Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: 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)

The authors assessed the characteristics of repeat human immunodeficiency virus (HIV) testers at publicly funded sites in San Francisco. During 1992-1993, 31% of all HIV tests were performed on persons testing negative for the third time or more. Persons with greater numbers of prior negative tests were less likely to test HIV-positive. Repeat negative testers were more likely than first-time negative testers to be homosexual or bisexual males, homosexual or bisexual injection drug users (IDUs), or heterosexual IDUs. Repeat testers who seroconverted were more likely to be in these same transmission categories than repeat testers who remained negative. Because of the similarities in risk profile between those most likely to retest and those most likely to seroconvert, attempts to limit repeat testing must proceed cautiously.
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PMID:Repeat negative human immunodeficiency virus (HIV) testing in San Francisco: magnitude and characteristics. 757 42

To examine the extent of hepatitis B virus infection (HBV) in an inner-city community, we determined the prevalence, incidence, and correlates of HBV seroreactivity in a representative sample of unmarried whites, African-Americans, and Hispanics living in San Francisco during 1988 to 1989 and again 1 year later in 1989 to 1990. Unmarried men and women aged 20 to 44 years were surveyed in a random household sample drawn from three neighborhoods of varying geographic and cultural characteristics. Hepatitis B infection was determined by testing specimens for antibody to hepatitis B core antigen (anti-HBc). Of blood samples available from 1,108 participants from the initial survey, 159 (14%) were anti-HBc positive. There was a strong positive association between anti-HBc positivity and positive serological tests for human immunodeficiency virus, herpes virus type 2, and syphilis. In women and heterosexual men, after controlling for other variables, anti-HBc positivity was significantly associated with older age (P < .001), nonwhite ethnicity (P < .01), less education (P < .05), injection drug use (P < .001), being paid for sex (P < .05), and lifetime number of sexual partners (P < .05). Among homosexually active men, after controlling for other variables, anti-HBc positivity was significantly associated with nonwhite ethnicity (P < .001), injection drug use in a sexual partner (P < .05), and number of lifetime sexual partners (P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hepatitis B virus infection in high-risk inner-city neighborhoods in San Francisco. 760 32

The authors analyzed temporal trends in human immunodeficiency virus (HIV) infection among men and women who visited the San Francisco municipal sexually transmitted disease clinic between 1989 and 1992, using blinded HIV seroprevalence data. Temporal changes in sexual behavior were evaluated by abstracting self-reported information on sexual behaviors from a random sample of charts of men who visited the clinic between 1990 and 1992. From 1989 to 1992, HIV seropositivity declined from 2.0% to 1.0% among women (p = 0.06) and from 18.9% to 12.0% (p < 0.001) among men. The percentage of patients who reported having anal intercourse in the previous year did not change significantly during the study period. The percentage of male patients who reported having vaginal intercourse during the previous year decreased from 82.9% to 78.6% (p < 0.05), and the percentage of male patients who reported engaging in receptive oral sex during the previous year increased from 24.0% to 41.6% (p < 0.001). The percentage of male patients who reported that they always used condoms increased from 31.8% to 49.2% for anal sex, from 8.7% to 19.5% for vaginal sex, and from 1.4% to 6.3% for oral sex (p < 0.05). Among patients visiting the sexually transmitted disease clinic, there was a steady and significant decline in HIV seroprevalence. The decline in HIV seroprevalence was accompanied by a significant trend toward safer sexual practices. However, by the end of the study period, less than half of the patients reported using condoms all of the time, which suggests that there is a need to expand behavioral interventions to focus on high-risk persons.
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PMID:Temporal trends in human immunodeficiency virus seroprevalence and sexual behavior at the San Francisco municipal sexually transmitted disease clinic, 1989-1992. 763 35

