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Biomedical subjects

C Hankins

Publications and source records attributed to C Hankins.

At least 37 records · Page 2Linked to original sources

Prevalence of HIV infection among pregnant women in Newfoundland.

OBJECTIVE: To determine the prevalence of HIV infection among pregnant women in Newfoundland. DESIGN: Anonymous unlinked seroprevalence study. SETTING: Newfoundland. PATIENTS: A total of 14911 women receiving prenatal care or undergoing an abortion, representing nearly all pregnancies in Newfoundland from Nov. 1, 1991, to Oct. 31, 1993. OUTCOME MEASURES: HIV antibody status, as determined by enzyme immunoassay of leftover serum samples (initially obtained for routine screening) and confirmation of reactive samples by the Western blot technique, health region of residence, and age group. RESULTS: Of the 14911 serum samples 13 were positive for HIV, for an overall crude prevalence rate of 1 per 1147 or 8.7 per 10000 pregnant women (95% confidence interval [CI] 4.7 to 14.9). Seven of the positive samples were from women residing in the Eastern Health Region of the province, for a crude prevalence rate of 1 per 376 or 26.6 per 10000 pregnant women (95% CI 10.7 to 54.8) for that region. All women found to be HIV positive were 15 to 29 years of age, the peak prevalence (20.8 per 10000 pregnant women [95% CI 9.5 to 39.4]) was observed among those 20 to 24 years. CONCLUSIONS: The overall prevalence rate of 8.7 per 10 000 pregnant women in Newfoundland is the highest provincial rate recorded among those from similar studies in Canada. Although it may be concluded that there are an estimated 125 HIV-positive women of childbearing age in Newfoundland (95% CI 67 to 213), the age-adjusted estimate is 84 (95% CI 36 to 131). This study provides an independent confirmation of an outbreak of HIV infection among women in the Eastern Health Region of the province.

Adolescent↗

Prevalence and risk behaviours for HIV infection among inmates of a provincial prison in Quebec City.

OBJECTIVE: To assess HIV prevalence and related risk factors among inmates at the Quebec Detention Centre (QDC). DESIGN: Cross-sectional prevalence study. METHODS: Inmates incarcerated at the QDC in September 1994 were asked to participate in an anonymous survey concerning HIV infection. Volunteers answered a questionnaire and provided a saliva sample during a meeting with an interviewer. RESULTS: The overall participation rate was 95% (618 out of 651). HIV prevalence was 2% (11 out of 499) in men. All HIV-infected men were injecting drug users (IDU) with an HIV prevalence of 9% (11 out of 129) in this group. HIV prevalence was 14% (9/63) among male IDU admitting previous needle-sharing and 3% (two out of 66) among the other IDU (odds ratio, 5.3; P = 0.028). Twelve male inmates admitted injecting drugs during imprisonment, of whom 11 shared needles and three were HIV-positive. HIV prevalence in men reporting sexual intercourse with men prior to incarceration was 10% (five out of 52). Nine of the 119 women were HIV-infected (8%), seven of whom were IDU (prevalence of 16% in female IDU). One of the two non-IDU had sexual contacts with male IDU, and the other with men who had sex with men. Tattooing was not associated with HIV infection in either men or women. CONCLUSIONS: Prisoners constitute a group at high risk of HIV infection mainly because of the high proportion of them who are IDU. Imprisonment offers a good opportunity to provide education and preventive programs to this specific group that might otherwise be difficult to reach.

Female↗

Detection of a transforming fragment of herpes simplex virus type 2 in clinical specimens by PCR. The Canadian Women's HIV Study Group.

A PCR assay for the sensitive detection of a transforming fragment of herpes simplex virus type 2 (HSV-2) was developed. Oligonucleotide primers were selected in Xho-2, a transforming region of the BglII N fragment of HSV-2. The assay reached a sensitivity endpoint of 10 copies of the Xho-2 subfragment and did not show cross-reactivity with other herpesviruses, including HSV-1. All 42 HSV-2 isolates scored positive in the assay. The Xho-2 PCR assay was evaluated with 216 clinical specimens and the results were compared with those of cell culture. The best protocol for processing specimens contained in viral transport medium included a centrifugation step followed by cell lysis. Of the 107 specimens positive for HSV-2 by culture, 105 were PCR positive (sensitivity, 98.1%). For one of the two falsely negative samples, beta-globin as well as sequences from the HSV-2 DNA polymerase gene could not be amplified. The other sample scored positive in both of these reactions but was indeterminate in duplicate tests by Xho-2 PCR. Two of 109 HSV-2 culture-negative specimens tested positive in the PCR assay (specificity, 98.2%). The latter two samples tested positive in a PCR test for the HSV-2 DNA polymerase gene. This novel tool was shown to be sensitive and specific for HSV-2 sequences and should allow for the investigation of the role of HSV-2 in genital cancers.

