Search PubMed⌕ Search

Biomedical subjects

D Osmond

Publications and source records attributed to D Osmond.

16 recordsLinked to original sources
PubMed1992

Progression to AIDS in HIV-infected homosexual and bisexual men with hairy leukoplakia and oral candidiasis.

OBJECTIVE: This study was designed to assess the significance of HIV-related oral lesions in predicting the rate of progression to AIDS. DESIGN: Cohorts were investigated prospectively, and oral examinations were performed by clinicians trained in the diagnosis of oral lesions. SETTING: We studied three existing cohorts of homosexual and bisexual men in San Francisco, California, USA. PARTICIPANTS: Of the HIV-infected men who received standardized oral examinations (n = 791), 603 were eligible for analysis of baseline examinations and 448 for analysis of follow-up examinations. MAIN OUTCOME MEASURES: We determined time from presence of oral lesion at baseline or follow-up examination, or from participant self-reported history of the lesion, to diagnosis of AIDS. RESULTS: Using proportional hazard regression and stratifying by CD4 lymphocyte count at the time of baseline oral examination, we found that the rate of development of AIDS was increased among men with hairy leukoplakia [relative hazard, 1.8; 95% confidence interval (CI), 1.2-2.7], oral candidiasis (relative hazard, 7.3; 95% CI, 3.1-17.3), and both lesions (relative hazard, 3.1; 95% CI, 1.6-6.1) compared with men with normal findings. On follow-up examination, stratifying for CD4 count, the rate of progression to AIDS was similar for those with hairy leukoplakia compared with those with oral candidiasis. The progression rate from oral candidiasis to AIDS was faster from presence on baseline examination than from presence on follow-up examination or from self-reported history of the lesion. CONCLUSION: The presence of oral candidiasis and/or hairy leukoplakia on baseline examination confers independent prognostic information and should be incorporated into HIV-staging schemes.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Population-based estimates of zidovudine and aerosol pentamidine use in San Francisco: 1987-1989.

From the San Francisco Men's Health Study (SFMHS) and the San Francisco General Hospital Cohort we derived partially population-based estimates of zidovudine (ZDV) use in San Francisco from 1987 to 1989. Data from the SFMHS alone were used to make estimates of aerosol pentamidine (AP) use in 1989. From 1987 to 1989, zidovudine use increased from 36 to 68% in participants with AIDS. In participants with symptomatic HIV infection without AIDS and in those with less than 200 CD4 cells, ZDV use increased initially but then leveled off (from 6 to 25% and 24 to 55%, respectively). Zidovudine use with more than 500 CD4 cells increased from 0.5 to 4%. In 1989 AP use with less than 200 CD4 cells was 42% and with AIDS was 44%. Whereas 50% of participants with AIDS and less than 200 CD4 were using both ZDV and AP, only 14% of those without AIDS but with less than 200 CD4 cells were using both. Surprisingly few members of these cohorts are using therapies proven effective in reducing the morbidity and mortality of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Cocaine use and HIV infection in intravenous drug users in San Francisco.

We assessed risk factors for human immunodeficiency virus (HIV) infection in 633 heterosexual intravenous drug users. The HIV seroprevalence was 26% in blacks, 10% in Hispanics, and 6% in whites. Intravenous cocaine use significantly increased the risk of HIV infection, with a seroprevalence of 35% in daily cocaine users (odds ratio, 6.4; 95% confidence interval, 3.0 to 13.3). Black subjects were more likely to use cocaine regularly. Drug use in shooting galleries and sharing of drug injection equipment were also associated with HIV infection and were more common in cocaine users. By multivariate analysis, black race, daily cocaine injection by blacks and Hispanics, all other cocaine injection, heavy use prior to entry into methadone treatment by blacks, and use of drugs in shooting galleries were independent predictors of HIV infection. Methadone therapy was associated with substantial reductions in heroin use and some reduction in cocaine use, but 24% of cocaine users receiving methadone began or increased cocaine injection after entry into treatment.

Black or African American↗
PubMed1989

Lymphocyte subset analysis to predict progression to AIDS in a cohort of homosexual men in San Francisco.

A group of 10 leukocyte and lymphocyte subsets were measured by simultaneous dual immunofluorescence and flow cytometry in a group of homosexual men from the San Francisco General cohort. Absolute numbers and percentages of lymphocytes were determined in 30 individuals who progressed to AIDS and 29 who did not over a 44-month period at annual intervals. At entry into the study, all subjects were asymptomatic, HIV seropositive, and had multiple changes in lymphocyte subsets compared to HIV-negative controls. In progressors, large changes occurred from the first visit to the last visit before progression in both absolute numbers and percentages of CD4 cells. The percentage of HLA-DR-bearing CD8 cells also increased. We utilized a proportional hazards model to assign a predictive value for progression to AIDS to lymphocyte subsets in both univariate and multivariate tests. Increased DR-positive CD8 cells, decreased CD4 cells, and increased CD8-positive, Leu 7-positive cells independently predicted progression to AIDS at P less than 0.006 (relative hazard 5.8-4.0). In a multivariate model, the most useful tests were either increased numbers or percentages of DR-positive CD8 cells. These data suggest parsimonious approaches to following HIV-positive individuals and further support the possibility of autoreactive T cells in the pathogenesis of HIV-associated diseases.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Seropositivity for HIV and the development of AIDS or AIDS related condition: three year follow up of the San Francisco General Hospital cohort.

The three year actuarial progression rate to the acquired immune deficiency syndrome (AIDS) in a cohort of men in San Francisco who were seropositive for the human immunodeficiency virus (HIV) was 22%. An additional 26 (19%) developed AIDS related conditions. Beta 2 Microglobulin concentration, packed cell volume, HIV p24 antigenaemia, and the proportion and number of T4 lymphocytes each independently predicted progression to AIDS. Beta 2 Microglobulin was the most powerful predictor. The 111 subjects tested who were normal by all predictors (40%) had a three year progression of 7%, and the 68 subjects who were abnormal by two or more predictors (24%) had a progression rate of 57%. Two thirds of all men who progressed to AIDS were in the last group. The median T4 lymphocyte count in subjects who did not progress to AIDS fell from 626 x 10(6) to 327 x 10(6)/l. HIV p24 antigenaemia developed in 7% of the subjects per year. The proportion who were abnormal by two or more predictive variables rose to 41%. At three years an estimated two thirds of the seropositive subjects showed clinical AIDS, an AIDS related condition, or laboratory results that were highly predictive of AIDS. It is concluded from the observed rates and the distribution of predictive variables at three years that half of the men who were seropositive for HIV will develop AIDS by six years after the start of the study, and three quarters will develop AIDS or an AIDS related condition.

AIDS-Related Complex↗
PubMed1988

Time of exposure and risk of HIV infection in homosexual partners of men with AIDS.

We interviewed, and tested for HIV antibody, 117 homosexual men who had been regular sexual partners of men who developed acquired immunodeficiency syndrome (AIDS); 85 tested seropositive. Receptive anal intercourse with the index AIDS case and number of different sexual partners with whom subjects were anally receptive were both risk factors. Controlling for the number of partners with whom subjects were anally receptive, we found that the odds ratio of receptive anal intercourse with the case was infinite (95% confidence intervals, 3.3-infinity) if sexual contact continued up to or beyond the time of diagnosis, while the odds ratio was 1.0 (95% CI 0.3-3.2) if contact ceased before the case's AIDS diagnosis. Risk was not associated with the duration or frequency of contact. Our data suggest that the potential for sexual transmission from an HIV-infected person may be greater close to or after the onset of disease.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Risk of transmitting the human immunodeficiency virus, cytomegalovirus, and hepatitis B virus to health care workers exposed to patients with AIDS and AIDS-related conditions.

This prospective cohort study was designed to evaluate the risk of occupational transmission of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and cytomegalovirus (CMV) to health care workers with intensive exposure to HIV-infected patients. Seventy-five percent of the 270 subjects had been exposed to patients with AIDS and AIDS-related conditions (ARC) for at least one year before enrollment, 18% worked in specialized AIDS units, and 35% sustained a total of 342 accidental parenteral exposures to HIV-infected body fluids. At the time of enrollment, none had antibody to HIV, and none of the 175 subjects retested 10 months later had acquired antibody. No evidence of increased risk of acquiring CMV or HBV was obtained. These results indicate that health care workers are at minimal risk for HIV, CMV, and HBV transmission from occupational exposure to patients with AIDS or ARC, even when intensively exposed for prolonged periods of time.

AIDS-Related Complex↗
PubMed1987

Human immunodeficiency virus infection in heterosexual intravenous drug users in San Francisco.

To investigate the risk of infection with the human immunodeficiency virus (HIV) in San Francisco, the prevalence of antibodies to HIV was determined in 281 heterosexual intravenous drug users recruited from community-based settings. Ten per cent of subjects had ELISA and Western blot confirmed seropositivity for antibodies (95 per cent CI 6.8-14.2 per cent). Analysis of behavioral factors revealed an increased risk of seropositivity in addicts who reported regularly sharing needles when injecting, particularly those sharing with two or more persons (odds ratio = 5.43; 95 per cent CI 1.08-52.5). Blacks and Latinos also had a greater prevalence of seropositivity than Whites, and this finding persisted after adjustment for needle sharing (adjusted odds ratio = 2.8; 95 per cent CI .84-8.59). Seropositivity was not associated with age, sex, duration of drug use, or history of prostitution. These data indicate that a new epidemic of AIDS (acquired immunodeficiency syndrome) in intravenous drug users, similar to that which has occurred among homosexuals in San Francisco, is possible. The relatively low seroprevalence in 1985 provides health officials an important opportunity to intervene and attempt to prevent widespread infection of drug users with HIV.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Exposure to hair dyes and polychlorinated dibenzo-p-dioxins in AIDS patients with Kaposi sarcoma: an epidemiological investigation.

Fifty male AIDS patients with Kaposi sarcoma and 50 matched controls were interviewed about occupation, exposure to pesticides, Vietnam service, smoking habits, etc. No difference in use of pesticides was seen. One case but no control had served in Vietnam and was thereby exposed to agent orange. Dioxins are known to be immunosuppressive in animals. No significant difference in exposure to dioxin-containing products was found between cases and controls, however. Of interest was the fact that four cases but no control were occupationally exposed to hair dyes, some of which have been reported to be carcinogenic.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Hormonal risk factors in testicular cancer. A case-control study.

The authors interviewed 273 northern California testicular cancer cases aged 40 and under diagnosed between 1976 and 1981, their mothers, and matched peer controls and their mothers on prenatal hormone exposure and other variables. Included was a population-based substudy (1979-1981) of all interviewable cases reported to the San Francisco Bay Area Surveillance, Epidemiology, and End Results registry. They found odds ratios (OR) of from 8.3 (sons' report) to 4.5 (mothers' report) associated with cryptorchidism, but found no association with mothers' hormone exposure or diethylstilbestrol exposure in pregnancy. They also found a significant association with lower age at puberty (OR = 2.0); a marginally significant association with mothers' breast cancer (OR = 2.9, p = 0.054); and a significant protective effect of reported mononucleosis (OR = 0.6). These associations remained strong in the population-based substudy. When cases were divided by histology, strong and specific associations of earlier puberty (OR = 2.3) and mothers' breast cancer (OR = 4.4) with nonseminomatous cancer, and of reported mononucleosis (OR = 0.3) with seminomatous cancer, were found. These observations suggest that 1) prenatal exogenous hormone exposure does not account for a significant fraction of testicular cancer, 2) a cluster of "breast-cancer-like" risk factors are associated with nonseminomas, and 3) there is some genetic risk of nonseminomas.

Adult↗
PubMed1986

Risk of seroconversion for acquired immunodeficiency syndrome (AIDS) in San Francisco health workers.

The occupational risk of acquiring acquired immunodeficiency syndrome (AIDS) virus infection in health workers exposed to AIDS patients and specimens was assessed by a serologic study at San Francisco General Hospital and collaborating research laboratories. A total of 101 medical workers without risk factors for AIDS were examined for antibodies to two isolates of the AIDS retrovirus (AIDS-associated retrovirus 2[ARV-2] and human T cell lymphotropic virus III). Most had heavy, long-term exposure to AIDS patients and 29 had been exposed by needlestick or mucocutaneous accident. None of the 101 had antibodies to ARV-2 by immunofluorescence or to HTLV-III by enzyme-linked immunosorbent assay and Western Blot.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Police request.

Explore the source record for details and available documents.

Adult↗