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Bloodborne viruses may have spread in rural China during the past 25 years, but population-based prevalence estimates are lacking. We examined the frequency of hepatitis C virus (HCV) and HIV [...]

Research has been conducted on the role of heterozygosity for basepair deletion in CC chemokine receptor gene in susceptibility to perinatal HIV-1 infection. The results of the meta-analysis indicate that perinatal infection is not altered by heterozygosity in children .

Researchers reject the hypothesis that fluctuations in viral load in the early stages of HIV infection randomly occur around a set point or underlying growth trend. Instead, they found that the fluctuations were better explained by changes in CD4+ T-cell counts.

People with two copies of the CCR5-delta32 gene mutation have no serious health problems. This means that blocking the CCR5 receptor that HIV uses to infect cells will have no serious adverse effects on HIV patients.

A sensitive/less sensitive testing strategy may effectively identify patients with early HIV infection. Early HIV infection describes the period soon after HIV antibodies become detectable in the blood. Researchers tested a large number of HIV patients, AIDS patients, and blood donors for immune markers of infection. The new testing strategy correctly identified 95% of patients with early HIV infection. Identification of these patients facilitates their enrollment in studies of the development and progression of HIV.

A sensitive/less sensitive testing strategy may effectively identify patients with early HIV infection. Early HIV infection describes the period soon after HIV antibodies become detectable in the blood. Researchers tested a large number of HIV patients, AIDS patients, and blood donors for immune markers of infection. The new testing strategy correctly identified 95% of patients with early HIV infection. Identification of these patients facilitates their enrollment in studies of the development and progression of HIV.

A sensitive/less sensitive testing strategy may effectively identify patients with early HIV infection. Early HIV infection describes the period soon after HIV antibodies become detectable in the blood. Researchers tested a large number of HIV patients, AIDS patients, and blood donors for immune markers of infection. The new testing strategy correctly identified 95% of patients with early HIV infection. Identification of these patients facilitates their enrollment in studies of the development and progression of HIV.

A sensitive/less sensitive testing strategy may effectively identify patients with early HIV infection. Early HIV infection describes the period soon after HIV antibodies become detectable in the blood. Researchers tested a large number of HIV patients, AIDS patients, and blood donors for immune markers of infection. The new testing strategy correctly identified 95% of patients with early HIV infection. Identification of these patients facilitates their enrollment in studies of the development and progression of HIV.

People who have low blood levels of HIV RNA one or two years after becoming HIV-positive may be less likely to develop AIDs. Researchers measured HIV RNA in blood samples taken from 165 hemophiliacs up to three years after they had been infected and followed them until they developed AIDS. Ten years after infection, 72% of those with 100,000 or more copies of HIV RNA per milliliter (ml) had AIDS, compared to 52% of those with 10,000 to 99,999 copies/ml, 22% of those with 1,000 to 9,999 copies/ml and none of those with fewer than 1,000 copies/ml.

Objectives. We conducted sentinel surveillance in persons practicing behaviors known to transmit retroviruses to determine the US presence and extent of human immunodeficiency virus type 2 (HIV-2). Methods. Sentinel surveillance for HIV-2 was conducted by testing 31 533 anonymous blood specimens from patients at sexually transmitted disease clinics, injecting drug users at treatment centers, and clients at HIV counseling and testing sites in 14 US cities where West African immigrants often settle. Specimens were tested by HIV-1 and HIV-2 whole virus and synthetic peptide enzyme immunoassay and confirmed by HIV-1 and HIV-2 Western blots. Results. Nearly 10%, of 31 533 sera were positive for HIV-1. Two heterosexual Black male sexually transmitted disease patients were infected with HIV-2. One of the HIV-2 positive specimens did not cross-react on HIV-1 enzyme immunoassay screening. One client had antibodies consistent with malarial infection in West Africa; the other, who had syphilis, did not have antibodies to malaria or to any of 20 arboviruses present in Africa. Conclusions. Clinics serving clients from HIV-2 endemic areas should test persons practicing risk behaviors for both HIV-1 and HIV-2. Sentinel surveillance for HIV-2 serves as an early warning system for the possible spread of this virus in the United States. (Am J Public Health. 1993;83:515-519), Sexually transmitted disease clinics and drug treatment centers should test at-risk clients for HIV type 2 (HIV-2) infection to monitor its spread in the US. HIV-2 is a retrovirus very similar to HIV-1 that has mostly been seen in West Africa. As of 1992, 17 cases of HIV-2 infection in the US had been reported to the CDC. All known cases involve people who have emigrated from West Africa, have had sexual contact with West Africans or have traveled to West Africa. Of 31,533 blood samples collected from people attending sexually transmitted disease clinics and drug treatment centers, 9.9% were positive for HIV-1. Altogether only two people, both black male clients of sexually transmitted disease clinics, tested positive for HIV-2. One of the samples was also positive for the malaria-causing parasite Plasmodium, which suggests the person had lived or traveled in West Africa.

