ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Selected findings from the Multicenter AIDS Cohort Study (MACS) of homosexual/bisexual men are reviewed. High risk sexual behaviors, the use of drugs/alcohol, condom use, and behavior change are addressed in a public health context. The potential significance of education/behavior modification programs as strategies for public health intervention emerges from these findings. Until there is a realistic timetable for vaccine availability and more effective chemotherapy, the MACS provides the opportunity to continue to study the effects of behavior change on the AIDS epidemic.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A seroepidemiological study of human immune deficiency virus type 1 (HIV-1) and HIV-2/human T-lymphotropic virus type IV (HIV-2/HTLV-IV) infections was performed in Angola in October 1986. Until then five cases of acquired immune deficiency syndrome (AIDS) had been registered in Angola. During this study, another three cases with clinical AIDS were found and confirmed by HIV-1 serology. A total of 1,215 sera from groups of healthy persons and patients were tested for HIV-1 and HIV-2/HTLV-IV antibodies by enzyme-linked immunosorbent assays (ELISA). Sera positive by ELISA were also tested by Western blot (WB) analysis. In Luanda, the capital, HIV-1 antibodies were demonstrated in 0.4% (2/452) of male blood donors, in 0.3% (1/357) of pregnant women, in 1% (1/100) of tuberculosis patients, in 4% (4/94) of patients at medical wards, and in none of 22 women hospitalized with pelvic infections. In the Cabinda province, 11% (4/38) of postnatal women at a maternity ward were found to be HIV-1 seropositive, but only 2% (1/55) of other hospitalized patients and none of 32 male blood donors or 59 healthy persons in a village on the border to Zaire. Specific antibodies to HIV-2/HTLV-IV were not found in any of the sera. However, 16 out of 17 HIV-1 positive sera cross-reacted with HIV-2/ HTLV-IV core proteins by WB. In October 1987, 280 of the blood donors from Luanda were retested for HIV-1 antibodies and one of them was found to have seroconverted during the previous year. HIV-1 infection exists in Angola, but the prevalence in Luanda is lower than in the capitals of some neighboring countries in central Africa.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

HLA-A, -B, -C, -DR, and -DQ antigen phenotypes were determined in 266 Caucasian homosexual men, 90 of whom were HIV-1 seronegative, 94 HIV-1 seropositive AIDS-free, and 82 with a diagnosis of AIDS [36 with Kaposi's sarcoma (KS), 34 with opportunistic infection (OI), and 12 with KS and OI]. No significant differences in HLA-A or -B antigen frequencies were found in any comparisons of these groups. However, in comparisons of seropositive AIDS-free men with the AIDS groups, HLA-Cw7 was increased in frequency in OI and HLA-DR1, -DRw 14, and -DQw 1 in KS. HLA-DR3 and -DQw3 frequencies were decreased in KS, and DRw53 was decreased in OI. In a cohort of 102 HIV seropositive individuals that were followed for a mean of 43 months, AIDS developed in HLA-DR 1 positive men more frequently than in individuals with other HLA-DR phenotypes (p = 0.02). These results demonstrate probable genetic differences between individuals developing KS and OI and indicate that the HLA-DR 1 phenotype is a risk factor in disease progression in human immunodeficiency virus (HlV)-infected individuals.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

To determine whether systemic lupus erythematosus (SLE) is associated with human T-lymphotropic virus, type I (HTLV-I) infection in Jamaica, an endemic area for the virus, we studied 63 patients with SLE at the University Hospital of the West Indies in Kingston. Antibodies to HTLV-I were measured by an enzyme-linked immunosorbent assay (ELISA) technique using purified disrupted whole virus as antigen, with confirmation by p24protein RIA or competitive binding. Four of 63 SLE patients were HTLV-I seropositive (6.3%). There was no evidence for excess HTLV-I infection in SLE patients when their age- and sex-standardized HTLV-I seroprevalence rate was compared to that of a large group of healthy food service employees. None of 13 patients with rheumatoid arthritis were seropositive for HTLV-I. We conclude that HTLV-I infection does not appear to be linked with SLE in Jamaica.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

