AIDS Transmission Research Articles

AIDS: The Challenge to Science and Medicine

A comprehensive review of the AIDS phenomenon in the U.S. as of 1985 is a introducing a series of articles on the topic. It begins with an introduction to the history of AIDS and of the AIDS virus called HTLV for human T-cell lymphotropic virus. The biology of the virus is described noting several of its virulent characteristics such as the fact that it is a retrovirus and thus will be incorporated into cell genes releasing new virus particles for a lifetime; its tendency to mutate and thus be highly difficult to design a vaccine to match; and the poor performance of HTLV antibodies in inactivating the infecting virus. The review goes on to discuss the origin of AIDS and its behavior in African populations. A final section speculates on the risk of transmission of AIDs to heterosexual Americans not belonging to any of the identified high risk groups male homosexuals intravenous drug users or hemophiliacs or their sexual partners. Since the case mortality rate is 100% the only way to block the spread of AIDs is to discover a vaccine or a drug which will slow down the replication of the virus once it enters the body. There are no practical drugs envisioned for these types of treatment except for the natural interferons.

Heterosexual transmission of AIDS

Heterosexual transmission of AIDS

Screening for antibodies to HTLV-III amongst the semen donors of an AID programme.

This study suggests that, at the present time, AID is not likely to be a significant risk factor in the transmission of AIDS in Britain, particularly in centres which are already practising careful screening of semen donors. New facilities which are becoming available for HTLV-III screening should help to provide reassurance that semen donations are free from the virus.

Infection control at home. A guideline for caregivers to follow.

By early 1986, over 16,000 people had been diagnosed with AIDS in the United States. It has been estimated that between 5percent and 15 percent of these are hospitalized at any given time. Of the 80 to 95percent who are living at home, some are experiencing few symptoms and independent in their activities of daily living. However, approximately 20 to 25 percent of those living at homeexperience chronicor acute symptoms associated with AIDS, requiring intervention by the home team. Home care agencies throughout the country have provided services to people with AIDS in the home utilizing basic, standard precautions for infection control. This article will provide information regarding disease transmission, both to allay the anxieties of homecare personnel concerned aboutworking with AIDS patients, and to enable them to utilize appropriate precautions to prevent the transmission of AIDS and the associated opportunistic infections.

New Directions in AIDS Transmission

New Directions in AIDS Transmission

Insect-borne transmission of AIDS

Insect-borne transmission of AIDS

Insect-Borne Transmission of AIDS-Reply

In Reply.— I am pleased that Dr Blaser agrees with me that mosquitoes do not play a significant role in transmitting AIDS in the United States. 1 Some routes of AIDS transmission have been suggested that are clearly not supported by scientific evidence. Our society is depending on physicians to speak out on this subject and related subjects, because there is great fear of AIDS and because many seem willing to adopt nonproductive strategies of control in the name of public health. Although we physicians may be frustrated in our current inability to treat AIDS definitively, we can educate and comfort those whose chief concern is that of theoretical exposure. Dr Blaser suggests that mosquitoes or other vectors may play a role in transmitting HTLV-III/lymphadenopathy-associated virus (LAV) in the tropics. Each of the published references Dr Blaser cites (other than his own letter) either does not mention arthropod transmission or

Female-to-male transmission of AIDS

Female-to-male transmission of AIDS

How should we handle the ethical questions regarding information to donors and patients and the practical implications regarding deferral of donors and handling of donated blood in the event of introducing a screening test for HTLV-III as in order to prevent transmission of AIDS by blood transfusion?

How should we handle the ethical questions regarding information to donors and patients and the practical implications regarding deferral of donors and handling of donated blood in the event of introducing a screening test for HTLV-III as in order to prevent transmission of AIDS by blood transfusion?

Female-to-male transmission of AIDS

Female-to-male transmission of AIDS

Recommended precautions for patients undergoing hemodialysis who have AIDS or non-A, non-B hepatitis.

Precautions used for dialysis patients who have acquired immunodeficiency syndrome or non-A, non-B hepatitis are based on infection control strategies developed for the control of hepatitis B in dialysis centers. Specifically, these recommendations include identifying infected patients; isolating (except for non-A, non-B hepatitis patients) patients, and separating staff, and equipment; applying blood precautions and aseptic techniques; and using good environmental control procedures. AIDS patients can be safely dialyzed by either hemodialysis or peritoneal dialysis in hospital-based or free-standing centers, or at home without risk of AIDS transmission to other patients or to staff members, if precautions that have been developed for the control of hepatitis B infection in dialysis units are employed. Further, the type of dialysis treatment, or modality, should be based on the needs of the patient and not on a fear of risk of disease transmission.

