99% confidence interval). Because newborns are an accessible group for the study of HIV, and can act as surrogates for their mothers, anonymous testing of this sentinel group will remove some of the limitations generalizing the information in the present database of HIV infection in Australia. This study provides baseline data and suggests that there is not a widespread epidemic of HIV infection among heterosexual persons in Australia at the present time and that routine antenatal testing of women for antibody to HIV may not be cost-effective. However, it will be important to repeat this study at regular intervals to detect any increase in HIV seroprevalence.
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PMID:Prevalence of maternal HIV infection based on anonymous testing of neonates, Sydney 1989. 221 7

We performed an anonymous seroprevalence survey of human immunodeficiency virus (HIV) type 1 infection through HIV antibody testing of blood samples from 22,512 women aged 15 to 44 years receiving prenatal care in British Columbia and the Yukon Territory from Mar. 15 to Sept. 30, 1989. Of the samples six were confirmed to be HIV positive; this yielded a crude overall seroprevalence rate of 2.7 per 10,000 pregnant women (95% confidence interval [CI] 1.0 to 5.8). All of the positive samples were from women 20 to 29 years of age; four were from Vancouver, one was from Victoria, and one was from elsewhere. The highest seroprevalence rates were among women aged 15 to 29 years in Vancouver and Victoria (7.2 and 9.4 per 10,000 pregnant women respectively). Thus, 1 in 1300 pregnant women in that age group in the metropolitan areas of British Columbia was HIV positive. Application of seroprevalence rates to the total female population in British Columbia and the Yukon Territory revealed that as many as 401 women had HIV infection in 1989. Our estimates likely represent the minimum. As a subset of women of childbearing age pregnant women are likely at lowest risk of HIV infection, and so the true number of women 15 to 44 years of age with HIV infection is probably several times higher. Our study has provided a baseline assessment and will be repeated annually to analyse trends in HIV seroprevalence among pregnant women in British Columbia and the Yukon Territory.
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PMID:An anonymous seroprevalence survey of HIV infection among pregnant women in British Columbia and the Yukon Territory. 199 8

This is the first anonymous unlinked seroprevalence study in Canada to use serum samples from newborns to determine the seroprevalence rate of human immunodeficiency virus (HIV) infection among childbearing women. Of the 68,808 samples tested 42 were confirmed as positive, for an overall crude seroprevalence rate of 6.1 per 10,000 live births (95% confidence interval [CI] 4.4 to 8.3), or 1 woman in 1638. Women who lived on Montreal island had an overall rate of 17.9 per 10,000 live births (95% CI 12.2 to 25.4), or 1 woman in 559. We observed a significant association between revenue index and seroprevalence; the rates were as high as 46.4 per 10,000 live births (95% CI 18.7 to 95.3), or 1 woman in 216, for Montreal island postal code areas with revenue indexes 20% or more below the provincial median. Extrapolation of the data suggested that 56 women with HIV infection gave birth to a live infant during 1989 in Quebec. Even though attempts to generalize the data from childbearing women to women of childbearing age have an inherent conservative bias, the results of our study suggest that 988 women (95% CI 713 to 1336) aged 15 to 44 years in Quebec had HIV infection in 1989. The actual number is likely substantially higher. The need for well-designed, creative interventions to prevent further HIV transmission to women is evident. Planning for the provision of medical and psychosocial services sensitive to specific needs of women who are already infected should start immediately.
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PMID:HIV infection among Quebec women giving birth to live infants. 198 1

Women attending an inner-city prenatal clinic between February, 1987 and August, 1988 completed a questionnaire to assess risk factors for human immunodeficiency virus (HIV) infection. Women with risk factors were offered HIV testing. Testing was available to women without risk factors upon their request. Stored sera were obtained for anonymous HIV testing on patients not consenting for testing. Overall, 30 of 622 women (5%) tested HIV positive. Ten per cent of women acknowledging risk factors were seropositive vs 3% denying risk factors (P less than .001). Intravenous (IV) drug use was reported in 40% of seropositive women. However, 47% (14/30) of HIV seropositive women denied risk factors for infection. Limiting prenatal HIV screening to women acknowledging risk factors may fail to identify a substantial number of infected women. Screening for HIV infection, counseling, and education on risk reduction should be offered to all pregnant women.
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PMID:Human immunodeficiency virus infection in women attending an inner-city prenatal clinic: ineffectiveness of targeted screening. 224 1

An anonymous human immunodeficiency virus (HIV) seroprevalence survey was performed on bloods sent for syphilis serologic testing from the general medical or pediatric clinics or emergency room of a municipal hospital in the Bronx, New York City. From July-December 1987, 549 sera from persons aged 15-54 were collected. HIV antibody was detected in 29/549 (5.3%) sera, increased with age from 0% in the group under 20 to 16.7% in those aged 35-39, and was significantly higher in men (27/230, 11.7%) compared to women (2/319, 0.6%) (P less than .05). Among men aged 35-39, 10/29 (34.5%) were HIV infected. The HIV seroprevalence in emergency room sera was 8/61 (13.1%) versus 21/488 (4.3%) from the out-patient clinics (P less than .05). The presence of a reactive syphilis serology was strongly associated with HIV infection independent of gender (Mantel-Haenszel summary odds ratio (OR) 4.1, 95% CI [1.8, 7.7]) but was stronger for women with reactive syphilis serologies (OR 45.5, 95% CI 5.3, 387.6) than for men (OR 2.6, 95% CI 1.2, 5.8). AIDS prevention strategies may reach at-risk sexually active individuals by focusing on hospital-based emergency rooms and out-patients clinics in areas with high HIV seroprevalence.
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PMID:HIV antibody in persons screened for syphilis: prevalence in a New York City emergency room and primary care clinics. 226 7


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