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Biomedical subjects

P Piot

Publications and source records attributed to P Piot.

At least 181 records · Page 10Linked to original sources
PubMed1988

AIDS: an international perspective.

The acquired immunodeficiency syndrome (AIDS) and infection with the human immunodeficiency virus type 1 (HIV-1) constitute a worldwide public health problem. Whereas in Europe and in most of the Americas transmission of HIV-1 has occurred predominantly among homosexual men and intravenous drug abusers, in Africa a distinct epidemiologic pattern has emerged that indicates that HIV-1 infection is mainly heterosexually acquired. Heterosexual transmission appears to be increasing in some parts of Latin America and the Caribbean, and possibly in the United States. In addition to HIV-1, at least one other human retrovirus, namely HIV-2, has been implicated as a cause of AIDS in Africa and Europe. Factors that influence heterosexual transmission of HIV-1 include genital ulcerations, early or late stages of HIV-1 infection in the index case, and possibly oral contraception and immune activation. The rate of perinatal transmission is enhanced when the mother's illness is more advanced. AIDS and HIV-1 infection may have a significant impact not only on public health, but also on the demography and socioeconomic conditions of some developing countries. Programs for the prevention and control of AIDS should be an immediate priority in all countries.

Acquired Immunodeficiency Syndrome↗
PubMed1988

The prevalence of infection with human immunodeficiency virus over a 10-year period in rural Zaire.

In 1985 we tested 659 human serum samples, collected in the remote Equateur province of Zaire in 1976, for antibody to human immunodeficiency virus (HIV). Five (0.8 percent) were positive, and HIV was isolated from one of these. Follow-up investigations in 1985 revealed that three of the five seropositive persons had died of illnesses suggestive of acquired immunodeficiency syndrome (AIDS), and two remained healthy but seropositive. In 1986, a serosurvey we conducted using a cluster-sampling technique in the same region showed a seroprevalence of 0.8 percent in 389 randomly selected residents. The seroprevalence in 283 prostitutes was 11 percent. Patients with AIDS were identified in various hospitals in the province. Risk factors for AIDS included a greater than average number of sexual partners and residence outside the area. We believe that the long-term stability of HIV infection in residents of rural Zaire suggests that social change may have promoted the spread of AIDS in Africa.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Prostitutes: a high risk group for HIV infection?

Female prostitutes are at increased risk for sexually transmitted diseases and HIV infection. However, the prevalence rate of HIV infection among prostitutes varies geographically, with the highest rates occurring in Africa and in areas with large numbers of HIV infected intravenous drug users (IVDU). In Europe the most important risk factors for HIV infection in prostitutes are intravenous drug use and unprotected intercourse with non-paying partners. Whereas in Europe, there is as yet no evidence that female prostitutes are a source of HIV infection for the heterosexual population, they are playing a major role in the spread of HIV in Africa. Education about safe sex practices should be included in prevention programmes aimed at IVDUs. HIV infection should be monitored in prostitutes, and health education on AIDS prevention should be offered to prostitutes and their clients.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Acquired immunodeficiency syndrome and human immunodeficiency virus infection in Bujumbura, Burundi.

In the first seroepidemiological survey in Burundi in 1984, only 59 acquired immunodeficiency syndrome (AIDS) cases were recognized. We report here clinical surveillance of AIDS cases in the 4 hospitals in Bujumbura during a 4-month period in 1986. The project was combined with a seroprevalence study of pregnant women in the 6 dispensaries in Bujumbura. 258 AIDS patients were recorded. 16% of the 925 pregnant women were seropositive for human immunodeficiency virus (HIV). The clinical characteristics of 120 adult AIDS patients were similar to those reported in Kinshasa or Kigali. From demographic findings we presume that the major mode of HIV transmission in Bujumbura is by sexual contact. The results of this study formed the starting point of prevention activities against AIDS in Burundi.

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

Use of an enzyme immunoassay to detect serum IgG antibodies to Haemophilus ducreyi.

