Association between serum total cholesterol and HIV infection in a high-risk cohort of young men.
Claxton AJ. Jacobs DR Jr. Iribarren C. Welles SL. Sidney S. Feingold KR.
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015, USA.
Low serum total cholesterol (TC) is associated with a variety of nonatherosclerotic diseases, but the association of TC with infectious disease has been little studied. In this study, we examined the relationship between serum TC and HIV infection in members of a large health maintenance organization in Northern California. The cohort consisted of 2446 unmarried young men 15 to 49 years of age at high risk of HIV infection, defined as self-reported history of sexually transmitted disease or liver disease. Baseline measurements were taken between 1979 and 1985, and subjects were passively followed for HIV infection until the end of 1993 (average length of follow-up, 7.7 years). From a multivariate-adjusted Cox regression, the rate ratio (RR) of HIV infection was 1.66 (95% CI = 1.07, 2.56) for men with serum TC levels
Association between Cryptosporidium infection and animal exposure in HIV-infected individuals.
Glaser CA. Safrin S. Reingold A. Newman TB.
AIDS Prevention Studies and Pediatric Infectious Disease, University of California, San Francisco, USA.
Cryptosporidium causes a debilitating illness in immunocompromised individuals, yet the source of sporadic Cryptosporidium infections is unknown. Because early cases of cryptosporidiosis were associated with animals, and pets are a source of companionship to individuals with AIDS, determination of the risk of cryptosporidiosis associated with pets is important. To assess this risk, we conducted a case-control study of HIV-infected individuals with and without cryptosporidiosis. No statistically significant difference in the rate of overall pet ownership, cat ownership, or bird ownership was found between the two groups. Dog ownership reached borderline statistical significance; 15 of 48 (31%) cases owned a dog, compared with 17 of 99 (17%) controls (odds ratio [OR] = 2.19; p = .05; 95% confidence interval [CI], 0.9-5.3). No statistically significant differences between cases and controls were found in the frequency of surface water ingestion, rural exposure, travel history, or contact with diarrheic individuals. Our findings indicate that pets do not represent a major risk factor for acquisition of Cryptosporidium for HIV-infected individuals. Whether dog ownership presents a minimal risk for cryptosporidiosis needs further investigation.
Effect of GB virus C/hepatitis G virus coinfection on the course of HIV infection in hemophilia patients in Japan.
Toyoda H. Fukuda Y. Hayakawa T. Takamatsu J. Saito H.
Second Department of Internal Medicine, Nagoya University School of Medicine, Japan.
OBJECTIVE: A novel virus, GB virus C (GBV-C)/hepatitis G virus (HGV), has been isolated. This virus is parenterally transmissible, but its effect on various diseases remains to be disclosed. We investigated the effect of GBV-C/HGV coinfection on the course of HIV infection. METHODS: GBV-C/HGV RNA was measured by nested reverse transcription polymerase chain reaction (RT-PCR) in 41 HIV-infected hemophilia patients in Japan. Patient characteristics, HIV RNA concentrations, and rates of progression to AIDS and to death were compared in patients with and without GBV-C/HGV coinfection. HIV RNA was quantified by the Amplicor HIV Monitor test (Roche Molecular Systems, Somerville, NJ, U.S.A.), and progression to AIDS and to death was analyzed using Kaplan-Meier plots. RESULTS: GBV-C/HGV infection was present in 11 of 41 of patients (26.8%). Mean HIV RNA concentration was lower in patients with GBV-C/HGV coinfection (3.52+/-4.81 x 10(4) copies/ml) than in patients without coinfection (5.76+/-14.78 x 10(4) copies/ ml) and progression to AIDS and to death were slower in patients with GBV-C/HGV coinfection than patients without it, although the differences were not statistically significant. CONCLUSION: In Japanese hemophilia patients, coinfection with GBV-C/HGV does not have an adverse effect on the course of HIV infection.
