Dilated Cardiomyopathy in Haemophiliacs Infected with the Human Immunodeficiency Virus

1993 ◽  
Vol 38 (4) ◽  
pp. 112-113 ◽  
Author(s):  
A.J. Jacob ◽  
G.R. Sutherland ◽  
N.A. Boon ◽  
C.A. Ludlam

Infection with the human immunodeficiency virus (HIV) can result in several cardiac abnormalities including dilated cardiomyopathy. These phenomena have been described in people contracting the virus through sexual intercourse, injection drug use and by vertical transmission. We have identified recently two Scottish haemophiliacs who have developed dilated cardiomyopathy in the context of HIV infection acquired through treatment with contaminated factor VIII. The significance of this finding is discussed.

PEDIATRICS ◽  
1992 ◽  
Vol 89 (4) ◽  
pp. 791-794
Author(s):  

PERINATAL INFECTIONS The primary route of human immunodeficiency virus (HIV) infection in infants is vertical transmission from HIV-infected mothers. This is of particular concern as the number of infected women and the number of children infected by perinatal transmission continue to increase rapidly. The number of perinatally acquired acquired immunodeficiency syndrome (AIDS) cases increased 17% in 1989 and 21% in 1990. Similarly, the number of heterosexually acquired AIDS cases increased 27% in 1989 and 40% in 1990. There is evidence that vertical transmission of HIV can occur in utero (congenital/transplacental, similar to rubella),1,2 in the postpartum period (breast-feeding), and perhaps in the intrapartum period (similar to hepatitis B).3 The relative frequency and efficiency of transmission during each of these periods remains uncertain. The best estimates of vertical transmission from an HIV-seropositive mother to the fetus range from 12.9% to 39%4-6 Although the risk of transmission appears to be increased in women who are symptomatic, this point is still unclear.5 Preliminary information suggests that the presence of high levels of high-affinity/avidity antibodies to specific epitopes of the gp 120 of HIV may be protective and may decrease or prevent vertical transmission,7-10 although others have not been able to confirm this finding.11 More detailed information on perinatal HIV infection,12 and infection control13 in pediatric HIV infection is available in previously published statements from the AAP Task Force on Pediatric AIDS. SEROPREVALENCE Anonymous seroprevalence data from newborn specimens are being collected in 44 states, Puerto Rico, and the District of Columbia. In some states, seroprevalence data are available by metropolitan area and/or by hospital of birth.


2019 ◽  
Vol 6 (5) ◽  
Author(s):  
Jing Han ◽  
Zunyou Wu ◽  
Jennifer M McGoogan ◽  
Yurong Mao ◽  
Houlin Tang ◽  
...  

Abstract Background Why some persons living with human immunodeficiency virus (HIV) (PLWH) progress quickly and others remain “healthy” for a decade or more without treatment remains a fundamental question of HIV pathology. We aimed to assess the epidemiological characteristics of HIV long-term nonprogressors (LTNPs) based on a cohort of PLWH in China observed between 1989 and 2016. Methods We conducted a nationwide, retrospective cohort study among Chinese PLWH with HIV diagnosed before 1 January 2008. Records were extracted from China’s national HIV/AIDS database on 30 June 2016. LTNPs were defined as those with AIDS-free, antiretroviral therapy–naive survival, with CD4 cell counts consistently ≥500/μL for ≥8 years after diagnosis. Prevalence was calculated, characteristics were described, and determinants were assessed by means of logistic regression. Potential sources of bias were also investigated. Results Our cohort included 89 201 participants, of whom 1749 (2.0%) were categorized as LTNPs. The injection drug use (IDU) route of infection was reported by 70.7% of LTNPs, compared with only 37.1% of non-LTNPs. The odds of LTNP status were greater among those infected via IDU (adjusted odds ratio [95% confidence interval], 2.28 [1.94–2.68]) and with HIV diagnosed in settings with large populations of persons who inject drugs (1.75 [1.51–2.02] for detention centers, 1.61 [1.39–1.87] for Yunnan, 1.94 [1.62–2.31] for Guangdong, and 2.90 [2.09–4.02] for Xinjiang). Conclusions Overrepresentation of the IDU route of infection among LTNPs is a surprising finding worthy of further study, and this newly defined cohort may be particularly well suited to exploration of the molecular biological mechanisms underlying HIV long-term nonprogression.


Author(s):  
Nathan W Furukawa ◽  
Erin F Blau ◽  
Zach Reau ◽  
David Carlson ◽  
Zachary D Raney ◽  
...  