An experimental enzyme immunoassay (EIA) for detecting serum IgG antibody to Haemophilus ducreyi was developed using an ultrasonicated whole-cell antigen. The mean optical densities (OD) for sera from men with proven chancroid from Nairobi (47 patients) and Bangkok (72 patients) were significantly higher than those obtained from Nairobi men with genital ulcers not due to H. ducreyi, from Nairobi men with urethritis, from pregnant women in Nairobi, and from European men with sexually transmitted disease. When an OD of 0.500 was taken as the cutoff value, 89% and 55% of men with proven chancroid in Nairobi and Bangkok, respectively, were positive for H. ducreyi antibody, as compared with 2%-17% in the control groups. A rise in OD was observed in five of 18 patients with clinical chancroid. These results confirm the development of circulating antibodies in chancroid and suggest that this EIA may be useful for the diagnosis and epidemiological study of H. ducreyi infection.

Antibodies, Bacterial↗
PubMed1988

Infection and disease after perinatal exposure to Chlamydia trachomatis in Nairobi, Kenya.

A cohort of 49 infants exposed to maternal chlamydial infection and 40 nonexposed infants was studied after birth for a mean of 3.3 +/- 1.5 and 3 +/- 1.7 mo, respectively. Eighteen (37%) exposed infants had at least one positive culture for Chlamydia trachomatis, whereas C. trachomatis was not isolated from any of the nonexposed infants. Eighteen (37%) exposed infants developed ophthalmia neonatorum (n = 12) or infant conjunctivitis (n = 7), compared with six (15%) of the nonexposed infants (P = .04). Six (12%) exposed infants developed pneumonia, compared with none of the 40 nonexposed infants (P = .05). One infant in the exposed group died during follow-up. These results suggest that appreciable infant morbidity in Kenya may be associated with the high prevalence of maternal chlamydial infection.

Chlamydia Infections↗
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

Microbial aetiology and diagnostic criteria of postpartum endometritis in Nairobi, Kenya.

Using a protected triple lumen device, Neisseria gonorrhoeae or Chlamydia trachomatis, or both, were isolated from the endometriums of five out of 35 women with clinical postpartum endometritis compared with none of a control group of 30 puerperal women without endometritis (p less than 0.05) in Nairobi, Kenya. These sexually transmitted agents were also found in 12 cervical specimens from women with and three without postpartum endometritis (p = 0.04). Mycoplasma hominis and Ureaplasma urealyticum were equally isolated from the endometrium in both groups. Histology showed plasma cell infiltration in 6/25 patients compared with 1/22 controls (p = 0.06). A history of foul lochia (p less than 0.01) and abdominal pain (p = 0.02) were associated with postpartum endometritis. Sexually transmitted agents appear to be major causes of puerperal upper genital tract infections in Nairobi.

Adult↗
PubMed1988

Serodiagnosis of the acquired immune deficiency syndrome by enzyme-linked immunosorbent assay compared to cellular immunologic parameters in African AIDS patients and controls.

The sensitivity and specificity of an enzyme-linked immunosorbent assay (ELISA), absolute numbers of T-helper cells, and T-helper: T-suppressor cell ratios were compared in asymptomatic controls and IgG Western blot-confirmed patients with the acquired immune deficiency syndrome (AIDS) in Kinshasa, Zaire, between August 1984 and May 1985. Two hundred sixteen (97.7%) of 221 IgG Western blot-positive AIDS patients and 4 of 97 (4%) controls were ELISA-positive, 3 of whom were Western blot-positive. The sensitivity and specificity of the ELISA was 97.7% and 99.0%, respectively, compared to Western blot results. Detection of the human immune deficiency virus using absolute number of T-helper cells (less than 400 cells/mm3) was as sensitive (98.2%), but less specific (90.7%). A T-helper: T-suppressor ratio of less than 0.9, had a sensitivity of 97.3%, and specificity of 94.8%. The ELISA test had the highest predictive value and greatest utility in an African clinical setting for detecting HIV infected patients where a wide range of other immunocompromising diseases are seen.

AIDS Serodiagnosis↗