Analyses of the effects of prophylactic use of zidovudine (AZT) on progression to acquired immune deficiency syndrome (AIDS) in human immunodeficiency virus seropositive (HIV+) asymptomatic persons with T4 lymphocyte (CD4+) cell counts > or = 500/mm3 is reported for data obtained from two studies, the Australian European Group Collaborative Study, a multi-centered double-blind placebo-controlled clinical trial of the effects of AZT on progression to AIDS and other clinical endpoints, and the San Francisco Men's Health Study, an observational cohort. The analyses of the data of both studies demonstrate no benefit from AZT treatment in terms of progression to AIDS for those who are asymptomatic with CD4+ cell counts > or = 500/mm3. The analysis of the San Francisco study, performed with Kaplan-Meier survivorship estimates, indicates a heterogeneity in the efficacy of AZT between baseline CD4+ cell count strata, 200-499/mm3 and 500-800/mm3. Within the 200-499 stratum, 47% of those receiving AZT therapy and 62% of those not receiving AZT therapy progressed to AIDS during the study period. By contrast, within the 500-800 stratum 41% of those receiving AZT therapy and 27% of those not receiving AZT therapy progressed to AIDS during the same period. Application of the Cox proportional hazards survivorship regression model for the relative risk of progression to AIDS to these same data accounts for this heterogeneity. The model includes an interaction between AZT treatment and baseline CD4+ cell counts. The hematological toxicity of AZT, demonstrated in clinical studies and laboratory investigations, indicates a biological correlate for this interaction: the toxic effects of AZT on the more intact immune system of those with CD4+ cell counts in the 500-800/mm3 range [corrected].
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PMID:AZT toxicity and AIDS prophylaxis: is AZT beneficial for HIV+ asymptomatic persons with 500 or more T4 cells per cubic millimeter? 774 65

As part of an epidemiologic study of Mycobacterium avium complex (MAC) infection in San Francisco, water, food and soil samples were collected from the home environment of 290 persons with human immunodeficiency virus (HIV) infection and cultured for mycobacteria. Isolates recovered from the environment were compared with isolates cultured from study patients. Although mycobacteria were recovered from numerous environmental samples, isolates reactive with MAC-specific DNA probes were recovered from only four of 528 (0.76%) water samples and one of 397 (0.25%) food samples. The species M. avium was recovered from one water (0.19%) and one food sample. In contrast, MAC was recovered from 55% and M. avium from 27% of soil samples taken from potted plants in patients' home. Speciation of 76 MAC isolates from study patients showed all isolates belonged to the species M. avium. With use of serotype and multilocus enzyme electrophoresis analysis, some of the soil isolates were found to be similar to isolates recovered from study patients. The results of this study suggest that soil, rather than water, may be a significant reservoir of organisms causing MAC infection in San Francisco.
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PMID:Mycobacterium avium complex in water, food, and soil samples collected from the environment of HIV-infected individuals. 774 96

To assess a hypothesized trend that persons recently infected with the human immunodeficiency virus (HIV) may have more rapid declines in absolute CD4 T-lymphocyte (CD4+ cell) counts than those who were HIV-infected in earlier years, sequential CD4+ cell counts in three groups who had definable dates of HIV seroconversion between 1978 and 1992 were reviewed. The CD4+ cell counts examined were from some of the longest extant studies in the United States: 100 homosexual and bisexual men engaged in ongoing observational cohort studies in San Francisco, Denver, and Chicago since 1978 (Group 1); 89 persons in South Carolina infected after 1986 (Group 2); and 155 injecting drug users participating in an observational cohort study in Baltimore since 1988 (Group 3). For all groups, individually and in the aggregate, mean CD4+ cell counts declined rapidly in the first year after HIV infection and then stabilized. However, there was no clear trend for lower (or higher) CD4+ cell counts by fixed time after HIV seroconversion among those seroconverting in recent compared with earlier calendar years. These data do not support a hypothesized trend for more rapid loss of CD4 T lymphocytes--and, by implication, more pathogenic strains of HIV-1--among persons acquiring HIV infection in recent years.
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PMID:Recent infection with human immunodeficiency virus and possible rapid loss of CD4 T lymphocytes. 778 28

Seroprevalence of human T lymphotropic virus (HTLV) and human immunodeficiency virus type 1 (HIV-1) was determined among 7841 intravenous drug users (IVDUs) from drug treatment centers in Baltimore, Chicago, Los Angeles, New Jersey (Asbury Park and Trenton), New York City (Brooklyn and Harlem), Philadelphia, and San Antonio, Texas; 20.9% had evidence of HTLV infection, as determined using a p21e EIA for screening and p21e blot for confirmation. With a type-specific EIA and blot used in combination, HTLV-II was identified in 97.6% of HTLV-positive IVDUs whose sera could be subtyped. HIV-1 seroprevalence was 13.2%. HTLV-II without HIV-1 was most common in Los Angeles and San Antonio. HIV-1 without HTLV-II was most common in New York, New Jersey, and Baltimore. Dual infection was most common in New York and New Jersey. Logistic regression analysis revealed that seroprevalence of HTLV-II was significantly greater with HIV-1 infection and increasing age and among women, blacks, and Mexican-Americans. In conclusion, it appears that among US IVDUs, nearly all HTLV infection is attributable to HTLV-II, and HTLV-II infection is associated with HIV-1 and sociodemographic background.
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PMID:Seroprevalence of human T cell lymphotropic virus type II infection, with or without human immunodeficiency virus type 1 coinfection, among US intravenous drug users. 779 46

