Human immunodeficiency virus among Peace Corps volunteers in Zaire: no evidence for unusual modes of transmission

Article Abstract:

AIDS and infection with human immunodeficiency virus (HIV) are particularly important health problems in parts of Africa: more than three million Africans may harbor the virus. Most AIDS cases in Africa, in contrast to the US where the disease is more prevalent among male homosexuals and intravenous drug users, are heterosexuals or children who were exposed to HIV before birth. To learn more about the risks of acquiring HIV and hepatitis B virus (another serious infection) in an expatriate population with extensive education concerning AIDS, a prospective study of 282 Peace Corps Volunteers (PCVs) in Zaire was carried out. Blood samples were analyzed at the beginning of the study, at the end of Peace Corps service, and, in some cases, at other times (average length of service, 27.4 months). No samples tested positive for HIV. The 14 (of 226) PCVs with a positive test result for hepatitis B virus had not developed the hepatitis B antibody during their service. The results indicate that the risk of acquiring HIV or hepatitis B virus is low, even in an area where both infections are endemic. It is likely that this results from the lack of participation by PCVs in high-risk behavior as well from the lack of transmission of these infections by unusual routes (sharing eating utensils, or via insects). It does not appear necessary for visitors and others who travel to countries with high rates of infection by HIV or hepatitis B to take precautions beyond those currently recommended. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, HIV infection, HIV infections, Disease transmission, Hepatitis B, United States. Peace Corps, Zaire

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Extrapulmonary Pneumocystis carinii infections in the acquired immunodeficiency syndrome

Article Abstract:

Pneumocystis carinii is a fungus that infects nearly 100 percent of the population by age four. In those patients with impaired immune systems, pneumocystis disease can be fatal, and in nearly all cases, this is due to Pneumocystis carinii pneumonia (PCP). PCP is typically seen in patients with AIDS or those with cancer who are receiving chemotherapy, which destroys some of the body's immune system. Pneumocystis rarely infects tissues outside the lungs, but autopsies of AIDS patients are demonstrating rates as high as 2.5 percent of extrapulmonary pneumocystosis. A review of the medical literature revealed nearly 40 cases of AIDS patients with extrapulmonary pneumocystosis. Some of the organs involved included the lymph nodes, the ears, the liver, the bone marrow, the kidneys and the spleen. The question has been raised whether one preventive therapy for PCP may be causing an increased incidence of extrapulmonary pneumocystosis. Aerosolized pentamidine, an anti-PCP drug given in inhaled form, may be suppressing the organism in the lungs, permitting it to grow in other tissues. An alternative explanation is that aerosolized pentamidine and other treatments for AIDS are permitting longer survival, and thus, more opportunity for patients to develop extrapulmonary pneumocystosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Diseases, AIDS patients, Pneumocystis carinii pneumonia, Pneumocystis carinii

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Human immunodeficiency virus transmission and hemophilia

Article Abstract:

Although heterosexual (opposite sex) transmission of the human immunodeficiency virus (HIV) represents a small percentage of persons with HIV, it is a public health care issue. Despite education and counseling regarding safe sex practices to prevent the transmission of HIV, fewer than half of the couples in which one member is a hemophiliac practice these measures consistently. Using safe sex methods may increase the HIV-associated stress that is experienced by these couples, as hemophiliac patients are often treated with blood products, and female partners may not be well-informed and may fear the loss of medical confidentiality. Health care providers who treat patients with hemophilia will fulfill their ethical and moral obligation to the sexual partners of their patients by providing these partners with appropriate education and counseling.

Sexually transmitted diseases, Prevention, Complications and side effects, Study and teaching, Hemophilia, Sexually transmitted disease prevention, AIDS (Disease), Safe sex

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