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Biomedical subjects

J W Curran

Publications and source records attributed to J W Curran.

At least 73 records · Page 4Linked to original sources
PubMed1985

Infection with HTLV-III/LAV and transfusion-associated acquired immunodeficiency syndrome. Serologic evidence of an association.

We studied patients with transfusion-associated acquired immunodeficiency syndrome (AIDS) and their blood donors for serologic evidence of infection with human T-cell lymphotropic virus type III/lymphadenopathy-associated virus with two enzyme-linked immunosorbent assays and a Western blot assay. All 19 patients with AIDS were seropositive by at least one test. In all 28 donor sets containing "high-risk" donors, at least one donor was seropositive by one or more tests. Of 255 donors not considered high risk, two (0.8%) were seropositive by all three tests. When 30 seropositive high-risk donors were evaluated a median of 29 months after donation, four (13%) had developed AIDS and eight (27%) had lymphadenopathy. Our findings support the hypothesis that human T-cell lymphotropic virus type III/lymphadenopathy-associated virus causes AIDS and indicate that seropositive high-risk donors may be at relatively high risk for developing AIDS or related conditions themselves.

Acquired Immunodeficiency Syndrome↗
PubMed1985

The incidence rate of acquired immunodeficiency syndrome in selected populations.

Population figures were obtained, and incidence rates of acquired immunodeficiency syndrome (AIDS) for the 12 months from June 1, 1983, to May 31, 1984, were estimated for single (never-married) men aged 15 years or older, intravenous (IV) drug users, Haitians living in the United States, persons with hemophilia A and B, female sexual contacts of male IV drug users, and blood transfusion recipients. Single men in San Francisco and Manhattan, IV drug users in New York City and New Jersey, hemophilia A patients, and recent Haitian entrants had the highest rates of disease (82.0 to 268.9 per 100,000). Male IV drug users and male Haitians were two to four times as likely to experience development of AIDS as were females in each group. Persons with hemophilia A had six times the incidence rate of AIDS as did those with hemophilia B. Persons with severe hemophilia A had three times the rate of those with moderate and seven times the rate of those with mild clotting factor deficiency. Although blood transfusion recipients and female sexual contacts of male IV drug users had much lower average yearly rates than did persons in the four other groups (0.4 to 9.4 per 100,000), they still had a higher incidence rate of AIDS than did persons not belonging to any of these groups (0.1 per 100,000).

Acquired Immunodeficiency Syndrome↗
PubMed1985

Acquired immunodeficiency syndrome among patients attending hemophilia treatment centers and mortality experience of hemophiliacs in the United States.

The acquired immunodeficiency syndrome (AIDS) was first recognized among hemophiliacs in 1982. The authors have conducted investigations to determine the onset and incidence of AIDS among hemophiliacs and to determine trends in hemophilia mortality since the introduction of clotting-factor concentrates in the late 1960s. A survey of United States hemophilia treatment centers, supported by the Centers for Disease Control and the National Hemophilia Foundation, defined a population of hemophiliacs which was monitored for AIDS cases through June 1984. Death reports from the United States Vital Statistics System and from the hemophilia treatment center survey provided mortality trends for 1968-1979 and for 1978-1982, respectively. The results of these investigations demonstrate the following points. 1) The AIDS epidemic is a new and important cause of illness and mortality among hemophiliacs, although a very low incidence of AIDS among hemophiliacs prior to 1982 cannot be ruled out. 2) The AIDS cases who attended the surveyed hemophilia treatment centers were distributed throughout the United States and were older than hemophilia treatment center patients without AIDS. AIDS cases also used more lyophilized clotting-factor concentrate, but only a small number of cases were reported with this information. 3) Improved care for hemophilia, including the use of clotting-factor concentrates, dramatically reduced hemophilia mortality rates during the 1970s. 4) In 1982, hemorrhage was the major cause of death among hemophiliacs. Deaths from non-alcoholic liver disease were also increased. AIDS incidence among hemophilia treatment center attendees was stable at 0.6 cases per 1,000 hemophilia treatment center attendees per year during 1982 and 1983 but increased sharply to 5.4 cases per 1,000 during the first quarter of 1984.

Acquired Immunodeficiency Syndrome↗
PubMed1985

The acquired immunodeficiency syndrome in a cohort of homosexual men. A six-year follow-up study.

