A cluster of HIV infection among heterosexual people without apparent risk factors

Article Abstract:

A group of Belgian women has been identified as infected with the AIDS virus (human immunodeficiency virus, HIV) as a result of heterosexual contact with a single infected African male (the index patient). These women were linked heterosexually with additional men which provided a cluster group of 39 men and women. The group was discovered when a heterosexual woman was diagnosed with AIDS-related-complex (ARC) and was reported to Belgian health authorities. This case was rapidly followed by three more women, all of whom named the same man as their source of contact with the virus. Interviews with the index patient produced a list of 19 more women; 14 were located and tested. Seven of these woman tested positive for the presence of HIV. Overall, a total of 11 of 18 established sexual contacts of the index patient were found to have been infected. None of these women had used intravenous drugs, had been prostitutes, or had received blood transfusions. Two of the women only had a single sexual encounter with the index patient, and only one of the group had engaged in anal sex. None had had sex during menstruation. Some of the women reported other heterosexual contacts and some refused to cooperate with health authorities by providing the names of their sexual contacts. Eight men were eventually identified and tested. One of the eight (12 percent) was found to be infected, and neither of his two sexual contacts were infected. The index patient, although apparently healthy when discovered, has since died of AIDS. The index patient is seen to be a "high disseminator" and a trend toward greater rate of infection toward the end of his life indicates that he was either highly infectious or infected with an unusually virulent (powerful) strain of HIV.

Demographic aspects, HIV (Viruses), HIV, AIDS (Disease), AIDS-related complex

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Zidovudine in persons with asymptomatic HIV infection and CD4+ cell counts greater than 400 per cubic millimeter

Article Abstract:

Zidovudine may be effective in slowing the progression to AIDS in HIV-positive patients without symptoms who have CD4+ cell counts of 400 or more cells per cubic millimeter. HIV is the virus that causes AIDS. CD4+ cells are a type of white blood cell associated with the body's immune response system. CD4+ cell counts usually drop during HIV infection. Patients taking part in a study were randomly assigned to one of two groups: 495 took zidovudine and 489 took a placebo, or inactive substance. Patients taking zidovudine took two 250 milligram capsules every 12 hours. Both groups had laboratory screening tests done on admission to the study. They were then seen regularly for evaluation. Disease progression occurred in 129 patients who took the placebo and in 76 patients who took zidovudine. Ten patients who took the placebo and six patients who took zidovudine developed AIDS or AIDS-related complex. Zidovudine treatment reduced by half the probability that an HIV patient would progress to AIDS or to CD4+ counts of less than 350 over a three-year period. Zidovudine was well tolerated by most participants.

Health aspects, Care and treatment, Zidovudine

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Choosing the best initial therapy for HIV-1 infection

Article Abstract:

Non-nucleoside reverse-transcriptase inhibitors may be used instead of protease inhibitors in some HIV patients. Non-nucleoside reverse-transcriptase inhibitors inhibit the viral enzyme reverse transcriptase. Three non-nucleoside reverse-transcriptase inhibitors are available for the treatment of HIV infection: nevirapine, delavirdine, and efavirenz. Two 1999 studies showed that efavirenz was more effective in combination drug therapy than protease inhibitors. It can be taken once a day and has fewer side effects than protease inhibitors. Long-term use of any drug may cause the virus to become resistant to the drug.

Editorial, Evaluation, Drug therapy, Reverse transcriptase inhibitors

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