摘要:

Reports of an increased proportion of AIDS cases occurring in small and medium-sized cities suggest that the HIV epidemic may be spreading into locations that were previously characterized by their low HIV antibody prevalences. Studying the question of the geographic spread of the HIV infection epidemic (rather than the AIDS epidemic) has been difficult largely because most serial seroprevalence data have been gathered from cohorts of high risk individuals (e.g., homosexual/bisexual cohorts) in New York City, San Francisco, and other geographically circumscribed areas. The U.S. military applicant HIV screening data were used in the current report to examine rates and 24 month temporal trends in geographic areas characterized by their HIV endemicities. The data examined concern the seven most populous states and four hyperendemic metropolitan areas located within those states (New York City, Miami, Houston, and San Francisco). In the nonepidemic regions, seroprevalence rates increased among black and white applicants. In the four epidemic urban areas, only young black applicants had higher HIV seroprevalence rates during the second 12 month period. Six of the seven nonepidemic regions had positive HIV seroprevalence trends, and these trends were significant in Florida, California, Texas, Illinois, and Ohio. The increases in these regions were greater for young blacks (30% excess for year 2 vs. year 1) compared to young whites (12% excess for year 2 vs. year 1). These data provide evidence of birth year specific increases in seroprevalence over time occurring in presumed low HIV prevalence areas. These increases cannot be due to, but are observed in spite of, biases associated with increasing self-selection over time.

ISSN:0894-9255    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

To explore the introduction of human immunodeficiency virus (HIV) infection into intravenous drug abusing populations, risk behaviors of 1,154 intravenous drug abusers (IVDAs) in four U.S. cities with low prevalence of IVDA/HIV infection (0.9–13.0%) were examined. Seropositive subjects (N= 54) were compared with demographically matched seronegative controls regarding drug use practices, homosexual contact, blood transfusions, risk behaviors while traveling or living in high prevalence areas, and acquaintance with persons with AIDS. With the exception of needle sharing with homosexual/bisexual males, no differences in risk behaviors were found between seropositive subjects and matched seronegatives. Seropositives were substantially more likely than matched seronegatives to report having shared a needle with a homosexual or bisexual male, suggesting that needle sharing between homosexual/bisexual IVDAs and heterosexual IVDAs may be an important means by which HIV is introduced among heterosexual IVDAs in low prevalence areas.

ISSN:0894-9255    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Antibodies to human cytomegalovirus (CMV) and Epstein-Barr virus (EBV) were evaluated among 1,171 persons with and without antibodies to human immunodeficiency virus type 1 (anti-HIV-1). These included 97 blood donors, 577 persons given blood components or products, and 497 controls. A significantly higher proportion of anti-HIV-1 positive than -negative donors were anti-CMV-positive, a finding associated with homosexual contact among some of the former. Among subjects with treated clotting disorders, there was no difference in prevalence of anti-CMV or anti-EBV between anti-HIV-1-positive and -negative persons. The prevalence of antibodies to EBV early antigens showed no relationship to anti-HIV-1 status. Anti-CMV positivity in anti-HIV-1-negative donors was associated with an increase in mean CD8 counts and lower mean CD4/CD8 ratio. Anti-CMV and anti-EBV positivity in anti-HIV-1-positive subjects with treated clotting disorders was not associated with a lower CD4 or higher CD8 count than HIV-1 infection alone. Subjects who developed AIDS after enrollment had no significant difference in median time from entry to diagnosis when analyzed by serologic evidence of CMV and EBV antibody status at entry, and a few subjects had AIDS at entry without serologic evidence of prior CMV or EBV infection. The overall results are consistent with acquisition and progression of HIV-1 independently of coincident CMV or EBV infection.

ISSN:0894-9255    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

HTLV-I is associated with tropical spastic paraparesis (TSP) in the Caribbean area and with certain chronic myelopathies termed HAM (HTLV-I-associated myelopathy) in Japan. In order to investigate the situation in Africa, we tested for HTLV-I, but also for HIV-1 and HIV-2 antibodies, 94 patients with epidemic spastic paraparesis (ESP) from Zaire and Tanzania, 26 cases of sporadic spastic paraparesis (SSP) and 21 cases of tropical ataxic neuropathy (TAN), both from Ivory Coast, and 319 unselected neurological patients from Ivory Coast, Congo, and Tanzania. While none of the 94 ESP cases nor any of the 21 TAN patients exhibited antibodies to any retrovirus, 4 of the 26 sporadic spastic paraparesis patients had high HTLV-I antibodies in their sera and cerebrospinal fluid (CSF). Three of those were clinically and immunologically identical to TSP, as observed in persons from the Caribbean region, and the fourth case, a poorly explored chronic pyramidal syndrome, could also represent a TSP. Only one of these four cases originally had HIV-1 antibodies. Among the 319 unselected patients, only 5 (1.6%) had HTLV-I antibodies, but 32 (10%) had HIV-1 antibodies and 14 (4.4%) had HIV-2 antibodies, with a number of combined infections, indicating that retroviruses represent potentially important etiological agents for African neurological diseases.

ISSN:0894-9255    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Six (13%) of 45 female partners of 45 HIV antibody positive [Ab(+)] hemophiliacs in Western Pennsylvania have become HIV Ab(+), a mean of 10.4 months from the time of first exposure. By comparison, the mean time from first exposure to the last/recent exposure in the HIV Ab(-) female partners was 54.2 months. All six hemophiliacs who transmitted HIV to their female partners were asymptomatic, with mean T4 of 403 ± 51/mm3at the time of estimated seroconversion in the female; currently, their mean T4 is 203 ± 75/mm3, which is not different from that in hemophiliac men whose partner remains HIV Ab(-) (170 ± 22/mm3). Thus, in this population, heterosexual transmission occurs early and is unrelated to clinical or immunologic status in the hemophiliac. The risk of HIV transmission in persistently HIV Ab(-) female partners is unknown but appears low.

