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AIDS is a slow virus disease caused by a lentivirus. The silent incubation period following infection usually lasts many years, during which the infected person is potentially infectious to others. Pathological changes accumulate imperceptibly. When major symptomatic disease develops it is eventually fatal. The epidemic spread of the virus is new in Africa, as well as in North America and Europe. Twenty-five per cent of people infected with the virus die within seven years of infection. The ultimate mortality 20 years after infection cannot yet be known, but it may turn out to be close to 100 per cent. It is already apparent that AIDS is the most lethal epidemic viral disease of humans known to medical science. Flaws in the generally accepted hypothesis that AIDS is a sexually transmitted infection are exposed. It has been, characteristically, a blood-borne infection in the early years of the epidemic. However, the AIDS virus is exceptionally unstable genetically and it is probable that means of transmission more efficient than through blood have already developed.
Vet Rec 1987 May 09
PMID:Pathogenesis and transmission of AIDS. 330 8

HIV and AIDS case surveillance is needed to monitor the course of the HIV pandemic and plan appropriate public health responses. The World Health Organization (WHO) recommends HIV sentinel surveillance to monitor HIV infection. This is a method in which the prevalence of HIV is measured in specific populations whose blood has been obtained in the health care setting for other purposes and then tested for antibody to HIV only after the removal of all patient identifiers. For the surveillance of AIDS cases, WHO recommends the systematic reporting of AIDS cases using an appropriate national AIDS surveillance case definition. In light of developments in the understanding of the spectrum of severe HIV-related illness in both developed and developing countries, and the increased availability of laboratory diagnostic methods, however, a meeting was convened in Geneva by the WHO Global Program on AIDS to review the current case definitions for AIDS surveillance in adults and adolescents, and to make recommendations for their modification and application. The meeting recommended modifying the 1985 provisional WHO clinical case definition for AIDS, now to be referred to as the WHO AIDS surveillance case definition; and introducing an expanded WHO AIDS surveillance case definition. These two case definitions for AIDS surveillance are recommended for use in adults and adolescents in countries with generally limited clinical and laboratory diagnostic capabilities. They should therefore not be confused with clinical staging systems for HIV infection, which are useful for the clinical management of patients and for clinical research purposes. Case definitions for AIDS surveillance in children remain unchanged for now. The WHO case definition for AIDS surveillance, the expanded WHO case definition for AIDS surveillance, and comments are presented.
Wkly Epidemiol Rec 1994 Sep 16
PMID:WHO case definitions for AIDS surveillance in adults and adolescents. 798 96

World Health Organization Global Program on AIDS data are presented for the western Pacific region in terms of HIV testing, sexually transmitted disease (STD) patients, prostitutes, injecting drug users, and homosexual and bisexual men. These HIV surveillance figures for the region have been obtained through a variety of survey methods which are not always clearly specified including voluntary confidential testing, screened donated blood, and compulsory testing. Data should therefore be interpreted with caution. Only a few countries perform HIV sentinel surveillance using unlinked anonymous testing. Data are presented from selected HIV prevalence studies in the region over the period 1984-1992, but the overwhelming majority of studies were conducted during 1990-92. The level of HIV infection among STD patients in Australia, Hong Kong, Papua New Guinea, and the Philippines remains under 1%, but 4.2% among the 72 patients tested in Cambodia. Available information suggests that HIV has not yet spread among prostitutes in the region to the same extent that it has in some other countries even though sex industries catering to both local and foreign clients are quite well established. The highest prevalence of HIV infection among prostitutes was found in Toul Kork, Cambodia, where 18 of 127 prostitutes tested were seropositive, while infection is gradually increasing in Malaysia, up to 1.3% in 1991. HIV transmission due to injecting drug use is becoming an increasing problem in Malaysia where the prevalence of HIV in the subpopulation has grown from 0.14% in 1988 to 6.9% in 1991. Australia, however, still has the highest reported overall prevalence of HIV infection in the region. Recent studies of small samples of homosexual and bisexual men in Japan, Philippines, and Singapore found HIV seroprevalence in the range of 2.0-3.6%. The cumulative numbers of AIDS cases and AIDS-related deaths is presented in tabular format.
Wkly Epidemiol Rec 1993 Dec 10
PMID:Global programme on AIDS. AIDS surveillance in the WHO Western Pacific Region. 830 95

There are an estimated 21.8 million people infected with human immunodeficiency virus (HIV) worldwide [Weekly Epidemiol Rec 1996; 27:204-208] and 90% of these people will have some form of neuropathological abnormality during the course of acquired immunodeficiency syndrome (AIDS). In this review, we will highlight the primary HIV-associated brain disorders. The role of HIV proteins and cytokines on neuronal damage will be assessed. We will also discuss the role of neuronal loss and functional damage in HIV-associated dementia.
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PMID:Neuronal damage and its relation to dementia in acquired immunodeficiency syndrome (AIDS). 915 23

This paper describes the reported distribution of AIDS cases in each country reporting 25 cases or more by November 20, 1997, by age and sex, as well as by assumed mode of transmission. These data come from surveillance systems of varying quality and must be interpreted with care when used for international comparisons, for the proportion of AIDS cases reported ranges from 10% in some countries to more than 90% in others. Moreover, AIDS develops rather late in the natural history of the disease and most people currently living with HIV infection have not yet developed AIDS. People who have developed AIDS are largely those who were initially infected with HIV up to a decade ago. The AIDS data presented in this paper therefore represent HIV transmission which occurred years ago. There is also considerable variation in the speed of progression from HIV to AIDS between children and adults, between those receiving treatment and those without treatment, and between different regions of the world. Finally, there is considerable variation in the way in which the data have been reported by countries.
Wkly Epidemiol Rec 1997 Dec 05
PMID:Global AIDS surveillance. Part II. 942 73

