[The prevention of AIDS].
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Biomedical subjects
Publications and source records attributed to M Leal.
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Infection with human retroviruses other than HIV in Spain has only been reported in isolated cases in African immigrants and intravenous drug abusers infected with HTLV-I. The status of the prostitute population is unknown. The sera of 88 prostitutes in Seville were therefore tested for HIV, HTLV-I and HTLV-II, and relevant epidemiological data were collected on the health status, sexual practices etc. In the prostitute population studied 2.5% of the non-intravenous drug abusers and 20% of the intravenous drug abusers were positive for HIV. However, infection with HTLV-I/II could not be demonstrated in any of them.
1. Plasma drug concentrations after a single oral administration of a suspension of carbamazepine (CBZ) and a 20/200 CBZ Oros osmotic pump system were measured in eight healthy male volunteers. The oral suspension contained 100 mg CBZ labelled with the stable isotope nitrogen-15, whilst the Oros contained 200 mg unlabelled CBZ. Plasma concentrations of [15N]-CBZ and CBZ were measured simultaneously by gas chromatography-mass spectrometry. 2. The position of the CBZ Oros (labelled with indium-111) in the gastrointestinal tract was followed by gamma scintigraphy. Plasma drug concentrations after the two treatments were used to relate pharmacokinetic with transit data. 3. The Oros was taken after breakfast and gastric emptying occurred between 1.1- greater than h post-dosing (median, 5.3 h). Small intestinal transit times ranged from 1.5- greater than 3.6 h, with a median of 2.2 h. There were wide individual variations in colonic transit, and the total transit time ranged from 10-60 h (median, 22 h). 4. Relative systemic bioavailability of CBZ from the Oros was reduced compared with that from the suspension (mean dose normalised AUC ratio = 0.69 +/- 0.17; mean dose-normalised AUC ratio = 0.85 +/- 0.13, allowing for actual release from the Oros system). 5. The in vivo absorption of drug into the systemic circulation from the Oros was estimated using the Wagner-Nelson method. This showed that absorption of CBZ was rapid when the Oros was present in the stomach and small intestine, the rate being determined by the release of drug from the system.(ABSTRACT TRUNCATED AT 250 WORDS)
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The aim of the present study was to identify the most useful serum markers for the early identification of the infection by the human immunodeficiency virus (HIV). To this end, sequential serum samples of 19 individuals who later had seroconversion to anti-HIV were evaluated. The p24 antigen (Ag-HIV) was the earliest marker of the infection, although it could only be detected in five of the 19 individuals: in two as an isolated marker and in the remaining four associated to anti-HIV (first generation Western blot: WB-1, and recombinant enzyme immunoanalysis: EIA-2G). In 12 of the 19 individuals, WB-1G (Pasteur) was the technique which permitted the earliest detection of anti-HIV: in five cases with bands which made the unequivocal diagnosis of the infection, and in seven with indeterminate results (anti-HIV against core or envelope antigens). The second earliest test was the detection of anti-HIV against envelope antigens with a competitive EIA-2G (Abbott). WB-1G (Sorin) detected anti-HIV in a late phase, as it was the case for EIA-1G or EIA-2G for anti-HIV against antigens encoded by the GAG gene. These results indicate that there may be remarkable differences in sensitivity among the different commercial kits. The use of EIA for Ag-HIV together with WB-1G shortens the gap period of HIV infection, even if seroconversion is identified with EIA-2G for global anti-HIV.
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As there is insufficient data available on the spread of hepatitis C virus (HCV) infection by sexual transmission, the prevalence of anti-HCV was determined in several sexually promiscuous groups (78 female prostitutes, 55 clients of prostitutes and 146 homosexual men) who denied intravenous drug abuse. The overall HCV infection rate was much higher in the sexually promiscuous groups (8.97%, 16.36% and 5.48% respectively) than in voluntary blood donors (0.48%), suggesting that HCV infection can be transmitted by sexual intercourse. Consequently, promiscuity may be a risk factor for this infection.
The relationship between fetal exposure and cardiovascular functional effects in the caffeine-treated pregnant rat was investigated. Caffeine (100 mg/kg) was administered intravenously to dams on day 21 of gestation. The transplacental transport of caffeine was studied by obtaining maternal and fetal blood (umbilical vein) samples at designated times after drug administration. Concurrent maternal-fetal electrocardiograms (ECGs) were measured and evaluated for caffeine-induced changes. Maternal and fetal plasma caffeine levels as well as area under the curve values were proportionally related throughout the experiment, indicative of equal exposure to caffeine. The fetal ECG exhibited more extensive changes associated with caffeine than did the dam's, but the effects were not detected in the first 30 min, suggesting a lag period for the action of caffeine on the fetal heart. The frequency of fetal ectopic beats and abnormal T waves were directly related to fetal plasma caffeine levels. Fetal ECG combined with the fetal blood microsampling technique was a practical method of testing for prefunctional effects of caffeine in the rat fetus.
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Nine hundred and fifty seven individuals from El Limon (Aragua State, Venezuela) were studied, in order to get information on their hematologic, immunologic and biochemical characteristics. The majority of surnames were of Spanish origin although there were also from other European nationalities. No surname from Venezuelan Indians was found. The pathologic hemoglobin variants (Hb S, Hb C and Hb D-Punjab) have a frequency of 4.3%. Eight albumin variants were detected. The hematologic values suggest a high frequency of iron deficiency. Positivity for hepatitis virus B was found in 0.9% of the population. The carriers and patients for hemoglobin variants per generation was calculated for the whole municipality (5062 and 26, respectively). The African component of the population was estimated in around 18%.
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In a cohort of 30 randomly selected hemophiliacs who were prospectively controlled for four years the predictive value of AIDS development was evaluated for serum markers of HIV infection and for lymphocytic subpopulations in peripheral blood. The patients were evaluated with a mean of 15.79 +/- 5.74 months, and overall antibodies, specific antibodies (anti-ENV and anti-p24), HIV antigen (Ag HIV) and lymphocyte subpopulations were determined. 50% of the hemophiliacs with positive serum Ag HIV (2/4) developed AIDS during the study, whereas this progression was not recorded in any anti-HIV positive, nonantigenic patient. The presence of Ag-HIV was detected at least two years before the diagnosis in these patients, and it was associated with the absence of anti-p24 in one or more determinations. The immune regulation parameters were not significantly different, at the beginning of the study, in the hemophiliacs who developed AIDS and in those who did not. However, the progression to AIDS was associated with a significantly smaller T4/T8 ratio at least one year before the diagnosis. Our results show that the development of AIDS in hemophiliacs is associated both with the presence of Ag-HIV in the serum and a reduction in the T4/T8 ratio, although the detection of the former appears to be earlier than that of the latter in this risk group.
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In a prospective study of 37 individuals in Spain who did not have AIDS or AIDS-related complex but were positive for antibody to HIV, 164 sequentially taken serum samples were tested for the presence of the p24 antigen of HIV. Six of the subjects were antigenemic at entry to the study and five of the remaining 31 subjects seroconverted for HIV antigen during follow-up. Six (55%) of the 11 antigenemic patients but none of those without antigenemia developed AIDS. The interval from the time of first detection of HIV antigen to the diagnosis of AIDS varied greatly. The results confirm that individuals with HIV antigenemia run a significantly higher risk of developing AIDS.
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