Signs and symptoms of 'asymptomatic' HIV-1 infection in homosexual men
HIV seropositivity can significantly affect an individual's physical and mental health even before the onset of AIDS or AIDS-related complex. The health status of 916 HIV-positive homosexual men at least 1.67 to 3.67 years before developing AIDS was compared with that of 2,161 HIV-negative homosexual men. The seropositive group reported a higher overall incidence of the following twelve symptoms: fatigue, shortness of breath, rash, diarrhea, cough, headache, thrush, skin discoloration, fever, weight loss and sore throat. The number of self-reported sexually transmitted diseases was higher among the HIV-positive group. HIV-positive men had a lower body mass index and lower levels of hemoglobin. As a group, they were more likely to be clinically depressed even before they knew they were HIV-positive, and after testing positive for HIV, they became more depressed. While these health effects are not as severe as those associated with AIDS, they should not be ignored.
Publication Name: Journal of Acquired Immune Deficiency Syndromes
Predictors for failure of Pneumocystis carinii pneumonia prophylaxis
HIV-infected patients who have severely compromised immune systems appear to be more likely than other HIV-infected patients to develop Pneumocystis carinii pneumonia (PCP) despite preventive drug therapy. PCP is a parasitic infection that may occur in people with damaged immune systems, particularly those with HIV infection. Researchers followed 476 HIV-infected homosexual men who took various drug regimens to prevent PCP between July 1989 and January 1993. Nineteen percent subsequently contracted PCP. Patients with helper T-cell counts below 50, which is indicative of severe immune system suppression, were nearly three times more likely to develop PCP than patients with helper T-cells counts between 100 and 200. Patients taking trimethoprim-sulfamethoxazole to prevent PCP and patients who smoked had approximately half the risk of developing PCP as the other patients. Those with fever were more than twice as likely to develop PCP as the other patients.
Publication Name: JAMA, The Journal of the American Medical Association
"Sensitivity" and "specificity" reconsidered: the meaning of these terms in analytical and diagnostic settings
The terms analytical sensitivity, diagnostic sensitivity, analytical specificity, and diagnostic specificity all have very different meanings and should be used appropriately. The term analytical refers to the test itself and diagnostic refers to its usefulness within a population. A test's analytical sensitivity is the smallest amount of target substance identifiable with the test while its diagnostic sensitivity is the percentage of people who test positive. A test's analytical specificity is its ability to distinguish the target substance from other substances while diagnostic specificity is the percentage of true negative results.
Publication Name: Annals of Internal Medicine
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