Virologic, immunologic, and clinical parameters in the incidence and progression of anal squamous intraepithelial lesions in HIV-positive and HIV-negative homosexual men.
Palefsky JM. Holly EA. Hogeboom CJ. Ralston ML. DaCosta MM. Botts R. Berry JM. Jay N. Darragh TM.
Department of Laboratory Medicine, University of California-San Francisco 94143, USA.
Anal cancer may be preceded by anal squamous intraepithelial lesions (ASIL), but the natural history of ASIL is poorly understood. In this report, we characterize the 2-year incidence and progression of low-grade SIL (LSIL) and high-grade SIL (HSIL) in a cohort study in 346 HIV-positive and 262 HIV-negative homosexual or bisexual men. Subjects were studied at defined intervals using anal cytology, anoscopy with biopsy of visible lesions, human papillomavirus (HPV) testing, HIV serostatus, CD4 level, and data on medical history and lifestyle. The incidence of HSIL within 2 years was 20% in HIV-positive men and 8% in HIV-negative men who were normal at baseline. In total, 62% of HIV-positive and 36% of HIV-negative men with LSIL at baseline progressed to HSIL. The relative risk (RR) for anal disease progression in HIV-positive men was 2.4 (95% confidence interval [CI], 1.8-3.2) when compared with HIV-negative men. The RR increased to 3.1 (95% CI, 2.3-4.1) in HIV-positive men with CD4 counts
Anal squamous intraepithelial lesions in HIV-positive and HIV-negative homosexual and bisexual men: prevalence and risk factors.
Palefsky JM. Holly EA. Ralston ML. Arthur SP. Jay N. Berry JM. DaCosta MM. Botts R. Darragh TM.
Department of Laboratory Medicine, University of California-San Francisco, 94143, USA.
Anal cancer is more commonly found in homosexual and bisexual men than cervical cancer is in women. Invasive anal cancer may be preceded by anal squamous intraepithelial lesions (ASIL), and treatment of ASIL may prevent the development of anal cancer. We characterized the prevalence and risk factors for ASIL in 346 HIV-positive and 262 HIV-negative homosexual men. Anal cytology, biopsy of visible anal lesions, and human papillomavirus (HPV) tests were performed, and data on HIV serostatus, CD4 count, and medical and lifestyle history were collected. ASIL was diagnosed in 36% of HIV-positive men and 7% of HIV-negative men (relative risk [RR] = 5.7; 95% confidence interval [CI], 3.6-8.9). Among HIV-positive men, the RR for ASIL increased with lower CD4 levels but was elevated even in men with CD4 levels >500/mm3 (RR = 3.8; 95% CI, 2.1-6.7) when compared with HIV-negative men. High-level HPV infection, as measured by detection of both hybrid capture (HC) group A and group B types, was another significant risk factor for ASIL in both HIV-positive men (RR = 8.8; 95% CI, 2.3-35) and HIV-negative men (RR = 20; 95% CI, 5.5-71) when compared with HC-negative men. HIV-negative men with anal HPV infection and HIV-positive men, regardless of CD4 level, are at high risk for ASIL.
Bacterial pneumonia in HIV-infected patients: analysis of risk factors and prognostic indicators.
Tumbarello M. Tacconelli E. de Gaetano K. Ardito F. Pirronti T. Cauda R. Ortona L.
Department of Infectious Diseases, Catholic University, Rome, Italy.
This case control study assessed risk factors and prognostic indicators of 350 episodes of bacterial pneumonia in 285 HIV-infected patients. On univariate analysis, intravenous drug abuse (i.v.DA; p < .001 versus controls), regular cigarette smoking (p < .001), cirrhosis (p = .04), and history of a previous episode of pneumonia (p = .04) were risk factors for community-acquired episodes of bacterial pneumonia, whereas length of hospitalization (p = .01) was a risk factor only for nosocomial bacterial pneumonia. The small amount of circulating T CD4+ cells (