This study examined acquired immune deficiency syndrome (AIDS)-related grief resolution and psychiatric morbidity in 286 human immunodeficiency virus (HIV)-positive and HIV-negative gay men examined between 1989 and 1993 in San Diego, CA. Psychiatric morbidity, mood ratings, and bereavement assessments were obtained using the Structured Clinical Interview for DSM-III-R, Hamilton Rating Scales for Depression and Anxiety, and Texas Revised Inventory of Grief. Sixty percent of the men (N = 171) reported a loss within the previous 12 months. Eighteen percent of the bereaved met criteria for unresolved grief. No differences were evident in lifetime psychiatric disorders, yet men with unresolved grief demonstrated an elevated prevalence of current major depression and panic disorder when compared with resolved grievers. Clinician sensitivity to the grief process and its relationship to psychiatric complications is an important component of comprehensive psychiatric and medical care of men at high risk for HIV during this era of AIDS.
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PMID:Psychiatric morbidity associated with acquired immune deficiency syndrome-related grief resolution. 779 87

To examine the extent of infection with syphilis in an inner-city community, we determined the prevalence, incidence, and correlates of syphilis seroreactivity in a representative sample of unmarried whites, African Americans, and Hispanics living in San Francisco during 1988 to 1989 and again 1 year later in 1989 to 1990. One thousand seven hundred seventy single men and women aged 20 to 44 were surveyed in a random household sample drawn from three neighborhoods of varying geographic and cultural characteristics. Syphilitic infection was determined by testing specimens with the microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP). Of blood samples available from 1262 participants from the initial survey, 32 (2.5%) were MHA-TP reactive. After adjustment for age, a reactive syphilis serology was significantly predicted (P < 0.05) by African American race, homosexual activity (men), and less education. In homosexually active men, lifetime number of male sex partners and the presence of antibody to the human immunodeficiency virus (HIV) significantly predicted syphilis seroreactivity (P < 0.01). One year later, of 841 specimens available for testing, an additional 13 (1.5%) had become MHA-TP reactive. Eleven (85%) of the new cases were in heterosexual men and women. Although San Francisco citywide incidence data indicate that syphilis may be decreasing for the city as a whole, incidence data on a community level suggests that syphilitic infection is increasing in high-risk heterosexual communities. Thus, syphilis prevention programs should rely on serologic testing at the community level to plan effective intervention strategies.
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PMID:Prevalence, incidence, and correlates of syphilis seroreactivity in multiethnic San Francisco neighborhoods. 780 1

HLA phenotype and immune responses to CMV were studied to determine whether the subset of AIDS patients who developed CMV retinitis were immunogenetically or immunologically predisposed. CMV retinitis develops in approximately 28-35% of AIDS patients and CMV encephalitis develops in 40% of those with retinitis, often leading to death. T-cell proliferation responses to CMV and HIV were assayed prospectively in individuals enrolled in a longitudinal study at the HIV Neurobehavioral Research Center (HNRC) in San Diego. Seventy-three participants, at various stages of disease, have been HLA typed and followed, clinically and immunologically, for up to 5 years. Six HIV infected individuals who eventually developed CMV retinitis, and were assayed prospectively, had a history of low T-cell proliferation to CMV antigens before they were profoundly immunosuppressed. All 10 individuals with CMV retinitis had at least one of three HLA alleles (or combinations): A2B44 (p = 0.02), B51(p = 0.02), or DR7 (p = 0.01) (collective p value = 0.007). Three of the 10 had two or more of these alleles. Of AIDS patients with CD4 counts below 100 and actively at risk for retinitis, 7/15 with A2B44,51, or DR7 have developed retinitis compared to 0/13 without these HLA alleles (relative risk = 23.8). All 4 patients with these alleles who have died, had retinitis. These results suggest that HIV infected individuals with HLA phenotypes A2B44, B51, and DR7 have low T-cell immune responses to CMV and are predisposed to CMV retinitis and encephalitis as immunodeficiency progresses.
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PMID:CMV-specific immune responses and HLA phenotypes of AIDS patients who develop CMV retinitis. HNRC Group. HIV Neurobehavioral Research Center. 787 1


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