Epidemiology of the sexually transmitted diseases.

We stand on the threshold of a new era for the STDs. The traditional STDs remain serious public health problems, particularly in the developing world, but they pale by comparison with AIDS. We can expect that the number of most STDs will decrease as the "baby boom" generation ages. We may also witness a change in sexual behavior caused in part by the fear of contracting AIDS, genital herpes, and perhaps other STDs. The challenge for the future is to improve control of chlamydial and gonococcal infections to prevent late sequellae such as infertility and ectopic pregnancy; to give greater attention to behavior modification to prevent transmission of AIDS, HSV, and HPV; to improve control of STDs in developing countries; to develop vaccines for the viral STDs, which are most difficult to cure; and to develop a better understanding of the mechanisms by which STD agents interact with each other and their host to cause cancer.

592 IS AIDS TRANSMITTED HORIZONTALLY?

To ascertain whether or not there is a risk of horizontal transmission of AIDS, we studied 24 pediatric household contacts of 9 pediatric AIDS index cases. Immune parameters studied included serum immunoglobulins, T4 and T8 cells, in vitro lymphocyte mitogenic responses to phytohemagglutinin, pokeweed mitogen and staph cowan A. Transient immunologic aberrations were noted in four children from three families. These aberrations included elevated IgG levels, reversed T4/T8 ratios and slightly diminished in vitro lymphocyte mitogenic responses to pokeweed mitogen. In no case could antibodies to the lymphadenopathy virus be documented. Clinically, all household contacts remained healthy over a four year follow-up.

Transmission of AIDS, and blood donors

Medical Journal of AustraliaVolume 142, Issue 3 p. 213-213 AIDS Task Force, December 1984 Bulletin Transmission of AIDS, and blood donors D.G. PENINGTON, D.G. PENINGTON Chairman AIDS Task ForceSearch for more papers by this author D.G. PENINGTON, D.G. PENINGTON Chairman AIDS Task ForceSearch for more papers by this author First published: 01 February 1985 https://doi.org/10.5694/j.1326-5377.1985.tb133108.xCitations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume142, Issue3February 1985Pages 213-213 RelatedInformation

Leads from the MMWR. Hepatitis B vaccine: evidence confirming lack of AIDS transmission

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A surgical oncology perspective on AIDS.

During the summer of 1981 reports of unusual opportunistic infections among male homosexuals first began to appear in the literature and by December 1983, 3000 cases has been reported to the Center for Disease Control in Atlanta, Georgia. Homosexual and bisexual men comprise 71% of the reported cases, while 17% are known intravenous drug users, and the remaining 12% made up of persons with other risk factors. Approximately 80% of AIDS patients with Kaposi's sarcoma have identifiable gastrointestinal lesions. Specific risk factors for Kaposi's sarcoma in AIDS patients have not been exclusively identified, but it is thought that repeated sexual involvement with multiple partners exposes the victim to the immunosuppressive effect of cytomegalovirus and allogenic sperm, which may in turn impair lymphoid cells. The immunological abnormalities associated with AIDS have included striking changes in T-cell ratios, with more profound changes in the Kaposi-AIDS groups. Increases in IgG, decreased antibody production by B-cells to challenge antigen, decreased B-cell proliferative responses to B-cell mitogens, abnormalities in macrophage function, and increased serum thymosin levels have been found. Various opportunistic infections afflict the patient with AIDS. Antimicrobial therapy, various interferons, interleukin-2, and immunomodulation with thymosin have all been used without much success. The distribution and transmission of AIDS parallels hepatitis B virus infection which is transmitted sexually and parenterally. On the whole the same precautions as for hepatitis B should be taken for AIDS. Health care personnel treating patients with AIDS should also wear masks and eye protection against the splatter of body fluids and secretions.(ABSTRACT TRUNCATED AT 250 WORDS)

How Should we Handle the Ethical Questions Regarding Information to Donors and Patients and the Practical Implications Regarding Deferral of Donors and Handling of Donated Blood in the Event of Introducing a Screening Test for HTLV-III as in Order to Prevent Transmission of AIDS by Blood Transfusion?

