The global epidemiology of HIV infection: continuity, heterogeneity and change

Article Abstract:

There are three major epidemiological patterns of HIV (human immunodeficiency virus type-1) infection in the world. One occurs mainly in North America, Europe, and Australia, with most cases of HIV infection occurring among homosexual men and intravenous drug users and their sexual partners and offspring. The second pattern occurs mainly in sub-Saharan Africa, where HIV infection occurs through heterosexual relations, perinatally from mothers to infants, and through blood transfusions. This pattern is occurring more frequently in other parts of the world. A third pattern dominates in the remaining countries of the world, where there are so far very few cases of HIV infection. However, these patterns are changing. The recent epidemiological trends were examined. The number of new cases of HIV infection and AIDS continues to rise. It is estimated that there will be 6 million cases of AIDS and 14 million cases of HIV infection worldwide by the year 2000. It is thought that even with the prevention programs that are available, only one-half of new HIV infections will be prevented. The rates of infection in countries were the virus has recently been introduced are higher than in countries were the virus has been present for some time. This high rate of transmission is seen especially in Latin American countries. It is imperative that these countries develop effective preventive programs. Studies are necessary to understand which groups are at risk and how to target prevention programs to these groups. The spread of HIV occurs more rapidly within some risk groups than others. The following variables affect the spread of HIV: demographic variables, such as the percentage of sexually active individuals in a country, ratios of males and females, and the degree of urbanization; behavioral variables, such as the number of sexual partners, type of sexual intercourse, size of and rate of contact with risk groups; biological variables, including the incidence of other sexually transmitted diseases, the infectivity of the various strains of HIV, and possibly male circumcision; and political/economic variables, such as the countries' response to the epidemic, the performance of the health care system and other political situations (e.g. war). HIV infection also contributes to the sickness and death from other diseases, such as tuberculosis, and it can change the clinical expression, progression of disease, and response to treatment of diseases such as syphilis, hepatitis B, herpes simplex virus infection, genital human papillomavirus infection, measles and infection with the parasite Leishmaniasis. HIV infection has a profound impact on both maternal and infant

Political aspects, HIV (Viruses), HIV, Disease transmission, AIDS (Disease) in children, Pediatric AIDS (Disease), AIDS virus carriers, HIV carriers

---

Detection of salivary HIV-1-specific IgG antibodies in high-risk populations in Zaire

Article Abstract:

Saliva can be used, instead of blood, to test for the presence of antibodies to human immunodeficiency virus type-1 (HIV-1). The ability to detect HIV antibodies in saliva is dependent on the sensitivity and the specificity of the detection assay test. A commercially available kit, normally used to test blood samples, was used in Zaire to test saliva samples in high-risk populations. The saliva samples were not diluted as was recommended for blood samples, because saliva is known to contain smaller concentrations of antibodies. Approximately 98 percent of the individuals tested (142 of 145) at a sexually transmitted disease clinic, who had antibodies against HIV-1 in their blood, also had antibodies against HIV-1 in their saliva. The saliva test did not detect antibodies that were not detectable in the blood, indicating that there were no false positives (in this case, only individuals who actually had HIV-1 antibodies were identified as such). Ninety-five percent of the positive saliva samples (137 of 142) were confirmed to be positive with another test, known as the Western blot procedure, in which antibodies react with specific viral proteins. In another study, 9 of 14 female prostitutes, who were previously shown to have no HIV-1 antibodies and were later found to have antibodies in their blood, were shown to have HIV-1 antibodies in their saliva. However, only 33 percent (3 of 9) of the women were confirmed to have antibodies in their saliva by Western blot analysis. Although the analysis of saliva is a convenient way to test individuals for the presence of antibodies to HIV-1, the method is not reliable in detecting individuals who recently developed antibodies to HIV-1. Testing saliva has advantages over the use of blood, especially when testing many individuals. It is a less costly and noninvasive procedure, which does not require drawing blood. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Identification and classification, Saliva, HIV antibodies

---

Cutaneous delayed-type hypersensitivity in patients with human immunodeficiency virus infection in Zaire

Article Abstract:

The number of T-helper cells contained in the blood is usually used as a indicator of the stage of human immunodeficiency virus (HIV) infection. However, in developing countries it is difficult to test levels of T-helper cells because the test is time-consuming, expensive, and requires special equipment. Skin testing for delayed-type hypersensitivity (DTH) is a method to test the functioning of cell-mediated immunity and is easily performed. Patients with AIDS have decreased cell-mediated immunity, including decreased DTH. In Zaire, DTH was tested in patients who were in various stages of HIV infection. Lack of reactivity to the antigens in the skin testing was seen more often in patients who were infected with HIV compared with healthy individuals, and in individuals with more advanced HIV illness. Most adults in Zaire have latent tuberculosis infections and react to the tuberculin test, a test that measures immune reactivity to the organism that causes tuberculosis. Patients who were infected with HIV and who reacted to the tuberculin skin test were more likely to have tuberculosis than those who were infected with HIV and did not react to the tuberculin skin test. It is concluded that cutaneous skin testing can be used as a indicator of the progression of HIV infection in developing countries such as Zaire. Reactivity to tuberculin in individuals who are infected with HIV, most likely means that the patient also has tuberculosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Complications and side effects, Tuberculosis, Immune response, Cellular immunity, Delayed hypersensitivity

Similar abstracts:

• Abstracts: Government moves to enshrine infection control in law. Nursing wherever they are needed. Slowing the progression?
• Abstracts: Introduction of HIV infection among intravenous drug abusers in low prevalence areas. Heterosexual transmission of human immunodeficiency virus among intravenous drug users
• Abstracts: Seroepidemiologic studies of cytomegalovirus and Epstein-Barr virus infections in relation to human immunodeficiency virus type 1 infection in selected recipient populations
• Abstracts: Survival differences in patients with AIDS. Cervical cytologic abnormalities and papillomavirus in women infected with human immunodeficiency virus

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.