All 50 states require AIDS cases to be reported to the department of health. Many jurisdictions require HIV and ARC reporting, as well. Many states have also enacted confidentiality provisions that prohibit health care providers from releasing HIV-related information without the patient's consent, although exceptions to the statutes authorize disclosure without consent to other health providers, spouses, and other persons under certain conditions set forth in the legislation. In addition, the patient may obtain access to his or her own records and may authorize release to third parties. Providers who violate the provisions are subject to liability. The patient usually has a private cause of action for damages and costs; in addition, the state may impose fines and jail terms for more egregious violations. Finally, courts may authorize disclosure of confidential HIV information in certain situations. In the absence of a statutory provision governing court-ordered disclosures, courts will balance the patient's privacy interest against the plaintiff's need to know and the public interest involved. Several states have enacted statutes that modify this traditional balancing approach, although it is unclear whether these statutes provide additional protection for health care providers and patients seeking to prevent disclosure of information. Health record practitioners should keep abreast of legislative and regulatory developments in their states that affect use and disclosure of AIDS patient records. Careful discussion with the health institutions' legal counsel of any situation not covered clearly by applicable statue or regulation is strongly recommended.
Top Health Rec Manage 1990 Jun
PMID:Legal review: AIDS patient records--legal issues of access and disclosure. 1010 75

Gene therapy in simple terms is the introduction of a gene into a cell, in vivo, in order to ameliorate a disease process. Human clinical trials have focused on the correction of monogenic deficiency diseases, cancer and AIDS. This paper summarises the technology of gene therapy, gives a brief synopsis of the current applications of gene therapy to veterinary medicine and discusses some of the problems which need to be overcome so that gene therapy can become accepted clinical practice.
Vet Rec 1999 Apr 03
PMID:Gene therapy in veterinary medicine. 1032 37

Cadavers remain a principal teaching tool for anatomists and medical educators teaching gross anatomy. Infectious pathogens in cadavers that present particular risks include Mycobacterium tuberculosis, hepatitis B and C, the AIDS virus HIV, and prions that cause transmissible spongiform encephalopathies such as Creutzfeldt-Jakob disease (CJD) and Gerstmann-Straussler-Scheinker syndrome (GSS). It is often claimed that fixatives are effective in inactivation of these agents. Unfortunately cadavers, even though they are fixed, may still pose infection hazards to those who handle them. Specific safety precautions are necessary to avoid accidental disease transmission from cadavers before and during dissection and to decontaminate the local environment afterward. In this brief review, we describe the infectious pathogens that can be detected in cadavers and suggest safety guidelines for the protection of all who handle cadavers against infectious hazards.
Anat Rec 2002 Aug 15
PMID:Infective agents in fixed human cadavers: a brief review and suggested guidelines. 1220 57

In this study, we sought to characterize the T lymphocyte recovery in vertically HIV-1-infected children who respond to long-term highly active antiretroviral therapy (HAART). A 3-year longitudinal retrospective study was used to perform a cross-sectional study of 32 children rated according to the time course of CD4(+) T cell percentages in response to antiretroviral therapy and CDC clinical classification: (1) long-term asymptomatic (LTA group): 8 children in A1 during the whole follow-up period; (2) responsive to HAART (Rec group): 13 children in C3 before HAART who achieved CD4(+) T cell counts of > 500 cells/mm(3) after 3 years of HAART; and (3) nonresponsive to HAART (Non-Rec group): 11 children in C3 during the whole follow-up period despite 3 years of HAART. We also studied 17 healthy age-matched uninfected children as controls. Lymphoproliferative responses (LPRs) were evaluated by incorporation of [(3)H]thymidine, identification of T cell subsets by three-color flow cytometry, and determination of thymic production of T cells by quantification of T cell receptor rearrangement excision circles (TRECs). Interestingly, the Rec group showed an increase in percentage of CD4(+) T cells and a decrease in viral load, and recovered LPRs to mitogens and recall antigens, with values similar to those of the LTA group. Moreover, the Rec group produced similar percentages and absolute counts of naive (CD45RA(+)CD62L(+)) CD4(+) and CD8(+) T cells, and TRECs similar to those of the LTA group. In particular, the Rec group produced similar percentages of CD8(+)CD28(-)CD57(+) and CD8(+)CD28(-)CD57(-) T cell subsets compared with controls. Our data indicate that among children who have already progressed to AIDS and severe immunodeficiency but who respond to HAART, the immune system can recover and resemble those of nonprogressors or even uninfected children, in quantitative as well as in functional terms.
AIDS Res Hum Retroviruses 2002 Dec 10
PMID:Characterizing immune reconstitution after long-term highly active antiretroviral therapy in pediatric AIDS. 1248 11

An idea to use 4'-C-substituted-2'-deoxynucleoside derivatives was proposed based on a working hypothesis to solve the problems of existing acquired immune deficiency syndrome chemotherapy (highly active antiretroviral therapy). Subsequent studies have successfully proved the validity of the idea and resulted in the development of 2'-deoxy-4'-C-ethynyl-2-fluoroadenosine, a nucleoside reverse transcriptase inhibitor, which is highly potent to all human immunodeficiency viruses type 1 (HIV-1s) including multidrug-resistant HIV-1 and has a low toxicity.
Chem Rec 2006
PMID:2'-deoxy-4'-C-ethynyl-2-fluoroadenosine, a nucleoside reverse transcriptase inhibitor, is highly potent against all human immunodeficiency viruses type 1 and has low toxicity. 1679 5


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