Cases Of Acquired Immune Deficiency Syndrome Research Articles

PENGETAHUAN MAHASISWA UNIVERSITAS JEMBER TENTANG HIV/AIDS

Human Immunodeficiency Virus (HIV) is the cause of Acquired Immune Deficiency Syndrome (AIDS). In Indonesia, the number of people infected with HIV reaches 50,282 while the number of people with AIDS is 7,036. East Java is the province with the highest number of HIV infection cases in Indonesia, while AIDS is in the third position. Jember Regency is the fifth largest district/city reporting AIDS cases in East Java Province. Knowledge is closely related to attitude. Good knowledge will affect a positive attitude, and vice versa. Stigma can be formed because there is no knowledge about how HIV/AIDS is transmitted. Ignorance causes fear so that an attitude of rejection is formed towards People Living with HIV/AIDS (PLWHA). This study aims to determine the knowledge of students at the University of Jember towards HIV/AIDS. This research was conducted in 2021 with a cross-sectional research design. Data was collected online based on a questionnaire adapted from Shokoohi et al. (2016). There were 378 students involved in the study. There were 24 questions about HIV/AIDS. The level of knowledge was divided into 3: low (correct score ≤ 12), medium (correct score 13-18) and high (correct score ≥ 19). A total of 80.2% of students have a high level of knowledge. Most of the respondents knew the main routes of HIV transmission and answered correctly about the prevention, diagnosis and treatment of HIV/AIDS. It is necessary to conduct a follow-up reseach in a broader population.

A comparative study on the prediction of the BP artificial neural network model and the ARIMA model in the incidence of AIDS

BackgroundAs a kind of widely distributed disease in China, acquired immune deficiency syndrome (AIDS) has been quickly growing each year, become a serious problem and caused serious damage to the life and health of people and the social events of China and the world because of its high fatality rate. It has been much concerned by all aspects of society. Therefore, developing early warning technology and finding the trend of early development are of quite significance to prevent and control human immunodeficiency virus (HIV)/AIDS. This study aimed to explore a suitable model for the morbidity of AIDS in China and establish a professional and feasible disease prediction model for the prevention and control works of AIDS.MethodsAt present, the traditional linear model is still utilized by most scholars to predict the incidence of HIV/AIDS. In addition, some scholars may attempt to use the nonlinear prediction model. Both prediction models showed good fitting and prediction effects. In China, the incidence of AIDS presents linear and nonlinear characteristics. In this research, the nonlinear back propagation artificial neural network (BP-ANN) model and the typical auto-regressive integrated moving average (ARIMA) linear model were applied to predict the incidence of HIV/AIDS and compare their fitting effects.ResultsBoth models were capable of predicting the expected cases of AIDS. It was seen that ARIMA and BP-ANN models could be used to forecast the monthly incidence of HIV/AIDS, but the fitting and forecasting effects of the nonlinear BP neural network model were better than those of the traditional linear ARIMA model.ConclusionsIn summary, it was further concluded that the BP-ANN model was a suitable way to monitor and predict the change trend and morbidity of AIDS in China.

Estimation of the Number of HIV Infections and Time to Diagnosis in the Korea.

BackgroundStatistical data of undiagnosed people living with human immunodeficiency virus (PLHIV) are of great importance to human immunodeficiency virus (HIV) infection control. This study estimated the total number of PLHIV using nationwide claims data.MethodsThis study used data of the incident HIV cases identified by the National Health Insurance System between 2009 and 2015. The number of patients with acquired immune deficiency syndrome (AIDS) was identified by diagnoses or prescription records. The estimated number of PLHIV and the time to diagnosis were calculated from the incident numbers of HIV and AIDS cases using the HIV Modeling Tool of the European Center for Disease Prevention and Control.ResultsBetween 2009 and 2015, a total of 7,033 PLHIV and 2,899 AIDS patients were diagnosed. In 2009, the number of incident HIV cases was 873 (460 AIDS patients), increasing to 995 (337 AIDS patients) in 2015. Besides, the estimated number of prevalent cases was 10,753 in 2009, compared to 14,880 in 2015. Patients visiting health facilities accounted for 42.9% (4,616/10,753) in 2009 and 64.1% (9,544/14,880) in 2015. In 2009, there were 8,363 (77.8%) undiagnosed HIV cases, experiencing a decline to 6,215 (41.8%) in 2015. It took a mean of 6.96 years to diagnose after HIV infection.ConclusionThis study estimates the total burden of HIV infection in Korea for the first time using an internationally recognized HIV modeling tool. Claims data can be used to estimate the number of undiagnosed cases by identifying the total number of PLHIV and AIDS patients visiting health facilities.

