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Biomedical subjects

J W Curran

Publications and source records attributed to J W Curran.

At least 55 records · Page 3Linked to original sources
PubMed1987

Risk factors for human immunodeficiency virus (HIV) infections in homosexual men.

To clarify risk factors for infection with the human immunodeficiency virus (HIV) we selected at random 785 homosexual men who had participated in studies of hepatitis B in San Francisco in 1978-80 for a follow-up study of the acquired immunodeficiency syndrome. Although most had not been contacted in over five years, 492 (63 per cent) were located and enrolled. The 240 (67 per cent) who had developed antibodies to HIV, as measured by an enzyme-linked immunosorbent assay (ELISA), were compared with 119 who had remained seronegative. In multivariate analyses, receptive anal intercourse with ejaculation by nonsteady sexual partners, many sexual partners per month, and other indicators of high levels of sexual activity were highly associated with seroconversions. None of the sexual practices that we studied appeared to offer protection against HIV infection.

Adult↗
PubMed1987

Opportunistic diseases reported in AIDS patients: frequencies, associations, and trends.

To look for associations and trends in the reported frequencies of particular opportunistic diseases in AIDS patients, we analyzed diseases in the 30,632 AIDS patients in the United States reported to the Centers for Disease Control (CDC) by 9 February 1987. Compared with all other AIDS patients, children were three times more likely to have cytomegalovirus disease, homosexual men were seven times more likely to have Kaposi's sarcoma, and Haitian-born patients were six, 14 and 13 times more likely to have toxoplasmosis, tuberculosis, and chronic enteric isosporiasis, respectively. The proportions of patients initially presenting with particular diseases have changed; from before 1983 to 1986, the proportion with Pneumocystis pneumonia climbed from 41.9 to 63.6% and the proportion with extrapulmonary cryptococcosis rose from 4.5 to 6.2%, while Kaposi's sarcoma fell from 30.9 to 14.2%, chronic herpes simplex declined from 4.2 to 2.1%, and toxoplasmosis of the brain dropped from 3.5 to 1.5%.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Persistent diarrhea, strongly associated with HIV infection in Kinshasa, Zaire.

Ninety-eight (40%) of 243 acquired immune deficiency syndrome inpatients at Mama Yemo Hospital, Kinshasa, Zaire, presented with a history of diarrhea for at least 1 month. To determine the predictive value of persistent diarrhea for human immune deficiency virus (HIV) infection, 128 consecutive patients presenting at Mama Yemo Hospital with persistent diarrhea were tested for the presence of HIV antibodies. One-hundred seven (84%) of the 128 patients with diarrhea lasting at least 1 month were found to be HIV seropositive. HIV seropositive patients with persistent diarrhea more often had a generalized papular pruritic eruption (p = 0.02), a genital herpes simplex infection (p = 0.05), a history of herpes zoster (p = 0.08), and infection with cryptosporidia (p = 0.006) than HIV seronegative patients with persistent diarrhea. Bacterial enteric pathogens were found in 5 (7%) of the 76 seropositive and in none of the 14 seronegative patients in whom stool cultures were performed. Presently persistent diarrhea in adults in central Africa is strongly associated with HIV infection, but the pathophysiological mechanisms causing this diarrhea remain unclear.

Acquired Immunodeficiency Syndrome↗
PubMed1986

AIDS in Africa: an epidemiologic paradigm.

Cases of the acquired immune deficiency syndrome (AIDS) have been reported in countries throughout the world. Initial surveillance studies in Central Africa suggest an annual incidence of AIDS of 550 to 1000 cases per million adults. The male to female ratio of cases is 1:1, with age- and sex-specific rates greater in females less than 30 years of age and greater in males over age 40. Clinically, AIDS in Africans is often characterized by a diarrhea-wasting syndrome, opportunistic infections, such as tuberculosis, cryptococcosis, and cryptosporidiosis, or disseminated Kaposi's sarcoma. From 1 to 18% of healthy blood donors and pregnant women and as many as 27 to 88% of female prostitutes have antibodies to human immunodeficiency virus (HIV). The present annual incidence of infection is approximately 0.75% among the general population of Central and East Africa. The disease is transmitted predominantly by heterosexual activity, parenteral exposure to blood transfusions and unsterilized needles, and perinatally from infected mothers to their newborns, and will continue to spread rapidly where economic and cultural factors favor these modes of transmission. Prevention and control of HIV infection through educational programs and blood bank screening should be an immediate public health priority for all African countries.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Prevalence of HTLV-III/LAV in household contacts of patients with confirmed AIDS and controls in Kinshasa, Zaire.

Household members of 46 patients with confirmed acquired immunodeficiency syndrome (AIDS) and 43 human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV)-seronegative controls from Kinshasa, Zaire, were identified and sought for serologic testing for evidence of HTLV-III/LAV infection. Twenty (9.8%) of 204 case-household members and three (1.9%) of 155 control-household members were HTLV-III/LAV seropositive (relative risk = 5.1; 95% confidence interval, 1.7 to 15.2). Eleven (61.1%) of 18 spouses of patients with AIDS were HTLV-III/LAV seropositive, compared with one (3.7%) of 27 control spouses (relative risk = 16.5; 95% confidence interval, 3.7 to 75.0). Except for spouses, the rate of HTLV-III/LAV seropositivity did not differ significantly between case and control households. Furthermore, for adults in case households who were not spouses, the number seropositive for HTLV-III/LAV was identical to that predicted from sex- and age-specific HTLV-III/LAV seroprevalence rates. These data from Zaire confirm the results of US and European studies of household contacts of infected hemophiliacs and pediatric patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1986

The economic impact of the first 10,000 cases of acquired immunodeficiency syndrome in the United States.