How Should we Handle the Ethical Questions Regarding Information to Donors and Patients and the Practical Implications Regarding Deferral of Donors and Handling of Donated Blood in the Event of Introducing a Screening Test for HTLV-III as in Order to Prevent Transmission of AIDS by Blood Transfusion?

4 - HLA, Blood Transfusion and the Immune System

The HLA region controls the major antigen system responsible for graft rejection and alloimmunization. More fundamental to the immune response, it controls the individual genetic elements regulating the interactions responsible for cellular immune functions. These HLA genetic determinants operate as permissive signals. When appropriate epitopes are available for presenting antigen to T cells, the effect is to facilitate response. If effector cells are activated, immune response is initiated. If suppressor cells are activated, immune response may be inhibited. Another genetic system separate from HLA presumably contains the genetic information that provides diversity for the T cell antigen receptor. Multiple nongenetic factors may also influence the immune response, among them prior alloimmunization via transfusion or pregnancy, viral infections and potentially a variety of other transfusion-related factors. Exposure to HLA and other tissue antigens has in general no clinical benefits and potential major adverse effects for an immunocompetent patient. Subsequent rejection of grafts of haematopoietic stem cells or of other tissues can result, as well as refractoriness to platelet and granulocyte transfusions. In the setting of profound immune suppression, infusion of viable lymphocytes can result in planned or inadvertent engraftment and a graft versus host reaction. The latter can occur even in the absence of measurable engraftment of haematopoietic cells. The apparent paradoxical effects of blood transfusion in aplastic anaemia, leading to marrow graft rejection, and in renal transplantation, leading to improved graft survival, reflect the lack of knowledge about which factors lead to Ir gene phenomena and which lead to Is gene phenomena. The observation that alloimmunization can result in specific immune suppression raises the exciting prospect of transplantation without the necessity of establishing a general state of immune compromise in the host. Since the effect of alloimmunization from transfusion or other sources is so unpredictable, it is difficult to ascertain whether transfusion is immunosuppressive in healthy individuals. Transfusion-related viral infections can lead to reversible immune compromise; much less is known about the effects of non-viral factors. Of these factors, HLA antigens in unaltered or in soluble form are probably important, but their relation to Ir and Is appears unpredictable. Evidence for transmission of AIDS via blood products has added to concern about transfusion-related immune suppression. Individuals at highest risk for transfusion-transmitted disease have received heavy exposure to multiple donor blood products. They are expected to exhibit the most pronounced non-specific immunological changes as well. If the aetiologic agent(s) responsible for AIDS can be identified, then the prevalence of seropositivity among those high risk patients can be ascertained and immunological effects unrelated to this disease can be identified. The problems in analysing this disease provide a more general caution about transfusion-transmitted infection. It is not clear that these infections need to be clinically overt to cause immunological alterations. An analysis of the immunological effects of HLA antigens or other non-infectious factors must therefore control as much as possible for potential infectious cofactors.

Impact pratique des instructions concernant le SIDA

Following an inquiry to determine what measures has been taken since january 1984 in French Blood Centers to avoid transmission of AIDS by blood, answers from 49 % of the centers, representing 75 % of the blood collection in France were analyzed. Due to the absence of a biological marker, only information given to blood donors, unpaid in France, permitting spontaneous autoexclusion had been used to screen donors in blood center. Direct questioning of donor for risk factors before taking blood raised numerous problems in donors of whole blood, but could be satisfactorily implemented in cytapheresis and plasmapheresis donors mainly because of closer human contact between volunteers and the medical staff.

Syndrome de déficit immunitaire acquis: Mesures à prendre dans les établissements de Transfusion Sanguine afin de protéger les personnels

There is presently no evidence of AIDS transmission to laboratory workers. Because transmissible agent is suspected, precautions should be taken in laboratories. As a general rule, procedures appropriate for hepatitis B prevention are advised. These procedures concern blood collection, carrying, and processing. Measures should be taken in order to avoid blood spilling and work surfaces should be decontaminated. Disposable material should be preferred, and all potentially contaminated material should be decontaminated before disposal or reprocessing. All personnel should be aware of usual laboratory procedures concerning pipetting, hand washing, protective clothing and of general precautions against viral contaminations.