ISSN:0894-9255    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

To assess subclinical involvement of the peripheral nervous system and its relationship to the immunological status of human immunodeficiency virus (HIV)-infected patients, we prospectively studied the peripheral nerve conductions and the subsets of peripheral blood lymphocytes of HIV patients. Fifty-seven patients, aged 20–54 years, 28 homosexuals and 29 heterosexuals, classified as CDC II-III (40 patients) and CDC IV (17 patients) were studied. No neurological symptoms or signs were present on bedside examination or questioning for all of the CDC II-III patients. For each conduction measured (H-reflex, sural and sciatic velocities, sural amplitude), the geometric mean was below normal values (p< 0.05). Among the 57 HIV-infected patients, 20 (35%) had a significant decrease of at least one electrophysiologic measurement: 10/17 CDC IV patients vs. 10/40 CDC II-III patients (p< 0.05). Two or more simultaneous abnormalities were more often observed in the CDC IV than in the CDC II-HI group (9/10 vs. 4/10) (p< 0.01). In the CDC II–III group, patients with subclinical neuropathies had higher T-helper and lower T-suppressor cell counts and higher T-helper/T-suppressor ratios than random patients without any neurologic abnormalities (1,057 vs. 657 cells/μl,p< 0.05, and 757 vs. 1,304 cells/μl,p< 0.01, 1.55 vs. 0.68,p< 0.01, respectively). We conclude that (a) the peripheral nervous system is precociously and subclinically involved in the HIV disease; (b) the patients with infraclinical neuropathies have a significantly higher T-helper cell count than those without any neurologic involvement. The mechanism and the prognostic value of these two findings remain to be more precisely examined, and further studies are required.

ISSN:0894-9255    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

We sought to determine whether women infected with human immunodeficiency virus (HIV) had cervicovaginal cellular changes suggesting lower genital tract neoplasia or human papillomavirus (HPV) infection at a rate different from that in women without HIV infection. In a blinded fashion, cytological preparations of cervicovaginal smears from women infected with the HIV were analyzed and compared to preparations from women at high risk for but not infected with HIV. Eleven of 35 (31%) HIV-infected subjects had evidence of squamous abnormalities compared with 1 of 23 (4%) non-HIV-infected women (p= 0.019). Nine of 35 (26%) HIV-infected women had cytohistological evidence of human papillomavirus (HPV) infection compared to 1 of 23 (4%) non-HIV-infected women (p= 0.072). We conclude that HIV-infected women have a high prevalence of cervical and vaginal cytological abnormalities and evidence of genital HPV infection. Further study is necessary to determine whether there is an increased risk for cervicovaginal neo-plastic disorders in women infected with HIV.

ISSN:0894-9255    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Cutaneous delayed-type hypersensitivity (DTH) reactions were assessed by the CMI-Multitest (Merieux, Lyon, France) in patients with different stages of human immunodeficiency virus (HIV) infection in Kinshasa, Zaire. Skin tests were read after 48–72 h. A reaction to an antigen was considered positive if there was induration of >2 mm. Cutaneous anergy occurred more often in HIV-seropositive patients than in healthy controls (p < 0.001) and was most prevalent in patients with advanced HIV illness. HIV-seropositive patients with a positive tuberculin reaction were more likely to have active tuberculosis (TB) than HIV-seropositive patients without a positive tuberculin reaction (p < 0.001). Therefore, a TB diagnosis should be pursued in HIV-seropositive patients with a positive tuberculin reaction.

ISSN:0894-9255    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The human immunodeficiency virus type 1 (HIV-1) reverse transcriptase (RT)/ribonuclease H has been expressed to high levels inEscherichia colifrom a recombinant plasmid constructed using the polymerase chain reaction (PCR) for in vitro mutagenesis. Translational initiation and termination codons were introduced by the PCR at points corresponding to sites of cleavage of the RT from thegag-polprecursor polyprotein by the HIV-1 protease; the HIV-1 protease is not expressed from this construct. Most of the RT coding sequences derived from PCR were exchanged for a DNA fragment cloned by standard methods to minimize the possibility that an unwanted mutation was introduced during the in vitro amplification. The RT is expressed in bacteria from this plasmid as 66 and 51 kDa proteins, has both RNA-dependent DNA polymerase and ribonuclease H (RNase H) activities, and is indistinguishable from native HIV-1 RT in electrophoretic mobility and immunoreactivity. Peptide sequencing of the amino terminus of the HIV-1 RT purified from bacterial lysates is also presented. A novel activity gel assay was used to confirm that only the 66 kd protein catalyzes the RNase H reaction; this assay will simplify analysis of this catalytic activity. This HIV-1 RT expression plasmid is of interest because of the high level of expression in bacteria and the demonstrated RNase H activity of the enzyme. This plasmid will be distributed for research purposes through the NIH AIDS Repository and will facilitate enzymologic, structural, and immunologic evaluation of reverse transcription and its chemotherapeutic inhibition.

ISSN:0894-9255    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The human T cell leukemia/lymphoma virus type I (HTLV-I) encodes two regulatory proteins, a 42 kDatrans-activator protein (p42tax) and a 27 kDa protein (p27rex), required for virus capsid protein synthesis. The experiments described here show that the p27rexprotein negatively regulates the expression of the p42taxprotein by suppressing the accumulation of the spliced messenger RNA from which the p42taxand p27rexproteins are made. It is proposed that such an interplay between the two regulatory genes results in a homeostatic system that may regulate the rate of viral replication as well as the growth of HTLV-I transformed cells.

ISSN:0894-9255    

出版商:OVID    

年代:1989

数据来源: OVID