Abstract Background Persons who inject drugs (PWID) have frequent healthcare encounters related to their injection drug use (IDU) but are often not tested for human immunodeficiency virus (HIV). We sought to quantify missed opportunities for HIV testing during an HIV outbreak among PWID. Methods PWID with HIV diagnosed in 5 Cincinnati/Northern Kentucky counties during January 2017–September 2018 who had ≥1 encounter 12 months prior to HIV diagnosis in 1 of 2 Cincinnati/Northern Kentucky area healthcare systems were included in the analysis. HIV testing and encounter data were abstracted from electronic health records. A missed opportunity for HIV testing was defined as an encounter for an IDU-related condition where an HIV test was not performed and had not been performed in the prior 12 months. Results Among 109 PWID with HIV diagnosed who had ≥1 healthcare encounter, 75 (68.8%) had ≥1 IDU-related encounters in the 12 months before HIV diagnosis. These 75 PWID had 169 IDU-related encounters of which 86 (50.9%) were missed opportunities for HIV testing and occurred among 46 (42.2%) PWID. Most IDU-related encounters occurred in the emergency department (118/169; 69.8%). Using multivariable generalized estimating equations, HIV testing was more likely in inpatient compared with emergency department encounters (adjusted relative risk [RR], 2.72; 95% confidence interval [CI], 1.70–4.33) and at the healthcare system receiving funding for emergency department HIV testing (adjusted RR, 1.76; 95% CI, 1.10–2.82). Conclusions PWID have frequent IDU-related encounters in emergency departments. Enhanced HIV screening of PWID in these settings can facilitate earlier diagnosis and improve outbreak response.


PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 945-947
Author(s):  

Injection and other illicit drug use plays a major role in the transmission of infection with human immunodeficiency virus (HIV), including cases among infants, children, and adolescents.1,2 Transmission to adolescents and adults occurs either directly from contaminated drug paraphernalia, including needles and syringes, or through sexual contact with an infected partner. Transmission to infants occurs transplacentally or perinatally from mothers who are most often either drug users themselves, or who have become infected from sexual partners who are injection drug users. It is therefore clear that a reduction in the transmission of HIV infection secondary to illicit drug use and the use of contaminated injection equipment is a pediatric concern and should be part of any prevention program. The adverse consequences of illicit drug use are multiple and certainly not limited to the potential acquisition and transmission of HIV infection. Ideally, treatment and prevention programs should seek to reduce drug use itself, not solely HIV infection. However, many users of injection drugs do not enter drug treatment, remain in treatment, or maintain complete abstinence while in treatment. Therefore, promoting safer injection practices can provide an important public health benefit in lowering the risk of HIV transmission, while simultaneous efforts continue to reduce and eliminate drug use. Initiatives with the singular objective of increasing access to sterile equipment are understandably controversial, as they do not directly address the causes and broader consequences of illicit drug use. In addition, there are continuing concerns that any program increasing access to sterile needles and syringes might actually increase injection drug use by creating the impression of relative safety and tacit community approval for such behavior.


PEDIATRICS ◽  
1993 ◽  
Vol 91 (5) ◽  
pp. 1019-1020
Author(s):  
WM BRENDLE GLOMB ◽  
SALLY L. DAVIDSON WARD ◽  
STEVE S. LEE ◽  
MICHAEL J. DURFEE

To the Editor.— We recently read the report of Thomas et al1 which suggested an association between twin gestation and human immunodeficiency virus (HIV) positivity in the offspring via vertical transmission. Dr Thomas speculated that there might be "an association between [maternal] drug use and twinning." She mentions that "the results of an analysis of 1988 birth certificates in progress at the New York City Department of Health suggests a higher incidence of twinning among women who mentioned narcotics use on the birth certificates."


1997 ◽  
Vol 8 (4) ◽  
pp. 251-255 ◽  
Author(s):  
Nina Singh ◽  
Cheryl Squier ◽  
Carla Sivek ◽  
Marilyn M Wagener ◽  
Victor L Yu

We aim to assess the age-related differences in psychological stress and depression in patients with human immunodeficiency virus (HIV) infection. Prospective, longitudinal, observational study of patients with HIV followed at a university affiliated VA Medical Center. Fifty-six consecutive patients with HIV infection aged 19-68 were studied. Data on demographics, living arrangements, education, employment, income, social, religious, and community support, medical status, psychological stress, depression, and coping was assessed at baseline and every 6 months. Instruments for psychological testing included Beck Depression Inventory, Profile Mood Status (POMS) scale and ways of coping scale (inventory of coping with illness scale). Sixty-nine per cent (38/56) of the patients were older than 35 years of age. Older patients exhibited significantly greater emotional and psychological stress; the mean POMS score for older patients was 56.8 as compared to 21.5 for younger patients (P=0.004). Older patients had significantly greater depression (P=0.001), higher tension and anxiety (P=0.005), greater anger and hostility (P=0.03), greater confusion and bewilderment (P=0.01), and more fatigue (P=0.003) as compared with younger patients. Older patients were significantly more likely to have intravenous drug use as an HIV risk factor (P=0.02), less likely to be employed (P=0.005), and more likely to use non-traditional therapies (P=0). Intravenous drug use was an independent predictor of psychological stress in older patients. Patients with HIV, older than 35 years of age, are significantly more likely to suffer from depression and psychological stress; intravenous drug use was an independent predictor of stress. Interventions for the treatment of depression should be especially sought in this subgroup of patients with HIV.


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