Impact of ART-induced viral suppression on the HIV epidemic in Italy.

The present study aims to clarify the role of the fraction of patients under antiretroviral therapy (ART) achieving viral suppression (VS) (i.e. having plasma viral load below the detectability threshold) on the human immunodeficiency virus (HIV) epidemic in Italy. Based on the hypothesis that VS makes the virus untransmittable, we extend a previous model and we develop a time-varying ordinary differential equation model with immigration and treatment, where the naive and non-naive populations of infected are distinguished, and different compartments account for treated subjects virally suppressed and not suppressed. Moreover, naive and non-naive individuals with acquired immune deficiency syndrome (AIDS) are considered separately. Clinical data stored in the nationwide database Antiviral Response Cohort Analysis are used to reconstruct the history of the fraction of virally suppressed patients since highly active ART introduction, as well as to assess some model parameters. Other parameters are set according to the literature and the final model calibration is obtained by fitting epidemic data over the years 2003-2015. Predictions on the evolution of the HIV epidemic up to the end of 2035 are made assuming different future trends of the fraction of virally suppressed patients and different eligibility criteria for treatment. Increasing the VS fraction is found to reduce the incidence, the new cases of AIDS and the deaths from AIDS per year, especially in combination with early ART initiation. The asymptotic properties of a time-invariant formulation of the model are studied, and the existence and global asymptotic stability of a unique positive equilibrium are proved.

The Effect of Counseling on Knowledge, Attitude, and Practice of Conducting HIV/AIDS Examination among Commercial Sex Workers

Background: HIV (Human Immune-deficiency virus) is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). AIDS is a symptom of diminished capacity defense caused by immune deficiency caused by HIV. In Central Java, Indonesia, the prevalence of HIV/AIDS cases is high enough in 2014 ( more than 500 HIV cases and 400 AIDS cases where the second most abundant group is found in Banyumas Regency due to the availability of prostitution complex in this area. Objective: The study aimed to determine the effect of education on knowledge, attitude, and practice of commercial sex workers to conduct HIV / AIDS test. Methods: This is a quasi-experimental research design using one group pretest and posttest. The population and the sample were 92 respondents applying total sampling using a questionnaire and checklist. Data were analyzed using Wilcoxon and Nemar test. Results: There are differences in knowledge, attitudes, and practices among commercial sex workers to conduct HIV / AIDS test before and after counseling. Conclusion: Counseling is essential to be provided to the prostitutes in the order they know if they have HIV/AIDS that they take preemptive action before the disease spread further. Keywords: HIV/AIDS, counseling, knowledge, attitudes, practices, prostitutes.

A Markov Chain Monte Carlo Approach to Estimate AIDS after HIV Infection.

The spread of human immunodeficiency virus (HIV) infection and the resulting acquired immune deficiency syndrome (AIDS) is a major health concern in many parts of the world, and mathematical models are commonly applied to understand the spread of the HIV epidemic. To understand the spread of HIV and AIDS cases and their parameters in a given population, it is necessary to develop a theoretical framework that takes into account realistic factors. The current study used this framework to assess the interaction between individuals who developed AIDS after HIV infection and individuals who did not develop AIDS after HIV infection (pre-AIDS). We first investigated how probabilistic parameters affect the model in terms of the HIV and AIDS population over a period of time. We observed that there is a critical threshold parameter, R 0, which determines the behavior of the model. If R 0 ≤ 1, there is a unique disease-free equilibrium; if R 0 < 1, the disease dies out; and if R 0 > 1, the disease-free equilibrium is unstable. We also show how a Markov chain Monte Carlo (MCMC) approach could be used as a supplement to forecast the numbers of reported HIV and AIDS cases. An approach using a Monte Carlo analysis is illustrated to understand the impact of model-based predictions in light of uncertain parameters on the spread of HIV. Finally, to examine this framework and demonstrate how it works, a case study was performed of reported HIV and AIDS cases from an annual data set in Malaysia, and then we compared how these approaches complement each other. We conclude that HIV disease in Malaysia shows epidemic behavior, especially in the context of understanding and predicting emerging cases of HIV and AIDS.