Acquired immunodeficiency syndrome (AIDS) is a serious, fatal disease affecting a relatively young population and has a great economic impact. Expenditures for hospitalization and economic losses from disability and premature death were estimated for the first 10,000 patients with AIDS reported in the United States. Extrapolation of data from surveys done in New York City, Philadelphia, and San Francisco suggests that these 10,000 patients with AIDS will require an estimated 1.6 million days in the hospital, resulting in over $1.4 billion in expenditures. Losses incurred for the 8,387 years of work that will be lost from disability and from the premature death of the 10,000 patients will be over $4.8 billion. The total economic burden of the AIDS epidemic will continue to rise as the number of diagnosed cases increases. These estimates reinforce the need for effective disease prevention strategies to reduce the number of cases.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Sex of interviewer, place of interview, and responses of homosexual men to sensitive questions.

Effects of sex of interviewer and place of interview on the responses of 57 AIDS patients and 145 other homosexual men were studied. Data on sensitive topics were collected by five male and three female medical officers at places convenient to respondents. Male physicians recorded fellatio more frequently, but female physicians recorded younger ages of initiating homosexual activities and more frequent use of certain recreational drugs. These differences apparently were due to different patterns of sexual contact and drug use in four cities. Patients with AIDS tended to be interviewed in hospitals and doctors' offices, other men tended to be interviewed in hotel rooms, and patients tended to be different from other men. After adjustments were made for confounding, sex of interviewer and place of interview seemed to have little influence on the answers obtained.

Acquired Immunodeficiency Syndrome↗
PubMed1986

The acquired immunodeficiency syndrome: epidemiology and risk factors for transmission.

The acquired immunodeficiency syndromE (AIDS) is a very serious illness caused by a human T-lymphotropic retrovirus: human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV). It primarily affects young adults living in one of several major metropolitan areas. Most patients are homosexual men, but heterosexual men and women have also been affected. Heterosexual men and women who use intravenous drugs, who are hemophiliacs, or who are sex partners of AIDS patients appear to be at increased risk for developing the disease.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Genomic diversity of the acquired immunodeficiency syndrome retroviruses is reflected in alteration of its translational products.

We have isolated retroviruses from six acquired immunodeficiency syndrome (AIDS) and three lymphadenopathy syndrome (LAS) patients by cocultivation of patients' lymphocytes with phytohemagglutinin-stimulated normal T cells. In an effort to address the extent to which these viruses have identical genetic information or there is divergence in their genomic sequences, we have compared the nine retrovirus isolates by the following criteria: (i) antigenic cross-reactivity by highly specific and sensitive competition radioimmunoassay for the major internal antigen; (ii) restriction site mapping analysis; and (iii) immunoblot analysis and metabolic labeling of viral structural proteins and their analysis by polyacrylamide gel electrophoresis. The data indicate that individual retroviruses have significant restriction site polymorphism in their genome even though they were isolated from patients residing at one geographic location. Furthermore, this polymorphism is reflected in the variation of the apparent size of the gag and env gene-encoded structural proteins. The heterogeneity in AIDS retrovirus-encoded proteins may be due to either substitutions in the primary amino acid sequence of the protein or deletions or additions in the coding regions of proteins. The alterations in viral structural proteins among various AIDS retroviruses could have important implications in antigenic properties and/or pathogenicity in development of the disease, its detection, and ultimately its eradication.

Acquired Immunodeficiency Syndrome↗
PubMed1985

The epidemiology of AIDS: current status and future prospects.

The reported incidence of acquired immune deficiency syndrome (AIDS) continues to increase in countries throughout the world. On the basis of a polynomial model for extrapolation, the cumulative number of cases diagnosed and reported since 1981 in the United States is expected to double during the next year with over 12,000 additional cases projected to be diagnosed by July 1986. The annual incidence rates for single (never-married) men in Manhattan and San Francisco, intravenous drug users in New York City and New Jersey, and persons with hemophilia A ranged from 261 to 350 per 100,000 population during 1984. For single men aged 25 to 44 years in Manhattan and San Francisco, AIDS was the leading cause of premature mortality in 1984 as measured by years of potential life lost. Infection with HTLV-III/LAV is considerably more common than reported AIDS in high-risk populations and can persist at least for several years, so the presence of specific antibody should be considered presumptive evidence of current infection. The screening of donated blood and plasma for antibody to HTLV-III/LAV and use of safer clotting factor concentrates should greatly reduce HTLV-III/LAV transmission through blood and blood products. Most HTLV-III/LAV infections occur through sexual transmission, use of contaminated needles, and as a result of infected mothers passing the virus to newborns. Continued research commitment is needed to develop an HTLV-III/LAV vaccine and therapy for this infection. In the interim, widespread community efforts are needed to minimize transmission.

Acquired Immunodeficiency Syndrome↗