As of 1992, 32 US residents have been found to be infected with HIV-2, a variant of the virus that causes AIDS. HIV-2 infection is endemic in parts of Africa, and cases have also been reported in Portugal, France and Germany. Of 17 of the US cases, 13 were West Africans. Two were US natives who had visited West Africa. HIV-2 seems to have many characteristics in common with HIV-1, including the manner in which it is transmitted, and the type of disease it causes. The viruses are also similar structurally, and most HIV-2 infected individuals will test positive or indeterminate on a Western blot test. However, the Food and Drug Administration has licensed enzyme immunoassays that can detect both HIV-1 and HIV-2. Western blot tests have also been developed to detect HIV-2. The risk of contracting HIV-2 from a blood transfusion in the US is very small.

HIV-infected men who have low CD4 T-cell counts, advanced disease or white blood cells in their semen are more likely to have the virus in their semen and would be more likely to transmit the virus through sexual intercourse. Semen samples taken from 95 HIV-positive men were tested for the presence of HIV. The virus was found in nine samples. Men who had CD4 counts less than 200, who were in an advanced stage of the infection or who were not taking zidovudine (AZT) were more likely to have the virus in their semen. Those who had white blood cells in their semen (seminal leukocytosis) were also more likely to have the virus in their semen. However, a separate study of 14 of the men whose CD4 counts were above 200 found that six had one semen sample that was positive for HIV at some time over a period of several months. All HIV-infected men should consider themselves potentially infective.

Non-hodgkin's lymphoma (NHL) are cancers of the lymph tissue, other than Hodgkin's disease. Recent studies have shown that exposure to phenoxy herbicides, chemicals used to kill plants, may increase the risk for NHL. 'Agent Orange' is a herbicide that was widely used during the Vietnam war. The question of whether Vietnam veterans are at greater risk for NHL has been raised. This study compared NHL rates in Vietnam veterans with rates in veterans from the same time period, but were not in Vietnam. The study randomly selected 18,313 veterans who served between January 1965 and December 1971, of which 9,324 were Vietnam veterans and 8,989 were non-Vietnam veterans. Phone interviews were conducted and 15,288 veterans were interviewed. Results showed that seven Vietnam veterans and one non-Vietnam veteran had been diagnosed with NHL. The expected number of cases were 3.9 for the Vietnam veterans and 3.5 for the non-Vietnam veterans. Therefore, these results suggest that Vietnam veterans may have an increased risk for developing NHL. However, the small number of cases in this study, and the inability to directly measure exposure to Agent Orange, make it difficult reach any definitive conclusions as to why these veterans have increased rates of NHL. (Consumer Summary produced by Reliance Medical Information, Inc.)

IL10 is a powerful TH-2 cell cytokine produced by lymphoid cells that limits HIV-1 replication in vivo, ostensibly by inhibiting macrophage/monocyte and T-cell lymphocyte replication and secretion of inflammatory cytokines (IL1, TNF[Alpha], IL6, IL8, and IL12). A genetic epidemiological scan of patients enrolled in AIDS cohorts for candidate gene-linked short tandem repeat polymorphisms revealed significant genotype associations for HIV-1 infection and progression to AIDS with markers adjacent to and tracking (by linkage disequilibrium) common single nucleotide polymorphic variants in the IL10 promoter region. Individuals carrying the IL10-5'-592A (IL10-5'A) promoter allele possibly were at increased risk for HIV-1 infection, and once infected they progressed to AIDS more rapidly than homozygotes for the alternative IL10-5'-592 C/C (IL10-+/+) genotype, particularly in the later stages of HIV-1 infection. An estimated 25-30% of long-term nonprogressors (who avoid clinical AIDS for 10 or more years after HIV-1 infection) can be attributed to their IL10-+/+ promoter genotype. Alternative IL10 promoter alleles are functionally distinct in relative IL10 production, in retention of an avian erythroblastosis virus transcription factor recognition sequence and in binding to specific putative nuclear transcription factors, suggesting a potential mechanism whereby IL10-5'A down-regulation of inhibitory IL10 facilitates HIV-1 replication in vivo, accelerating the onset of AIDS.

Despite important recent insights into the short-term dynamics of HIV-1 infection, our understanding of the long-term pathogenesis of AIDS remains unclear. Using an approach that places rapid progressors, typical progressors, and nonprogressors on a single clinical spectrum of disease progression, we quantitate the previously reported relationship between viral load and survival time. We introduce the concept of viral constant, present evidence that this quantity is conserved across patients, and explore the immunopathological implications of this finding. We conclude with a quantitative approach for assessing the benefits of a given regime of antiviral therapy.