The AIDS epidemic in south Florida: black non-Hispanics in our communities remain increasingly vulnerable

We compared demographic variables of individuals in Miami-Dade County, Florida, USA, with Acquired Immune Deficiency Syndrome (AIDS) during two time periods (1993 - 1995 and 2009 - 2011). Incidence and mortality-related data were explored in this observational study. Tests of significance were performed to identify differences or associations between selected groups. A correlation analysis was conducted to identify relationships between AIDS diagnosis and socioeconomic indicators. We observed a reduction in the number of new AIDS cases reported and AIDS-related mortality. Nonetheless, AIDS is still disproportionately affecting the black non-Hispanic population. Black non-Hispanic women remain particularly vulnerable to the disease. A positive correlation between AIDS diagnosis and poverty rate and the lack of health insurance, and a negative correlation between AIDS diagnosis and education level were identified. Though the actual number of AIDS cases is declining in this region, it continues to disproportionately affect the poorer, less well educated communities. Despite the availability of improved medication, people in these communities remain particularly vulnerable.

AIDS patients with tuberculosis: characteristics and trend of cases reported to the National AIDS Registry in Italy--1993-2010

The co-infection of tuberculosis (TB) and human immunodeficiency virus (HIV) continue to be a severe problem in the European region. We estimated the extent of this phenomenon in Italy, describing and analysing the characteristics of persons with acquired immune deficiency syndrome (AIDS) and TB reported to the National AIDS Registry. We analysed the cases of TB reported to the National AIDS Registry in Italy since 1993, the year in which TB was introduced as an AIDS-defining disease. From 1993 to 2010, 45,403 cases of AIDS were reported; among these, 4075 (8.9%) had TB (any location). Since 1993, there has been a progressive increase in the proportion of persons with TB, from 6.8% in 1993 to 11.0% in 2010. Men accounted for 76.3%; the median age at diagnosis was 35 years (interquartile range: 31-42 years), and 34.1% were non-nationals. Compared with AIDS cases without TB, AIDS cases with TB were significantly associated with young age (≤33 years), being non-Italian, having heterosexual contacts, living in the south of Italy, being a late tester and being alive at the time of data analysis. The proportion of non-nationals increased from 10.8% in 1993 to 64.6% in 2010. The incidence of AIDS and TB among non-nationals for the whole study period was 2.97 cases per 100,000 non-nationals, compared with 0.11 cases per 100,000 Italians. These data suggest that the occurrence of TB among persons with AIDS is also increasing in Italy, with an increasing proportion of non-nationals, and emphasize the need to undergo HIV screening for all persons diagnosed with TB.

Lack of Response in Severe Pneumocystis Pneumonia to Combined Caspofungin and Clindamycin Treatment: a Case Report

Pneumocystis pneumonia (PCP) is among the most common opportunistic infections in patients with acquired immune deficiency syndrome (AIDS). Although trimethoprim-sulfamethoxazole (TMP-SMX) is the first line therapy for that condition given its efficacy, approximately one third of patients experienced dose-limiting toxicity. For cases of severe to moderate PCP, if TMP-SMX treatment fails or is contraindicated, primaquine combined with clindamycin or intravenous pentamidine is recommended as second line therapy. However, both primaquine and pentamidine are associated with severe adverse reactions and often unavailable at hospitals in China.As a result, other treatment options have been explored. Caspofungin, an echinocandin, has broad antifungal activity against a wide range of fungi including Candida and Aspergillus species. Cases of PCP patients treated with caspofungin have been reported, although conflicting conclusions have been arrived at. In addition, the use of caspofungin and clindamycin as the first line therapy for severe PCP in AIDS patients has not been reported yet. This article described an AIDS case with severe PCP, treated with the combination of caspofungin and clindamycin.

AIDS: otolaryngological presentation in the high-risk male homosexual

Since the Acquired Immune Deficiency Syndrome (AIDS) was first recognized in 1981 it has become a subject of increasing clinical importance. Patients with AIDS and related conditions often present with symptoms and signs in the head and neck region. This paper presents the experience of a joint consultation service run between the Departments of Otolaryngology and Venereology at St Mary's Hospital and discusses the clinical features seen in this group of patients. Statistical indicators predict a large increase in the number of cases of AIDS seen in the United Kingdom and the presentation of at-risk patients, particularly homosexuals, to otolaryngologists outside specialized centres is likely to occur with increasing frequency. A knowledge of the modes of presentation and the precautions necessary in undertaking operative treatment of otolaryngological conditions will therefore become mandatory.

Latinas and Deadly Sex: The Politics of HIV/AIDS Reporting

HIV and AIDSThe general public first acknowledgement of AIDS in the United States occurred in the early 1980s when Rock Hudson became infected and subsequently died. In the 1990s, largely due to categorization of the virus as Gay Related Immune Deficiency (GRID), and subsequent neglect by the nation's political system, the virus quickly spread to previously uninfected populations (Shilts, 1986). Human Immunodeficiency Virus (HIV) is caused by exposure to infected blood, semen, vaginal fluids, and breast milk. When an individual's CD-4 or T cell count falls below 200 and/or the individual begins to experience serious complications, the Acquired Immune Deficiency Syndrome (AIDS) is diagnosed as a disease. [http://hopkinsaids. edu/publications/ pocketguide/pocketgd0105.pdf]. As the science of treatment improved and public health surveillance and treatment systems were established, HIV infected individuals with knowledge of the risks of infection and access to health care progressed much more slowly to AIDS. New AIDS cases experienced a dramatically curbed escalation in 1996 with the introduction of Highly Active Antiretroviral Therapy (HAART). [http://www.cdc.gov/hiv/stats/2003SurveillanceReport.pdf]. Although cases of AIDS decreased markedly due to improvements in treatment, overall HIV infections did not.Although modes of infection have been clear for some time, reporting mechanisms within the country have been obscured by many issues including the requirement of the Centers for Disease Control and Prevention (CDC) to report all HIV infections using a confidential, albeit not anonymous, system of name-based reporting, to which some states, like California, have objected. Due to the extensive window period that can average 10 to 15 years wherein HIV infected individuals experience no symptoms, comprehensive data collection and reporting on HIV infection becomes imperative if the US is to accurately target HIV prevention and management efforts, particularly among underserved populations.The Reporting System: HIV versus AIDSPublic health in the US begins at the local level and involves both private and public health providers. Early work with other sexually transmitted diseases such as Gonorrhea and Syphilis at the local level initiated and improved the reporting process from the local level to the state. [http://www.cdc.gov/std/Syphilis2003/SyphSurvSupp2003.pdf]. Nationally, the Atlantabased CDC initiated the collection of AIDS case data from the states.As an understanding of HIV's progression to AIDS matured, terms such as ARC, (AIDS Related Complex), were eliminated and the staging became reduced to HIV and AIDS as measured by T cell or CD-4 cell counts and more recently viral load. [http://hopkinsaids. edu/publications/ pocketguide/pocketgd0105.pdf]. Although AIDS cases are reported by each state to the CDC, many states have been slower in their progression to HIV reporting. A major issue among and between the states and the CDC arose as to the classification system to be used for reporting of HIV and AIDS cases, one that has still not been fully resolved for 19 states and the District of Columbia. Exposure categories for adults are further broken down into the two categories of HIV and AIDS. This paper analyzes the categories of exposure for adults, with emphasis placed on the emergence of HIV and AIDS in the Latino population, particularly among women.Due to HIV underreporting or reporting practices that do not meet the CDC requirements of name-based case identification, the most recent edition of the CDC's HIV/AIDS Surveillance Report includes HIV data from only 31 states. [http://www.cdc.gov/hiv/stats/2004SurveillanceReport.pdf]. The underreporting of HIV to the CDC is problematic for a number of reasons, as it fails to provide the nation with the information needed for an effective HIV/AIDS prevention and management strategy. This is particularly true among underserved populations such as Latinos, who are often uninsured or underinsured and may lack access to culturally and linguistically appropriate health care and HIV prevention information. …

The tragic history of AIDS in the hemophilia population, 1982-1984.

The tragic history of AIDS in the hemophilia population, 1982-1984.

AIDS instruction in US schools of social work: 20 years into the epidemic

A survey of 108 accredited master of social work (MSW) programs was conducted to examine curriculum attention to acquired immune deficiency syndrome (AIDS). More than half of the programs (57.4%) offer no HIV/AIDS courses; more than three quarters (87%), however, do provide HIV/AIDS internship experiences. Interestingly, urban schools of social work, areas with higher rates of reported AIDS cases, and larger schools of social work do not offer more formal opportunities for HIV/AIDS education compared to rural schools, areas with lower rates of reported cases, and smaller schools of social work. Students wanting more formal instruction in HIV/AIDS issues, therefore, may not find more opportunities in larger urban schools. Institutes of higher education can be proactive in the continued need for offering HIV/AIDS educational opportunities.

AIDS in Africa: an epidemiologic paradigm

THE ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) has become recognized as a global health problem. Cases have now been reported in 74 countries with more than 25,000 cases in the United States, nearly 3,000 cases in other countries of the Americas, more than 3,000 cases in Europe, and several thousand cases suspected and many more unrecognized in Africa (1,2). It is estimated that at least several million people worldwide have been infected with the causative agent, referred to as human T-lymphotropic virus type III (HTLV-III)/lymphadenopathy virus (LAV), or more recently as human immunodeficiency virus (HIV) (3). As many as 10 to 30% of these HIV-infected individuals may develop AIDS within the next 5 to 10 years (4-6). With the present lack of a curative therapy or vaccine, this disease now ranks as the most serious epidemic of the past 50 years. Although the immunopathogenesis of HIV infection is similar in most AIDS patients (7), the epidemiology and clinical features of the infection in different countries may vary, depending on cultural differences, endemic diseases, and other unidentified risk factors. In Africa, the different clinical features of AIDS and the difficulty in identifying the risk factors frequently associated with AIDS in the United States, such as homosexuality and intravenous drug use, have raised questions regarding the nature of the disease and the factors responsible for HIV dissemination in that continent (1,2,4). Here we review the epidemiologic and clinical features of AIDS in Africa and discuss the potential problems faced by public health officials in developing prevention and control strategies. Historical Perspective Shortly after the recognition of AIDS in the United States, cases of the disease were identified among Africans residing in Europe (8). Immunologically, these cases were identical to AIDS cases in the United States, with marked depression of CD[4.sup.+] lymphocytes (T-helper cells) and cell-mediated immunosuppression. Clinically, the African cases resembled Haitian AIDS cases with prominent gastrointestinal symptoms and opportunistic infections, such as oroesophageal candidiasis, cryptococcosis, toxoplasmosis, and mycobacterial infections (8-10). As of 31 March 1986, 177 cases of AIDS were reported among Africans residing in ten European countries (Table 1) (2). These cases originated from 24 African countries, mostly in Central Africa. In contrast to the European cases, African cases had a male to female ratio of 1.7:1, and 90% had no identifiable risk factors. Even among Europeans with AIDS and a recent history of travel to Africa, nearly 90% denied homosexuality or intravenous drug use. These unusual epidemiologic features prompted a series of investigations in 1983 to determine the pattern of AIDS in Central Africa. During a 4-week period, 38 patients with AIDS and 20 patients with AIDS-related diseases were identified in a large general hospital in Kinshasa, Zaire (11). Cases were equally distributed among men and women; females with the disease were younger and more often unmarried than male AIDS patients; and clusters of AIDS cases among men and women were linked by heterosexual contact. In a simultaneous investigation of 26 cases in Kigali, Rwanda, 43% of the female patients were identified as prostitutes (12). The fact that there was no evidence of homosexual transmission or intravenous drug use indicated that the pattern of AIDS transmission was different, and that heterosexual contact might be an important factor in transmission. Although the recognition of AIDS in Africa is consistent with the temporal occurrence of the disease in the United States and Haiti, several case reports and retrospective serologic surveys of banked sera have suggested that HIV infection may have occurred earlier in Africa (13-15). The earliest serologic response to HIV was found in serum collected from Kinshasa, Zaire, in 1959 (14). Sera from West and East Africa in the 1960's and early 1970's have also shown a high prevalence of weakly Positive specimens (for example, seropositivity in 1. …

The distribution of early acquired immune deficiency syndrome cases and conditions for the establishment of new epidemics.

This article presents discussion on two issues: the distribution of early cases of acquired immune deficiency syndrome (AIDS), and the epidemiological conditions for the establishment of new diseases. Evidence from four presentations on early AIDS cases is discussed, together with issues of interpreting association and inferring causation. In the second section, the results of a stochastic epidemiological model using the 'real' geography of villages in northern Zaire is presented. This is used to investigate the conditions under which newly introduced infections with different characteristics are able to establish in human populations. It highlights additional spatial, temporal and behavioural conditions necessary for the persistence of introduced diseases, in addition to the condition that the basic reproductive rate R(0) > 1.

The geographic distribution of AIDS in the United States: is there a rural epidemic?

The goal of this study was to examine where people with acquired immune deficiency syndrome (AIDS) in the United States live and the degree to which AIDS is present in rural areas. AIDS cases reported to the Centers for Disease Control and Prevention (CDC) in 1996 were categorized by metropolitan statistical area (MSA) size and compared to the general population. Data were analyzed by region, race/ethnicity and risk exposure; AIDS incidence rates were compared over time by MSA size. Relative to the U.S. population, AIDS cases were disproportionately black (43 percent vs. 11 percent), male (80 percent vs. 48 percent), and from the Northeast (32 percent vs. 20 percent). In all regions, a greater proportion of AIDS cases reside in large MSAs compared with the general population. Risk exposures differ little by MSA size, except in the Northeast. The proportion of people with AIDS who reside in large MSAs exceeds the proportion of the population in those areas, especially when race/ethnicity is considered. AIDS rates have increased in non-MSAs relative to large MSAs, yet do not indicate that the epidemic is increasing rapidly in rural areas. Fewer AIDS cases are reported from smaller communities, yet require medical and social services that may burden the rural health care system.

HIV/AIDS and Older Adults: The Invisible Ten Percent

Human Immunodeficiency Virus (HIV) was first identified as the virus that causes AIDS (Acquired Immune Deficiency Syndrome) in 1983. Much information has come forward about this complex, elusive, and devastating illness since then. The HIV virus is transmitted via the exchange of certain bodily fluids: blood, semen, and vaginal secretions, exchanged during sexual intercourse; injection drug use; and, in very rare cases today, blood transfusions. Infected mothers can also transmit HIV to their nursing infants via breast milk. The HIV virus replicates itself in an infected individual billions of times a day. It does so by attaching itself to and taking over certain white blood cells (CD4 cells, also known as'T cells), thereby insidiously destroying the body's immune defense system. We have learned to develop treatments that inhibit or manage this cloning activity. Although these treatments do not result in a cure for HIV, they have so far helped many (though not all) infected individuals live longer and often (though not always) healthier lives. It is important to note that HIV/AIDS is not confined to so-called groups. In the past, HIV/AIDS has been erroneously perceived as a gay men's disease because in the United States it first surfaced in the gay community and wiped out almost a generation of this population. It is now known that risk behaviors promote transmission of the virus and that these behaviors are practiced by people of all sorts, including heterosexual men and women (Emlet, 1997). There appears to be much information yet to learn about HIV/ AIDS before a cure is discovered, a goal that has eluded scientists and researchers in the medical profession for more than two decades. In fact, the closer they appear to get, the further they seem to be from this goal. We now approach the third decade of the AIDS epidemic; yet apparently there is one particular aspect of HIV/AIDS we have chosen to deny: age is no barrier. What has been ignored from the outset is what Emlet (1997) calls a hidden population of older persons (persons aged 50 and above) who have been and are being infected in significant numbers. The Centers for Disease Control and Prevention (CDC) (1999) reports that as of June 1999, 75,266 people in the United States aged 50 and above have contracted AIDS, more than 10% of all AIDS cases in the United States (Figure 1). Almost 11,000 were women and more than 20,000 over the age of 60. In New York City, the epicenter of the epidemic in the United States, the numbers are even more dramatic. Older adults in metropolitan New York account for close to 13 percent of all AIDS cases; and in Manhattan that number is nearing 15 percent (New York City Department of Health, 1999). This is also the case in parts of Florida such as Dade and Palm Beach Counties, where there are many retirees, as well as in other densely populated urban areas of the country (Puleo, 1996). Emphasis must be placed on the fact that new AIDS cases are rising faster among this age group than any other; (Saag et al., 1998). New AIDS cases in persons aged 50 and above rose by 22 percent in the five years from 1991 to 1996, while the increase in that same period for persons 13 to 49 was only 9 percent (CDC, 1998)-that's more than double the increase. Another surprising figure surfaced in 1994 when Stall and Catania (1994) determined that by the early 1990s older adults accounted for the highest percentage of heterosexual transmission of HIV/AIDS among all age groups (10%). Prior to 1985, such transmission was virtually unheard of in this cohort. These figures represent persons with AIDS diagnoses only, not individuals that are simply HIV-positive. An HIV-positive test result indicates the presence of HIV-fighting antibodies in the bloodstream; people who are HIV-positive can remain so for a decade or more without any visible signs or symptoms. They have not yet contracted any opportunistic infections (OIs), seen their T-cell counts drop to below 200, or exhibited any of the other indicators which would give them a diagnosis of AIDS. …

