Search PubMed⌕ Search

Biomedical subjects

S J Costa

Publications and source records attributed to S J Costa.

10 recordsLinked to original sources
PubMed2001

Acquired immune deficiency syndrome and the increase in non-Hodgkin lymphoma incidence in New Jersey from 1979 to 1996.

BACKGROUND: In New Jersey, the age-adjusted incidence rate of non-Hodgkin lymphoma (NHL) increased more than a third from 1979 to 1996, the largest increase among the major cancers. METHODS: Data from a linkage of New Jersey's population-based cancer and acquired immune deficiency syndrome (AIDS) registries were used to obtain two sets of annual age specific incidence rates and estimated average annual percentage changes in the incidence rates, for each of five adult age groups within each gender, from Poisson regression models that 1) included all the NHL cases and 2) excluded the cases of AIDS-NHL. RESULTS: During 1979-1996, of the NHL cases aged 15 years and older reported to the cancer registry, 687 (6%) of the 11,725 male cases and 139 (1%) of the 10,785 female cases were AIDS-NHL. The highest percentages of AIDS-NHL were in the younger age groups--15-29, 30-39, and 40-49 years. Among both men and women, average annual percentage increases in NHL occurred overall (3.1 and 3.0, respectively), and in each age group, ranging from 1.6 and 1.9, respectively, in the 50-59 years age group to 6.6 and 4.2, respectively, in the 30-39 years age group (P <<0.01). Excluding AIDS-NHL, the estimated average annual percentage increases in NHL were greatest in the 30-39 and the 60 years and older age groups among men, and these two age groups plus the 15-29 years age group among women, ranging between 2.4 and 2.9 (P < 0.05). CONCLUSIONS: As elsewhere, factors in addition to AIDS are involved in the increasing incidence of NHL in New Jersey. Because diagnostic and classification changes probably do not explain the entire increase unrelated to AIDS, other risk factors are likely responsible. Public health interventions to reduce the incidence of NHL not related to AIDS are problematic until more is known about the causes of NHL.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Cancer in people with AIDS in New Jersey.

A total of 2,460 persons with AIDS (PWA) and cancer were identified--2,159 men and 301 women--among 22,382 men and 7,931 women reported with AIDS from 1979-1995 in New Jersey. Of these, 50% were diagnosed with Kaposi's sarcoma (KS), 33% with non-Hodgkin's lymphoma (NHL), and the remainder with other cancers, including lung and bronchus, oral, cervical, Hodgkin's disease, and digestive other than anal. The proportions of PWA who also had cancer, specifically KS and NHL, varied significantly by gender, race, and mode of HIV transmission. These findings are discussed in terms of risk factors in addition to immunosuppression that may account for the higher rates of cancer among PWA than the general population. Cancer prevention and detection measures likely will become more important as PWA survive longer.

Acquired Immunodeficiency Syndrome↗
PubMed2000

HIV disease surveillance: medicine and public health working together.

Public health surveillance is critical to the management of the HIV epidemic. Surveillance helps to define changing trends, formulate and strategically implement preventive initiatives, and evaluate the effectiveness of interventions. Collaboration between clinical medicine and public health is essential to reliable surveillance.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Risks and recommendations for HIV occupational exposures.

The Public Health Service recently updated its recommendations for chemoprophylaxis after exposure to HIV. These recommendations correlate the use of antiretroviral agents with the risk of infection, which is determined by evaluating the exposure and the potential for transmission from the source patient.

Antiviral Agents↗
PubMed1994

HIV-related deaths from selected infectious diseases among persons without AIDS in New Jersey.

This study sought to quantify HIV-related deaths among persons not classified as having AIDS, in an area where AIDS incidence among injecting drug users (IDUs) is high. Death certificates of persons who were aged 25-44 years at death, died in 1987 in two New Jersey counties, and had certain infectious conditions were compared with names in the AIDS Registry. Hospital and/or Medical Examiner records were reviewed for nonmatching cases. Cases were considered as confirmed HIV infection if there was laboratory evidence of such infection and as suggestive HIV infection if the decedent had oral thrush or a combination of certain other clinical findings were present. Of 412 deaths meeting the above criteria, 165 (40.0%) were in the AIDS Registry. We investigated 205 of the remainder; of these, 7.3% were found to have AIDS, 21.5% had confirmed HIV infection without AIDS, and 15.1% had suggestive HIV infection. This increased the HIV-related mortality in excess of deaths due to AIDS in this age group by 9.2% for confirmed HIV infections and 15.6% for both confirmed and suggestive HIV infections, with deaths among IDUs increasing 12.3% for confirmed HIV infections and 18.9% for both confirmed and suggestive HIV infections. Thus, in addition to AIDS indicator diseases, a variety of other infectious conditions can lead to death in HIV-infected persons, particularly in IDUs; however, the extent of such deaths may be less than previously described.

Adult↗
PubMed1991

Use of surveillance for invasive pneumococcal disease to estimate the size of the immunosuppressed HIV-infected population.

We used population-based surveillance in New Jersey in 1986 to quantify the risk of invasive pneumococcal disease in persons with the acquired immunodeficiency syndrome (AIDS) and in those who went on to develop AIDS. Using pneumococcal surveillance, we also devised a method to estimate the size of the immunosuppressed population infected with the human immunodeficiency virus (HIV), the so-called pre-AIDS population. From rates of pneumococcal disease that occurred in areas with a low incidence of AIDS, we calculated the number of patients expected to contract pneumococcal disease in areas with a high incidence of AIDS. There were 59 more cases of pneumococcal disease observed than expected; 14 of these patients had AIDS by the time of pneumococcal infection. We attributed the remaining 45 cases to the increased risk of pneumococcal infection in pre-AIDS. The pre-AIDS pneumococcal cases and the attack rate of pneumococcal disease in pre-AIDS were used to estimate the size of the 1986 pre-AIDS New Jersey population as 8823 pre-AIDS cases (95% confidence interval, 7377 to 10,714) or 0.37% of the adult New Jersey population. Surveillance for marker diseases may provide a simple, independent method of estimating the pre-AIDS population.

Acquired Immunodeficiency Syndrome↗