Diabetes mellitus is a serious disease rated as the seventh most common cause of death in the US. Diabetes can cause complications including blindness, heart disease, kidney failure, and limb amputation. Black Americans have a higher incidence of diabetes mellitus and approximately twice the mortality rate from diabetes compared to whites. The basis of these racial differences has not been determined. One important research question is whether higher rates of obesity among blacks lead to their greater incidence of diabetes. This survey evaluated 12,558 white and 1,677 black Vietnam veterans, age 30-47 years. Information collected included medical history as reported by the veterans, and for a sub-group, additional clinical examinations and laboratory tests. Blacks had a higher prevalence of diabetes than whites (3.0 versus 1.4 percent respectively) and this racial difference was not explained by adiposity (degree of fatness), age or socioeconomic status. Some participants had their fasting blood sugar tested, and more blacks had fasting hyperglycemia (high blood sugar) than whites. The data presented suggest that obesity does not account for the higher incidence of diabetes in blacks compared to whites., ABSTRACT: To determine whether the higher prevalence of diabetes found among blacks in the United States is explained by racial differences in obesity, we examined the prevalence of diabetes adjusted for adiposity, education, and income in a cohort of US Army veterans from the Vietnam era. Among 12 558 white men and 1677 black men, aged 30 to 47 years, blacks were more likely than whites to have diagnosed diabetes (adjusted prevalence ratio, 1.9; 95% confidence interval, 1.3 to 2.7). Within every age, adiposity, and socioeconomic stratum, blacks had a higher prevalence of diagnosed diabetes than whites. In a subgroup of veterans for whom fasting serum glucose values were measured, blacks were more likely than whites to have fasting hyperglycemia (fasting serum glucose value >/= 7.8 mmol/L)(adjusted prevalence ratio, 5.7; 95% confidence interval, 2.7 to 12.0). These data provide evidence that the higher prevalence of diabetes found among blacks is not explained by differences in obesity.

The contamination of drinking water by cryptosporidium is probably not detected by the current methods of treating public water supplies. An outbreak of gastroenteritis effected an estimated 13,000 people in a county in western Georgia. A parasite, cryptosporidium oocyst, was found in the stools of 39 percent of the patients with gastroenteritis. Studies eliminated the presence of other parasitic pathogens. Inefficient flocculation and filteration may have allowed the parasite to pass into the water supply.

Chemokine receptors appear to influence the infective ability of HIV and may affect the rate of HIV disease progression and AIDS. The virus may use several of these receptors to gain entry and infect cells. A mutation in the CCR5 receptor has been associated with resistance to HIV infection and slower disease progression. Researchers recently demonstrated the effect of variants in this receptor on the progression of HIV infection transmitted from pregnant women to their children. Research in chemokine receptors may produce novel therapies against HIV disease.

Epidemiologists' practice of using their published papers that compare rates of incidence and prevalence to support conclusions regarding public health is inappropriate. Incidence and prevalence are well-defined and well-accepted, and are distinctly different measures of disease frequency that are not directly comparable. For example, tumor registry rates are incidence rates and cannot be compared to prevalence at death or other prevalence measures. Direct comparison of incidence and prevalence is therefore inappropriate for conceptual, theoretical and practical reasons.

The CCR5 gene encodes a cell surface chemokine receptor molecule that serves as the principal coreceptor, with CD4, for macrophage-tropic (R5) strains of human immunodeficiency virus-type 1 (HIV-1). Genetic association analysis of five cohorts of people with acquired immunodeficiency syndrome (AIDS) revealed that infected individuals homozygous for a multisite haplotype of the CCR5 regulatory region containing the promoter allele, CCR5P1, progress to AIDS more rapidly than those with other CCR5 promoter genotypes, particularly in the early years after infection. Composite genetic epidemiologic analyses of genotypes bearing CCR5P1, CCR5-Δ32, CCR2-64I, and SDF1-3'A affirmed distinct regulatory influences for each gene on AIDS progression. An estimated 10 to 17 percent of patients who develop AIDS within 3.5 years of HIV-1 infection do so because they are homozygous for CCR5P1/P1, and 7 to 13 percent of all people carry this susceptible genotype. The cumulative and interactive influence of these AIDS restriction genes illustrates the multigenic nature of host factors limiting AIDS disease progression., The human CCR5 and CCR2 chemokine receptor genes, which serve as coreceptors with CD4 for HIV, are tightly linked on chromosome 3p21-22, separated by 20 kb (1-4). Common allelic variants [...]