To determine the distinguishing features of pulmonary Kaposi's sarcoma (KS) in patients with the acquired immunodeficiency syndrome (AIDS), we compared three groups of patients, 16 with endobronchial KS, 15 with endo-bronchial KS and an opportunistic lung infection, and 40 with Pneumocystis carinii pneumonia (PCP) without concomitant pulmonary KS. The majority of pulmonary KS patients had extensive cutaneous disease at the time of pulmonary diagnosis, and the diagnosis of pulmonary KS was easily established by the characteristic appearance of the endobronchial lesions. Dyspnea, fever, and cough were common presenting symptoms, but occurred more commonly in association with accompanying opportunistic infection. Diffuse interstitial infiltrates were observed in most patients in both groups, but the findings of nodular paren-chymal densities or pleural effusion were more commonly observed in patients with pulmonary KS than in those with PCP alone. Pulmonary uptake of gal-lium-67 citrate or a diffusing capacity less than 80% were unusual in patients with pulmonary KS alone, but common in those with accompanying opportunistic infection or with PCP alone. Median survival in patients with pulmonary KS was only 2 months, and most patients had complicating opportunistic infections at the time of death. Pulmonary KS is generally a late and often preterminal manifestation of AIDS. Chest radiographs, gallium lung scans, and pulmonary function testing may provide diagnostic information that is helpful in distinguishing pulmonary KS from opportunistic lung infections.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Data from the Centers for Disease Control (CDC) and from the hospitals affiliated with the University of California, San Francisco show a significant incidence of neurological complications in AIDS patients and suggest that patients from different risk groups and geographic regions are at different relative risk for specific neurological complications. CDC national surveillance data show that Haitian-born AIDS patients are 3.7 times more likely to have neurological complications than are patients in other risk groups; neurological illness is also reported more often in intravenous drug abusers and black AIDS patients. Cryp-tococcal meningitis is most prevalent among intravenous drug abusers, Haitians, and blacks, and is most commonly reported in New Jersey, a state with a large proportion of AIDS patients in these three groups. Cerebral toxoplasmosis is reported much more often in Haitians than in other risk groups and is most prevalent in Florida among both Haitians and non-Haitians, probably because of greater exposure to Toxoplasma gondii organisms in the semitropical climate of Florida. The prevalence rates for progressive multifocal leukoencephalopathy (PML) and primary central nervous system lymphoma are similar throughout various risk groups and regions of the United States.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Nearly 40% of AIDS patients develop neurological complications during the course of their illness, and about 10% experience neurological symptoms as the initial manifestations of AIDS. The most common neurological complication (14% of AIDS patients) is human immunodeficiency virus (HIV) encepha-lopathy, but opportunistic viral and nonviral infections and neoplasms are also quite common; the most frequent among these are cryptococcal meningitis, toxoplasmosis, primary central nervous system (CNS) lymphoma, progressive multifocal leukoencephalopathy, and herpesvirus infections. Most of the nonviral infections and neoplasms are potentially treatable. Neurological syndromes include diffuse and regional encephalopathies, myelopathy, meningitis, intraaxial cranial neuropathies, and retinopathy. About 10% of AIDS patients develop a CNS mass lesion; the chief causes of these lesions are toxoplasmosis and primary CNS lymphoma. Since the clinical profiles of the various diseases overlap to a great extent, differential diagnosis requires a thorough workup, including magnetic resonance imaging or computed tomography brain scanning, examination of the cerebrospinal fluid, and, frequently, brain biopsy. Because AIDS patients have a high incidence of multiple intracranial pathologies, the diagnostic workup may have to be repeated to identify all of the diseases present.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Chairman's Comment.When the 13-member Presidential Commission On the HIV Epidemic began hearings in September 1987 the enormity of the task to help the country face its greatest and most complex public health crisis ever soon became clear. Accordingly, the Commission's mandate, as established by President Reagan's executive order, was comprehensive. As key to developing a national strategy, we were to advise the White House “on the public health dangers including the medical, legal, ethical, social, and economic impact, from the spread of the HIV and resulting illnesses including AIDS, AIDS related complex, and other related conditions.” This included evaluating research activities, assessing the adequacy of the health care delivery system, reviewing legal liabilities, discrimination, education and much more. To manage this mass of data the Commission brought on a staff of 30 and planned a sweeping and disciplined set of public hearings where we could personally receive reports from and question the nation's top authorities on these many issues. When our work is completed in June, 1988, the Commission will have had about 45 full days of hearings and site visits. Many were held in Washington, D.C. but others were held in San Francisco, New York, Miami, Nashville and elsewhere. We will have had before us roughly 600 witnesses. They include several Cabinet officers, heads of the FDA, the CDC, the NIH, major corporations, pharmaceutical companies, researchers, nurses and doc- tors. We have heard from many persons with AIDS, including two who have since died. You have before you the first fruits of this process in the form of our interim policy recommendations of March 15, 1988. These cover less than half our work and will be inculcated in our final report due at the White House on June 24, 1988.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID