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Biomedical subjects

J W Curran

Publications and source records attributed to J W Curran.

At least 37 records · Page 2Linked to original sources
PubMed1989

Epidemiology of human immunodeficiency virus infection and acquired immunodeficiency syndrome.

As of December 31, 1988, 82,764 cases of acquired immunodeficiency syndrome (AIDS) and more than 46,000 AIDS-related deaths had been reported in the United States. In 1987, AIDS deaths accounted for 9% of the total mortality among men 25 to 34 years of age. Projections suggest that the impact of human immunodeficiency virus (HIV) infection on morbidity and mortality in young adults and children will continue to increase, with an estimated 50,000 cases projected to be diagnosed in 1989. The mean latency period between infection and diagnosis of AIDS is estimated to be more than seven years, and 78% to 100% of persons infected with HIV are predicted to develop AIDS within 15 years of onset of infection. Rates of seroconversions have been decreasing since 1984 among cohorts of homosexual HIV-seronegative men, and the proportion of AIDS cases among homosexual men is decreasing. In contrast, the proportion of AIDS cases attributed to intravenous drug use is increasing, with 33% of AIDS cases reported in 1988 occurring among intravenous drug users, their sex partners, or children of women who are intravenous drug users or sex partners of intravenous drug users. Worldwide, the differences in the epidemiology of HIV infection and AIDS are primarily due to differences in the proportions of the modes of transmission and in the time in which HIV infection was introduced.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[The definition of acquired immunodeficiency syndrome (AIDS)].

The new, revised CDC case definition of AIDS (1) specifies precisely, which laboratory results and which diseases may indicate HIV-infection. The indicator diseases are divided into those with HIV-positive and HIV-not positive laboratory findings. The latter group is subdivided into diseases diagnosed definitely and diagnosed presumptively. Appendices contain directions for the interpretation of results of laboratory examinations indicating, under which circumstances the diagnosis of AIDS can be excluded or can definitely be established or which findings must be considered inconclusive. Further, the methods are listed, which have to be employed in order to provide a definitive diagnosis of an indicator disease and under which conditions a presumptive diagnosis of a disease, indicative of AIDS, is admitted.

AIDS Serodiagnosis↗
PubMed1988

[Classification of manifestations in the course of infection with the human immunodeficiency virus (HIV)].

The vast number of symptoms, diseases and findings, which can be observed in the course of HIV-infection, required an arrangement in a systematic order. The classification system for adults of the Centers for Disease Control (CDC) distinguishes between 4 groups and some subgroups. Group I includes acute infection, group II asymptomatic infection, group II persistent generalized lymphadenopathy, group IV other diseases. Subgroup IV.A. stands for constitutional disease, IV.B. neurologic disease, IV.C. secondary infectious diseases, IV.D. secondary cancers and IV.E. other conditions. A somewhat different classification system is needed for children under 13 years of age. Class P-0 comprises indeterminate infection, P-1 asymptomatic infection and P-2 symptomatic infection. Subclass P-1.-A. concerns normal immune function, P-1.B. abnormal immune function, P-1.C. immune function not tested, P-2.A. nonspecific findings, P-2.B. progressive neurologic disease, P-2.C. lymphoid interstitial pneumonitis, P-2.D. secondary infectious diseases, P-2.E. secondary cancers and P-2.F. other diseases possibly due to HIV-infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Epidemiology of HIV infection and AIDS in the United States.

By the end of 1987, nearly 50,000 cases of acquired immunodeficiency syndrome (AIDS) had been reported since 1981, 20,745 in the past year alone. Black and Hispanic adults and children have reported rates 3 to 12 times as high as whites. This can be largely attributed to higher reported rates in black and Hispanic intravenous (IV) drug abusers, their sex partners, and infants. In 1986, reported AIDS deaths increased adult male and female mortality in the United States by an estimated 0.7 and 0.07%, respectively, with much greater increases in selected age groups or areas of the country. The greatest variation in infection with the human immunodeficiency virus (HIV) (0 to 70%) has been found in surveys of IV drug abusers, while surveys of homosexual men reveal infection rates of 20 to 50%. Infection with HIV ranged from 0 to 2.6% in limited sexually transmitted disease clinic surveys of heterosexual men and women without a history of IV drug abuse or known sexual contact with persons at increased risk. The modes of HIV transmission are now well understood, but a large amount of biologic variability in efficiency of transmission remains to be explained. The period between initial infection with HIV and the development of AIDS is variable, but the risk for disease progression increases with duration of infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Risk of human immunodeficiency virus transmission from heterosexual adults with transfusion-associated infections.

The risk of human immunodeficiency virus (HIV) transmission was studied by interviewing and testing the serum of heterosexual contacts and casual family contacts of adults with transfusion-associated HIV infections. Two (8%) of 25 husbands and ten (18%) of 55 wives who had had sexual contact with infected spouses were seropositive for HIV. Compared with seronegative wives, the seropositive wives were older (median ages, 54 and 62 years; P = .08) and actually reported somewhat fewer sexual contacts with their infected husbands (means, 156 and 82; P greater than .1). There was no difference in the types of sexual contact or methods of contraception of the seropositive and seronegative spouses. There was no evidence of HIV transmission to the 63 other family members. Although most husbands and wives remained uninfected despite repeated sexual contact without protection, some acquired infection after only a few contacts. This is consistent with an as yet unexplained biologic variation in transmissibility or susceptibility.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Herpes zoster in African patients: a clinical predictor of human immunodeficiency virus infection.

A recent episode or a history of herpes zoster was found in 30 (11%) of 284 patients hospitalized with human immunodeficiency virus (HIV) infection at Mama Yemo Hospital, Kinshasa, Zaire. Of 146 African patients with a history of herpes zoster who were referred to us by physicians at the Mama Yemo Hospital, 133 (91%) were HIV seropositive. The clinical characteristics of the herpes zoster episodes did not differ between HIV-seropositive and -seronegative individuals, except that 23% of the HIV-seropositive patients experienced recurrences compared with none of the HIV-seronegative patients (P = .05). No patient developed a generalized herpes zoster eruption, and only patients with ophthalmic zoster developed related complications. Patients who experienced severe pain during their herpes zoster attack lost more weight than did those who had only minor pain (P = .0003).

Acquired Immunodeficiency Syndrome↗
PubMed1988

Acute HIV illness following blood transfusion in three African children.

Three children are described in whom pre-transfusion samples were HIV-seronegative and post-transfusional samples, obtained within 1 week after transfusion, were HIV-seropositive. Two of them developed a transient fever within 1 week of receiving the blood transfusion, and a transient generalized skin eruption which lasted for about 2 weeks. All three developed persistent generalized lymphadenopathy. One child developed a lumbar herpes zoster 7 months after transfusion. IgM Western blots demonstrated the presence of antibodies to protein bands p17, p24 and p55 in all three children. These three case reports suggest that children who receive a seropositive blood transfusion are at high risk for developing acute manifestations of HIV infection.

Acute Disease↗
PubMed1988

HIV infection and associated risk factors in female prostitutes in Kinshasa, Zaire.

In Africa, female prostitutes represent a high risk group for HIV infection. In Kinshasa, Zaire, 101 (27%) out of 377 prostitutes were seropositive to HIV by ELISA and Western blot determination. Seropositivity was significantly associated with the number of lifetime partners with a median number of 600 partners, four seropositives and 338 for seronegative individuals (P = 0.02). Seropositivity was also significantly associated with a history of taking oral medications for the prevention of sexually transmitted diseases and/or pregnancy (odds ratio = 2.21, confidence interval = 1.2-4.2), and with the introduction of any product into the vagina for hygiene or other purposes (odds ratio = 2.3, confidence interval = 1.1-4.7). In addition, among 85 prostitutes reporting condom use by their sexual partners during the previous year, the use of condoms by 50% or more of partners was associated with a reduced risk of HIV seropositivity (P = 0.046). An increased risk of HIV seropositivity was not associated with fellatio, anal intercourse, or with any type of kissing. Twenty-nine per cent of prostitutes reported at least one symptom suggestive of HIV infection, and seropositivity was associated with weight loss, either with or without chronic diarrhea or pruritic dermatitis. These data confirm that African prostitutes are at high risk for HIV infection and that the number of lifetime sexual partners, and factors which interfere with the integrity of the vaginal or cervical mucosa, may be associated with an increased risk of HIV infection acquired through heterosexual contact.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1988

Interaction between rifabutin and human immunodeficiency virus type 1: inhibition of replication, cytopathic effect, and reverse transcriptase in vitro.

Rifabutin (ansamycin; LM427), a semisynthetic rifamycin derivative, inhibits the replication of human immunodeficiency virus type 1, the virus etiologically linked to acquired immunodeficiency syndrome. The inhibition of virus production was observed in human immunodeficiency virus type 1-infected peripheral blood mononuclear cells both by reverse transcriptase assay and virus-antigen assay. In addition, rifabutin effectively reduced human immunodeficiency virus type 1-associated cytopathic effect to OKT4-positive cells. Virion-associated reverse transcriptase was also markedly inhibited by rifabutin. The inhibitory dose of rifabutin was nontoxic to lymphoid cells, which further suggests that it might serve as a useful agent in the therapeutic modalities of acquired immunodeficiency syndrome.

Cell Line↗
PubMed1988

Prevention of AIDS and HIV infection: needs and priorities for epidemiologic research.

By the end of 1987, almost 50,000 cases of acquired immunodeficiency syndrome (AIDS) will have been reported in the United States. Although the primary epidemiology of the disease has been described, much work remains to be done to complete our understanding of the dynamics of transmission and infection with the causative virus, human immunodeficiency virus (HIV). At the state and local level, the highest priorities for epidemiologic research are to understand better the precise populations at risk of prevalent and incident HIV infection, and to use this information to direct and monitor specific prevention programs that are likely to be effective for the populations at risk. These parallel efforts-sophisticated investigative epidemiologic research and applied epidemiologic and serosurveillance studies-must be expanded rapidly and continued for the forseeable future if we are to accomplish the goal of preventing further spread of HIV.

Acquired Immunodeficiency Syndrome↗
PubMed1988

The projected incidence of AIDS and estimated prevalence of HIV infection in the United States.

Planning for health and social services and for prevention programs requires predicting the number of AIDS cases likely to be diagnosed during the next several years and estimating the prevalence of HIV infection. Extrapolating from recent AIDS incidence data, we estimate that 365,000 AIDS cases will be diagnosed in the United States through 1992 (68% prediction interval, 205,000 to 440,000). Both recent HIV seroprevalence surveys and historical AIDS incidence are consistent with the U.S. Public Health Service estimate that 1.0 to 1.5 million persons in the United States are now infected with human immunodeficiency virus (HIV). Although current estimates of future AIDS cases and of current prevalence of HIV infection are somewhat uncertain, better statistical estimation procedures are being developed, and current surveys will provide additional data on HIV prevalence in the United States within the next several years.

Acquired Immunodeficiency Syndrome↗