Adult↗

Sexual transmission of HIV to women in industrialized countries.

Biological differences between men and women help explain why the human immunodeficiency virus (HIV) is infecting increasing numbers of young girls and women in industrialized countries through heterosexual activity. As well, lack of economic and educational opportunities may not only lead women to resort to entering into sexual relationships for economic reasons but may also reduce both their willingness and their capacity to negotiate protection. Although advocating partner condom use remains the primary prevention message, increasing effort is being directed at the development and evaluation of woman-controlled prevention methods. Long-term solutions to women's vulnerability lie in the empowerment of women to achieve economic autonomy and full participation in decisions which affect their lives.

Bisexuality↗

HIV: evolution of a pandemic.

Although the prevalence of AIDS is still relatively low in many countries in Asia and the Pacific Rim, the rate of HIV transmission in this region continues to rise inexorably and will surpass that of sub-Saharan Africa by 1997. The challenge of mobilizing governments and communities to counter this largely invisible threat was the theme of the Third International Conference on AIDS in Asia and the Pacific, held in Chiang Mai, Thailand, in September 1995. Thailand has led the way with bold and far-reaching HIV prevention programs. Nevertheless, the long-term consequences of existing HIV infection in Thailand and elsewhere in Asia will be severe. Moreover, these repercussions will be felt globally as productivity is undermined, health care costs soar and purchasing power weakens. Supporting programs for HIV prevention and care abroad is thus an urgent matter of economic and political self-interest as well as a humanitarian imperative.

Asia↗

Aids-related knowledge and practices in migrant populations: the case of Montrealers of Haitian origin.

The objectives of the study were to determine knowledge levels regarding AIDS and its modes of transmission, and to describe sexual behaviour of Montrealers of Haitian origin. A serial cross-sectional study was conducted in three phases between 1987 and 1990. A questionnaire was administered in a face-to-face interview with the exception of the section concerning sexual practices which was self-administered for those respondents who were literate in French. The study was conducted among 775 men and women residing in the metropolitan Montreal region. These individuals were aged 15 to 39, were born in Haiti or had at least one parent born in Haiti. Knowledge levels were high except for misconceptions about HIV transmission through casual contact and mosquito bites. There was a significant association between high risk sexual behaviour and marital status with the odds of having had multiple partners significantly raised for previously married individuals (OR = 5.96, 95% CI = 3.09; 11.50). High risk behaviour was also associated with being under 25 years of age (OR = 2.83, 95% CI = 1.40; 5.74), knowing someone with HIV/AIDS (OR = 1.88, 95% CI = 1.05; 3.37), being male (OR = 6.81, 95% CI = 3.99; 11.60) and earlier year of interview. Montrealers of Haitian origin, with their specific AIDS-related socio-cultural characteristics, constitute a community which is intermediate between their country of origin, Haiti, and their host country, Canada.

Acquired Immunodeficiency Syndrome↗

Ontogeny of the humoral immune response to human immunodeficiency virus type 1 in infants.

In a cohort of infants born to human immunodeficiency virus type 1 (HIV-1)-infected mothers, changes in the levels of HIV-1 specific antibodies were measured during the first year of life. In uninfected children, the level of antibodies to six HIV-1 antigens (gp120, p66, p41, p31, p24, and p17) decreased continuously until becoming negative. In contrast, rising levels of one or more specific antibodies were detected in 9 of 12 infected children at a median age of 6 months. At 1 year of age, 8 infants were still asymptomatic and classified as P-1. All had serologic profiles consistent with de novo specific antibody production. In contrast, among the 4 infants who had early disease (class P-2), 3 had no significant rise in antibody to HIV-1. These results indicate that poor immune response, which could result from early infection of the infant, is often associated with rapid clinical progression.

Cohort Studies↗

[Psychosocial factors influencing the intention of women infected with HIV to have a child: study of 12 cases].

