Biomedical subjects

D L Cohn

Publications and source records attributed to D L Cohn.

93 records · Page 6Linked to original sources

PubMedDate not supplied

Opportunistic infections in patients with AIDS: clues to the epidemiology of AIDS and the relative virulence of pathogens.

The frequency of nine reactivating or opportunistic infections and Kaposi's sarcoma among patients with the acquired immunodeficiency syndrome (AIDS) was reviewed. The diagnoses of 87 patients reported from the Colorado AIDS registry and 359 others from literature reports were abstracted, and data were placed in one of 11 categories on the basis of the risk group of the patient. Pneumocystis carinii infection was significantly commoner among blood or blood-product recipients than among natives of the tropics (P less than .001). Tuberculosis and toxoplasmosis each were significantly commoner among natives of the tropics than natives of developed countries (P less than .001), whereas disseminated Mycobacterium avium-Mycobacterium intracellulare infections were present more often in the latter group. Among natives of the tropics treated in developed countries, cytomegaloviral infection was diagnosed significantly less often (22%) than among persons from developed countries in whom sexual transmission was presumed (47%; P = .0005). These data suggest that the pattern of infections manifested in AIDS could provide clues about transmission and that there may be a hierarchy of reactivation of latent infections in which populations with exposure to multiple agents manifest these preferentially to Pneumocystis carinii.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Factors influencing the risk of infection with human immunodeficiency virus in homosexual men, Denver 1982-1985.

The factors associated with infection with the human immunodeficiency virus (HIV) in 216 homosexual men enrolled from November 1982 through December 1985, including 40 asymptomatic HIV seronegative, 20 asymptomatic seropositive, 66 with generalized lymphadenopathy (GLS), 37 with AIDS-related complex (ARC), and 53 with AIDS were studied. Because univariate analysis did not show significant differences between asymptomatic seropositive men and men with GLS or between men with ARC and AIDS, these groups were combined for analysis. In multivariate analysis the number of episodes of receptive and intercourse, the age at which regular sexual intercourse with a male partner was started, the use of enemas, sexual contact with someone with ARC or AIDS, and a history of hepatitis B were all independently associated with HIV infection. In univariate analysis the men with ARC or AIDS did not differ significantly from asymptomatic seronegative men as to number of episodes of receptive or insertive anal intercourse and number of sexual partners, but this most likely represents confounding that occurs when current risk factor behavior in fatally ill men is used in place of risk factor behavior at the time of HIV transmission. It indicates, however, that this group has become less sexually active and that HIV infection is largely spread by relatively healthy infected men.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Human immunodeficiency virus seroprevalence and risk assessment of a homeless population in Denver.

OBJECTIVE: TO determine the prevalence of human immunodeficiency virus (HIV) infection among the homeless of Denver and to describe behaviors in the homeless that may be associated with HIV infection. DESIGN: A cross-sectional cohort study. METHODS: From July 1990 through June 1994, the authors conducted an unlinked survey collecting demographic and risk exposure data, and from August 1990 through June 1992, a more detailed risk behavior survey was completed on persons who attended the largest homeless clinic in Denver. RESULTS: For the combined survey years, the overall seroprevalence rate in the unlinked survey was 0.9%. Men were more likely to be seropositive than women (1.3% versus 0.1%) (P < 0.001). Black and Hispanic men had higher seroprevalence rates than white men (3.1% and 2.2% versus 0.5%) (P < 0.001). Gay and bisexual men, men who were injection drug users, and men with partners at risk had a nearly fivefold higher seroprevalence rate compared to other risk groups (3.1% versus 0.7%, P < 0.001). During the 4 study years, 14% of homeless persons tested positive for tuberculosis. In the risk behavior survey, 41% of the clients reported previous injection drug use (since 1978), and 22% reported recent use (past 12 months); of this 22%, 16% reported sharing their works (needles and paraphernalia). Seventy percent of the study participants stated that they changed their sexual behavior, and 39% reported using condoms in the past 12 months. CONCLUSIONS: In this homeless Denver population, there is a low seroprevalence of HIV but a high rate of HIV risk behavior. Certain groups of homeless persons are at high risk for HIV infection, and targeted interventions are necessary.

Adult↗