Search PubMed⌕ Search

Biomedical subjects

C A Kennedy

Publications and source records attributed to C A Kennedy.

64 records · Page 4Linked to original sources
PubMedDate not supplied

CD3+CD8+ cell levels as predictors of transmission in human immunodeficiency virus-infected couples: a report from the heterosexual HIV transmission study.

OBJECTIVE: The goal of this study was to identify in human immunodeficiency virus (HIV)-infected individuals immunologic markers that correlated with transmission of HIV by heterosexual contact. METHODS: In a case-control comparison of couples, immunologic and viral parameters were evaluated in 343 HIV-positive individuals who were members of 67 HIV-seroconcordant couples (both partners HIV positive) and 211 HIV serodiscordant couples (one positive, one negative). RESULTS: The most striking immunologic finding was the increased numbers of CD3+CD8+ cells found in the index member of discordant couples as compared to the index member of the concordant couples. Differences in CD3+CD8+ levels persisted after adjustment for stage of disease and CD3+CD4+ count. This increase in the number of CD3+CD8+ cells was accompanied by a concomitant decrease in the amount of viral replication measured by both HIV culture endpoint and quantitative RNA polymerase chain reaction (PCR). CONCLUSION: Data presented here further support the role of CD3+CD8+ cells in suppressing or controlling viral activity, although a causal role based on case-control data must be advanced cautiously. This in vivo biologic function may help prevent or lower the risk of HIV transmission.

Adolescent↗
PubMedDate not supplied

Herpes simplex type II and Mycoplasma genitalium as risk factors for heterosexual HIV transmission: report from the heterosexual HIV transmission study.

OBJECTIVES: Two hundred twenty-four human immunodeficiency virus (HIV) discordant couples (one HIV negative, one HIV positive) were compared with 78 seroconcordant heterosexually infected couples with HIV with regard to sexually transmitted diseases. METHODS: Serologic testing and cultures were used to determine exposure of participants to sexually transmitted pathogens. These data were compared with HIV concordance of partners to investigate possible risk factors for HIV transmission. RESULTS: Syphilis, chlamydia, and hepatitis B virus (HBV) serologies did not distinguish between concordant and discordant couples nor did cultures for Neisseria gonorrhoeae and Trichomonas or Chlamydia enzyme immunoassay (EIA). Risk of transmission increased with positive serologies for herpes simplex virus (HSV)-2 (P = 0.002), cytomegalovirus (CMV) (P = 0.04), and Mycoplasma genitalium (P = 0.01), but not with Mycoplasma fermentans or Mycoplasma penetrans. Cytomegalovirus was not a significant risk factor when controlled for HSV-2 status. Examination by partner status showed increased risk of concordance with: HSV-2 positive serology in both partners (odds ratio [OR] = 3.14; confidence interval [CI] = 1.62-6.09; P = 0.007); HSV-2 in female secondary partner (OR = 2.10; CI = 1.12-3.93; P = 0.02) or the male primary partner (OR = 2.15; CI = 1.15-4.02; P = 0.017); M. genitalium antibody in both partners (OR = 3.44; CI = 1.68-7.04; P < 0.001); M. genitalium antibody in the primary male partner (OR = 2.51, CI = 1. 27-4.91; P = 0.008) and M. genitalium antibody in the secondary female partner (OR = 2.52; CI = 1.21-5.23; P = 0.01). CONCLUSIONS: These data support the role of HSV-2 in transmission of HIV and, for the first time, suggest a role for M. genitalium as an independent risk factor.

Adult↗
PubMedDate not supplied

Fulminant endocarditis due to infection with penicillinase-producing Neisseria gonorrhoeae.

Endocarditis is a rare but potentially lethal manifestation of gonococcal infection. We report the case of a patient with fulminant endocarditis secondary to infection with penicillinase-producing Neisseria gonorrhoeae (PPNG). The patient had rapid deterioration from extensive destruction of the aortic valve with abscess and fistula formation. Lifesaving emergency surgery was performed. To our knowledge this is the first reported case of gonococcal endocarditis secondary to infection with a penicillinase-producing organism.

Adult↗
PubMedDate not supplied

Postoperative pancreatic abscess due to Plesiomonas shigelloides.

Plesiomonas shigelloides is being recognized with increasing frequency as a human pathogen. The organism is ubiquitous in fresh and brackish water, and clinical illness has been associated with foreign travel and ingestion of inadequately cooked seafood. We describe a 64-year-old Filipino woman who presented 2 weeks after elective cholecystectomy and pancreatic biopsy with left upper quadrant pain, abdominal distention, and fever. Computerized tomography of the abdomen revealed an abscess in the tail of the pancreas with fluid accumulation in the lesser omental sac. Percutaneous aspiration yielded purulent material, and P. shigelloides was recovered in pure culture. To our knowledge, this is the first reported case of pancreatic abscess due to P. shigelloides.

Abscess↗
PubMedDate not supplied

Medication costs associated with the care of HIV-infected patients.

The treatment costs for human immunodeficiency virus (HIV)-infected patients continue to rise as patients survive longer because of advances in antiretroviral therapy and effective chemoprophylaxis. Medication costs per patient increase in proportion to progressive immunodeficiency. We retrospectively studied medication costs for 196 HIV-infected patients with stratification by CD4-lymphocyte count. Medication costs per patient-month were correlated with CD4-lymphocyte count (linear regression, r = -.53, P < 0.01), with higher costs associated with lower CD4 counts. The medication cost for patients with CD4 counts < 100 cells/mm3 averaged $1043 per month. Medication costs per patient increase with the development of each new opportunistic infection or other AIDS-associated condition. Costs can be expected to increase as new therapeutic agents are introduced, as treatment is initiated at earlier stages of HIV infection, and as more patients survive to the point of severe CD4-lymphocyte depletion.

Anti-Infective Agents↗