A cohort of 6875 homosexual men, initially seen at the San Francisco City Clinic between 1978 and 1980, were studied to determine the incidence and prevalence of the acquired immunodeficiency syndrome, related conditions, and infection with the human T-lymphotropic virus, type III/lymphadenopathy-associated virus (HTLV-III/LAV). By December 1984, 2.4% of the men had the syndrome; mortality attributable to the syndrome in 1984 was 600/100 000. For each man with the syndrome in a representative sample of 474 cohort members seen in 1984, 7.5 men had generalized lymphadenopathy, 1.1 had other prodromal findings, and 0.8 had hematologic abnormalities. Prevalence of serum antibodies to HTLV-III/LAV, measured by an enzyme-linked immunosorbent assay, increased from 4.5% in 1978 to 67.4% in 1984. Of 31 persons who were seropositive and without the syndrome between 1978 and 1980, 2 developed the syndrome and 8 developed related conditions during a median follow-up of 61 months. Over a 6-year period, two thirds of cohort members were infected with HTLV-III/LAV and almost one third developed related conditions.

Acquired Immunodeficiency Syndrome↗
PubMed1985

The epidemiology and prevention of the acquired immunodeficiency syndrome.

The incidence of the acquired immunodeficiency syndrome (AIDS) has continued to increase worldwide. From June 1981 to September 1985, 12 932 cases have been diagnosed and reported in the United States; this number is expected to double during the next year. The incubation period is long and few persons infected with human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) have AIDS diagnosed within 2 to 5 years of infection. The widespread use of HTLV-III/LAV serologic tests to screen donated blood and plasma, the continued deferral of donors from groups with an increased incidence of AIDS, and the use of heat-treated clotting factor concentrates should help prevent HTLV-III/LAV transmission through blood and blood products. Preventing transmission among sexual partners, among intravenous drug users, and from infected mothers to newborns will continue to be difficult without a vaccine, specific antiviral therapy, or both. Risk reduction strategies should involve community groups to provide accurate information and influence behaviors that lead to transmission of the virus.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Epidemiological trends of AIDS in the United States.

The incidence of acquired immunodeficiency syndrome (AIDS) in the United States has increased rapidly since the first reports in 1981. Highest estimated rates are among single (never-married) men in Manhattan and San Francisco, men and women who have abused drugs intravenously, and persons with hemophilia. Serosurveys among populations at increased risk for AIDS have demonstrated a high prevalence of antibody to human T-cell leukemia virus III-lymphadenopathy-associated virus (HTLV-III/LAV), the virus which causes AIDS. The discovery of the virus and the widespread availability of serological tests greatly increase the ability to understand AIDS and to study the natural history of HTLV-III/LAV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Transfusion-associated AIDS: serologic evidence of human T-cell leukemia virus infection of donors.

An assay for antibodies to membrane antigens of cells infected by human T-cell leukemia virus was used to examine serum from persons who donated blood to 12 patients with acquired immunodeficiency syndrome (AIDS) associated with blood transfusions. The occurrence of positive results in the assay was significantly greater among donors to the AIDS patients (9 of 117; 7.7 percent) than among random donors (1 of 298; 0.3 percent). Of 12 sets of donors examined, 9 sets included a donor whose serum gave positive results for the presence of the antibodies. In six of these nine sets, the seropositive donor was an individual who was also identified as a possible source of AIDS transmission when epidemiologic and immunologic criteria were used.

Acquired Immunodeficiency Syndrome↗
PubMed1984

The syndrome of unexplained generalized lymphadenopathy in young men in New York City. Is it related to the acquired immune deficiency syndrome?

To establish whether the syndrome of unexplained generalized lymphadenopathy in homosexual men was new and related epidemiologically to the acquired immune deficiency syndrome (AIDS), we reviewed 3,139 pathology reports of lymph node biopsies performed at seven hospitals in New York City during the years 1977 through 1981. Three hundred twenty-nine patients (10%) were categorized as having unexplained lymph node hyperplasia; a detailed medical record review of 30% of these patients revealed three, two, six, eight, and 16 cases of unexplained generalized lymphadenopathy in the five years studied, respectively. Of these 35 cases, 26 (74%) occurred in males aged 16 to 44. A record review of 68 additional male patients aged 16 to 44 years with unexplained lymph node hyperplasia in two of the hospitals showed a similar increase in cases of unexplained generalized lymphadenopathy during the five-year period. Twenty-one of 25 cases in males with known sexual orientation were homosexual or bisexual. The increase in the syndrome of unexplained generalized lymphadenopathy from 1978 to 1981 and the characteristics of the population affected are similar to those observed for AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Acquired immunodeficiency syndrome (AIDS) associated with transfusions.

Of 2157 patients with the acquired immunodeficiency syndrome (AIDS) whose cases were reported to the Centers for Disease Control by August 22, 1983, 64 (3 per cent) with AIDS and Pneumocystis carinii pneumonia had no recognized risk factors for AIDS. Eighteen of these (28 per cent) had received blood components within five years before the onset of illness. These patients with transfusion-associated AIDS were more likely to be white (P = 0.00008) and older (P = 0.0013) than other patients with no known risk factors. They had received blood 15 to 57 months (median, 27.5) before the diagnosis of AIDS, from 2 to 48 donors (median, 14). At least one high-risk donor was identified by interview or T-cell-subset analysis in each of the seven cases in which investigation of the donors was complete; five of the six high-risk donors identified during interview also had low T-cell helper/suppressor ratios, and four had generalized lymphadenopathy according to history or examination. These findings strengthen the evidence that AIDS may be transmitted in blood.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Cluster of cases of the acquired immune deficiency syndrome. Patients linked by sexual contact.