This study documents the factors that influenced the decision of 12 women of child-bearing age whether to have a child in the three years following an infection by the human immunodeficiency virus (HIV). Three of the 12 women are intending to have a child, and their intention stems from their beliefs and positive attitudes toward having a child, their partner's positive influence, the absence of their children, their denial of the disease and the absence of symptoms within their family. For the nine other women, the factors that influenced their decision not to have a child include the sociopolitical and economical context, the fact their family is complete, the fact they are seropositive or III, their fear of transmitting the infection and the idea of losing a child to AIDS.

Adult↗

Diagnosis of vertical HIV-1 transmission using the polymerase chain reaction and dried blood spot specimens.

We have used the polymerase chain reaction (PCR) to detect HIV proviral sequences in minute amounts of peripheral blood collected onto newborn screening blotters. Forty-three newborns, infants, and children of HIV-infected mothers were serially studied: dried blood spot (DBS) specimens were processed for PCR; serum was assayed for HIV antibodies, p24 antigen, and immunoglobulins; mononuclear cells were cultured and CD4 cells were quantitated by immunofluorescence. There was excellent agreement between the results of blood spot PCR, viral culture, and clinical and immunological indicators of HIV infection. Eighteen of 19 infected children tested positive by both PCR and culture, including six asymptomatic infants who were less than 10 weeks of age. As expected, p24 antigen capture assays were insensitive, detecting only 13 of the 19 infected children. One infected infant tested positive by PCR, but negative by culture and antigen. This infant was seropositive at 27 months and had pronounced hypergammaglobulinemia in association with non-specific symptoms. Twenty-four of the 43 infants were asymptomatic with normal immune profiles, declining antibody levels and no evidence of infection. These children tested repeatedly negative by PCR, culture, and p24 antigen assays. Our results indicate that DBS PCR is a sensitive, specific, and cost-effective alternative to viral culture for the early diagnosis (or exclusion) of perinatal HIV infection. DBS sampling opens the way for large-scale prospective studies to determine the exact rates of vertical HIV transmission in industrialized, as well as, nonindustrialized countries.

Child, Preschool↗

Canadian experiences with AIDS and HIV infection.

Canada's first AIDS case was diagnosed in 1978, and a total of 2,003 cases had been recorded up to 19 September 1988. Nationwide, 82% of those afflicted have been homosexual or bisexual men, 5% have been immigrants from endemic regions, and 4.6% have been recipients of blood or blood products. Estimates of Canadians infected with HIV range from 10,000 to 50,000. A system of voluntary testing of individuals, combined with anonymous screening of populations for epidemiologic purposes, comprises the HIV testing program in Canada. Most major cities have volunteer AIDS support committees conducting education, advocacy, and support activities; Can$48 million has been allocated to educate the public about AIDS over the next five years. Research and international cooperation are also receiving increased priority and funding.

AIDS Serodiagnosis↗

A somatomedin assay using normal rabbit cartilage in clinical studies.

Somatomedin (SM) is a growth hormone (GH) dependent biological growth factor in serum. A SM assay, using mechanically sliced discs from young normal rabbit costal cartilage was developed and evaluated. This assay is as sensitive and precise, while much less laborious and costly, than the hypophysectomized rat cartilage SM assay. The elevated serum SM levels in patients with acromegaly returned to normal in two patients who were cured, and remained elevated in four incompletely treated patients. The low serum SM levels in five GH deficient patients were increased to normal after treatment with human GH. SM levels were normal in 10 patients with normal GH levels and short stature due to various causes. SM levels in serum were very low in patients with chronic renal insufficiency; the mean SM level increased significantly after renal transplantation, however, it increased only minimally after hemodialysis. SM levels were subnormal in 14 patients with sever chronic liver disease. One patient with severe acute liver disease had low serum SM levels which increased after clinical recovery. These results further suggest that the liver produces SM, while the relationship of the kidney and SM is not clear.

Acromegaly↗

HIV: the debate over isolation as a measure of personal control.

In the biomedical ethical debates over HIV/AIDS, the issue of personal control measures, including isolation and detention, should be addressed critically. Taking account of historical experience with epidemics and current legislation, several major policy options are identified, each of which has drawbacks. A sliding scale of personal control measures culminating in limited detention may offer a balance between private responsibility and public health to ensure responsible behaviour. Any measure of personal control must be linked to fully implemented, positive programmes in education and counselling within a coherent strategy for which there is no coercitive substitute.

Acquired Immunodeficiency Syndrome↗