Upregulated expression of Fas and Fas ligand in brain through the spectrum of HIV-1 infection

Apoptosis of neurons and glial cells has been shown to occur in the brain of patients with the acquired immune deficiency syndrome (AIDS) and was postulated as contributing to brain atrophy and white matter damage in these patients. Since apoptotic events may be induced by the Fas-Fas ligand (FasL) system, we analyzed the relevance of these molecules to cell depletion in eight brains from HIV-1-infected patients and nine HIV-1-negative controls all of whom were analyzed histopathologically. The presence of Fas and FasL in brain tissue was analyzed by PCR amplification using Fas- and FasL-specific oligonucleotide primers and immunohistochemistry. The visualization of DNA fragmentation was used to evaluate apoptosis. Fas transcripts were detected in brains from each of four AIDS patients, each of three asymptomatic HIV-1 carriers and each of two HIV-1-negative controls. In the brains from AIDS patients the level of Fas expression was higher than in asymptomatic carriers and uninfected controls. FasL transcripts were seen in three of seven HIV-1-infected brains, two AIDS cases and one asymptomatic HIV-1 carrier. The predominant Fas-expressing cells were reactive astrocytes seen in each of two AIDS patients and one pre-AIDS case, but not in HIV-1-negative controls. Occasional Fas-positive oligodendrocyte-like cells were also seen in AIDS and pre-AIDS cases. No significant expression of Fas and FasL was seen in neurons. Fas-positive reactive astrocytes were more frequent in foci of HIV-1 encephalitis (HIVE). In the same area reactive apoptotic astrocytes were seen in close vicinity to FasL-expressing CD3 T lymphocytes, suggesting that apoptosis of astrocytes is mediated by Fas-FasL. The Fas expression on glial cells in asymptomatic HIV-1 infection may indicate apoptosis already in the asymptomatic stage of HIV-1 disease. In AIDS brains expression of Fas and FasL may contribute to the loss of glial cells and indirectly to the loss of neurons.

AIDS‐Related Malignancies

OVERVIEW OF MALIGNANCY IN PATIENTS WITH AIDS: Despite the advent of highly active antiretroviral therapy, the incidence of human immunodeficiency virus (HIV)-associated malignancies has not decreased. The United States Centers for Disease Control (CDC) has determined that Kaposi's sarcoma, non-Hodgkin's lymphoma (including primary central nervous system lymphoma), and cervical carcinoma define the acquired immune deficiency syndrome (AIDS). Some literature reports include Hodgkin's disease, anal carcinoma, lung cancer, and non-melanomatous skin cancers as ones commonly found in people infected with HIV. The oncologist is further challenged treating a patient with malignancy whose malignancy is complicated by a concurrent compromised marrow function. This article will review the clinical presentation and current treatment for the HIV-associated malignancies and selected other tumors in the HIV-infected patient. Furthermore, HIV-associated myelosuppression is a common problem in antiviral-undertreated or antiviral-resistant patients.

Modelling human immunodeficiency virus infection and acquired immune deficiency syndrome cases in Scotland: data sources, prior information and Bayesian estimation.

"The paper describes the methodology developed to carry out predictions of the acquired immune deficiency syndrome (AIDS) epidemic in Scotland. Information on the human immunodeficiency virus (HIV) epidemic comes from formal case reports of AIDS cases and HIV positive tests, reports from surveillance schemes and from special studies. These sources of information, up to the end of 1994, are reviewed.... A simple model of the HIV epidemic in Scotland is proposed and the information is summarized in terms of this model. Bayesian methodology, using Markov chain Monte Carlo methods, is described and used to predict future cases of AIDS in Scotland and people who will be living with AIDS in the years 1995-1999."