摘要:

CD4 cell counts are one of the best available surrogate markers for disease progression: they are widely used laboratory parameters in clinical trials and commonly used indicators for the introduction of primary prophylaxis and antiretroviral therapy. However, measurement is too expensive to he done in most developing countries. The objective of this study was to derive a model for prediction of CD4 counts 200 cells mm based on the proposed World Health Organization (WHO) staging system for HIV infection and widely available laboratory parameters. One bundled and six consecutive patients enrolled in a prospective cohort study who were not taking anti-HlV drugs or prophylaxis for opportunistic infections were included. Blood tests were performed within 72 h of the outpatient visit. Lymphocyte phenotyping was done by How cytometry. Two models based on the WHO staging system. hematocrit and total lymphocyte counts, were developed. The two models had sensitivity and specificity 83%. These results indicate that the combined use of simple clinical and laboratory parameters can predict CD4 counts 200 cells mm3with high sensitivity and specificity. Similar studies should be conducted in other countries. Should our findings be confirmed, intervention strategies based on this model of potential universal applicability should be devised and validated.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

There is little information regarding the extent of HIV infection among women. Since late 1985. members of the Arms' Reserve Components have been routinely tested for HIV. providing an opportunity to measure directly the prevalence and incidence density of infection in a military-associated population with limited military contact. We evaluated the presalence among 122.195 women, and directly measured the incidence density among 96.001 women followed for 247.872 person-years. The overall prevalence was 0.65 (per 1000). and the incidence density was 0.12 (per 1000 person years follow-up). Several demographically defined groups, including minority, women. had elevated levels of infection. The incidence densities of infection between early and late in the testing program were compared, and no evidence of acceleration or deceleration was observed.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

To evaluate human immunodeficiency virus type I ( HIV-1) infection among patients of primary care physicians, we performed anonymous, unlinked HIV-I antibody testing on leftover blood specimens submitted to HI huge commercial clinical laboratories for complete blood cell count or hematocrit determination, the most commonly ordered diagnostic tests from January through August 1990. 55.613 specimens submitted by general internists. pediatricians, and family practitioners were sampled: 1.104 (2.0%) had HIV-I antibody. Seroprevalence among the laboratories varied 50-fold, from 0.3 to 12.4%. The HIV-I prevalence at each laboratory was not always consistent with the AIDS incidence in the area served by the laboratory. Overall the seroprevalence was almost eight times higher in men (3.9%) than in women (0.5%). Specimens from seropositive persons, especially from men. were unevenly distributed among the physician practices: only three practices submitted approximately 50% of all specimens from seropositive men. These data indicate that a few physicians treat the majority of HIV-1-infectcd primary care patients. The HIV-I prevalence among specimens at a clinical laboratory is thus determined by whether few physicians submit specimens to that laboratory. These results could be of use. for instance, in analyzing proposals to mandate physician reporting of HIV-I infection. The high HIV-I prevalence among laboratory specimens underscores the potential for exposure to HIV-I-infected blood by clinical laboratory personnel and emphasizes the need for universal precautions for all blood specimens.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

This paper develops a statistical procedure for estimating the HIV infection rate among needle exchange clients without using any self-reported information. Instead, data are accumulated by following the distribution and return of sequentially labeled syringes and by testing a sample of returns for the presence of HIV-1 proviral DNA using polymerase chain reaction. For each drug injector in the sample, a maximum likelihood change point model is constructed to determine if a statistically significant upward shift in the fraction of needles testing HIV positive is evident, as would occur if the drug injector in question became infected. A second maximum likelihood model is formulated to estimate the HIV incidence rate among needle exchange participants by aggregating the individual change point results. When these methods are applied to the syringe tracking and testing data collected to evaluate the legal needle exchange program in New Haven. Connecticut, the maximum likelihood incidence estimate equals zero, with a 95% confidence interval of 0–10.2 new infections per KM) drug injectors per year. Given these data, we cannot reject the null hypothesis that no new infections have occurred among needle exchange participants between November 1990 and May 1992.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Sexual behavioral data from a survey of 396 male drug injectors showed that 301 (76%) were behavioral heterosexuals. 49 (12.45%) were bisexuals. and 46 (11.6%) were homosexuals over the previous 5 years. Among those sexually active during the 6 months before the interview, bisexuals were similar to heterosexuals and homosexuals in reporting two or more female or male partners, respectively. Overall, almost three fourths of the bisexuals had two or more sexual partners. Bisexuals were also similar to heterosexuals in reported heterosexual anal intercourse ( 16 and 15% respectively), and to homosexuals in reported homosexual insertive anal intercourse (33 and 54%, respectively). They were less likely than heterosexuals to engage in vaginal and insertive oral sex with women and than homosexuals to practice receptive anal and oral sex with men. The three groups all practiced high levels of unprotected sex. Almost half the behavioral bisexuals identified themselves as heterosexuals. Self-identified heterosexuals in the sample were less likely than self-identified gays or bisexuals to state they reduced sexual risk; however. reported condom use was low for all three groups. With human immunodefi-ciency virus infection rates of 54% (21 of 39) for behavioral homosexuals. 24% (11 of 45) for bisexuals. and 9% (24 of 260) for heterosexuals, these findings indicate an urgent need for more effective sexual risk reduction among injection drug users and their partners.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The human T-lymphotropic Virus type I (HTI.V-I) antibody profile of 216 asymptomatic carriers in Miyazaki. Japan, was analyzed in conjunction with the HTL V-I proviral DNA levels in their peripheral blood mononuclear cells (PBMC) determined by the semiquantitative polymerase chain reaction (PCR) method. The geometric mean HTL V-I titer by particle agglutination assay (FA) of 58 subjects (27%) with a high DNA level was 1:1. 240:94 (44%) with a medium DNA level. 1:740:38 (18%) with a low level. 1:476: and. 26 (12%) with an undetectable level. 1:263. Moreover, when the subjects were divided into four groups according to titer from high to low. the correlation between DNA level and antibody titer level was highly significant (p. 0.0001) HTLV-I antibody subclass by Western blot (WB) was determined for 78 randomly selected samples from these carriers. Immunoglobuin (lg) M antibody was detected in 35 (45%). The mean PA antibody titer was higher in carriers with IgM antibody than in those without, at each detectable proviral DNA level. These findings suggest that HTI.V-1 antibody titer is related to proviral DNA level and also to the presence of IgM antibodies among those with proviral DNA of the same level. Seven carriers (9%) were negative for IgG antibody by WB. among whom the proviral DNA level was low or undetectable and the PA titer was also low. Three of these were positive only for IgM antibody.

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1994

数据来源: OVID