The possibility that homosexual men with the acquired immune deficiency syndrome (AIDS) had been sexual partners of each other was studied. Of the first 19 homosexual male AIDS patients reported from southern California, names of sexual partners were obtained for 13. Nine of the 13 patients had sexual contact with one or more AIDS patients within five years of the onset of symptoms. Four of the patients from southern California had contact with a non-Californian AIDS patient, who was also the sexual partner of four AIDS patients from New York City. Ultimately, 40 patients in 10 cities were linked by sexual contact. On the basis of six pairs of patients, a mean latency period of 10.5 months (range seven to 14 months) is estimated between sexual contact and symptom onset. The finding of a cluster of AIDS patients linked by sexual contact is consistent with the hypothesis that AIDS is caused by an infectious agent.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Acquired immune deficiency syndrome (AIDS) trends in the United States, 1978-1982.

This report summarizes results of surveillance for the acquired immune deficiency syndrome (AIDS) in the United States by the Centers for Disease Control through the first quarter of 1983. Surveillance has been predominantly passive, supplemented by active follow-up of requests to the Centers for Disease Control for pentamidine isethionate for treatment of Pneumocystis carinii pneumonia. The 1,299 reported cases showed trends of increasing incidence among all risk groups: homosexual men (72 percent), intravenous drug abusers (17 percent), persons of Haitian origin (5 percent), persons with hemophilia (1 percent), and others (6 percent). Cases were reported among residents of 35 states and the District of Columbia, with the majority from New York (49 percent) and California (22 percent). Of the 6 percent of patients without well-established risk factors for AIDS, many have suspected risk factors (e.g., blood transfusion or a sexual partner in a high-risk group).

Acquired Immunodeficiency Syndrome↗
PubMed1984

Heterosexual and homosexual patients with the acquired immunodeficiency syndrome. A comparison of surveillance, interview, and laboratory data.

Homosexual and heterosexual patients with the acquired immunodeficiency syndrome were compared by risk group. Race; diagnoses; history of sexually transmitted diseases, sexual behavior, and drug use; and socioeconomic indicators differed considerably among risk groups, suggesting different risk factors for acquisition of the syndrome. Patients in the homosexual, intravenous drug user, and Haitian risk groups differed in their serologic response to cytomegalovirus and syphilis testing, presumably due to lifestyle-related exposures. Differences in the rate of recovery of cytomegalovirus, serum levels of IgA and IgG, and antibody titers to Epstein-Barr virus were noted among patients with different diagnoses. We conclude that in studies of risk factors for the acquired immunodeficiency syndrome, patients should be analyzed by risk group and diagnoses.

Acquired Immunodeficiency Syndrome↗
PubMed1984

The acquired immunodeficiency syndrome in patients with hemophilia.

Since mid-1981 the Centers for Disease Control (CDC) has received reports of more than 1900 cases of the acquired immunodeficiency syndrome. These cases had either Kaposi's sarcoma confirmed by biopsy or a life-threatening opportunistic infection confirmed by biopsy or culture. In January 1982 a hemophiliac with Pneumocystis carinii pneumonia was reported to the CDC, and by July 1982 two other hemophiliacs had developed P. carinii pneumonia. During the next 12 months a total of 22 confirmed cases of the acquired immunodeficiency syndrome occurred in hemophiliacs, 17 in the United States and 5 outside the United States. We report the nature of the epidemic of the acquired immunodeficiency syndrome in hemophiliacs and summarize pertinent clinical aspects.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Acquired immunodeficiency syndrome in the United States: an analysis of cases outside high-incidence groups.

From 1 June 1981 through 31 January 1984, 201 cases of the acquired immunodeficiency syndrome were reported involving persons who could not be classified into a group identified to be at increased risk for this syndrome. Thirty-five had received transfusions of single-donor blood components in the 5 years preceding diagnosis of the syndrome and 30 were sexual partners of persons belonging to a high-risk group. Information was incomplete for most remaining patients, but because many of these patients were demographically similar to populations recognized to be at increased risk for the syndrome, previously identified risk factors may have been present but not reported for some of them. Additionally, a few persons who met the case definition for the syndrome probably had other reasons for their opportunistic disease and did not have the acquired immunodeficiency syndrome. The slow emergence of the acquired immunodeficiency syndrome in new populations is consistent with transmission mediated through sexual contact or parenteral exposure to blood.

Acquired Immunodeficiency Syndrome↗