HIV, bleach, and needle sharing.
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
D Osmond
Publications and source records attributed to D Osmond.
Risk of transmitting the human immunodeficiency virus, cytomegalovirus, and hepatitis B virus to health care workers exposed to patients with AIDS and AIDS-related conditions.
This prospective cohort study was designed to evaluate the risk of occupational transmission of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and cytomegalovirus (CMV) to health care workers with intensive exposure to HIV-infected patients. Seventy-five percent of the 270 subjects had been exposed to patients with AIDS and AIDS-related conditions (ARC) for at least one year before enrollment, 18% worked in specialized AIDS units, and 35% sustained a total of 342 accidental parenteral exposures to HIV-infected body fluids. At the time of enrollment, none had antibody to HIV, and none of the 175 subjects retested 10 months later had acquired antibody. No evidence of increased risk of acquiring CMV or HBV was obtained. These results indicate that health care workers are at minimal risk for HIV, CMV, and HBV transmission from occupational exposure to patients with AIDS or ARC, even when intensively exposed for prolonged periods of time.
AIDS-Related Complex↗
Risk factors for AIDS and HIV seropositivity in homosexual men.
The authors compared cases of acquired immunodeficiency syndrome (AIDS) diagnosed in San Francisco, California, during 1983-1984 with human immuno-deficiency virus (HIV) antibody-negative neighborhood and clinic controls, looking for risk factors for clinical AIDS. They also compared antibody-positive with antibody-negative neighborhood and clinic controls for risk factors for HIV infection. Odds ratios were 52.0 for AIDs and 7.8 for seropositivity for more than 100 sexual partners versus 0-5 partners when antibody-negative neighborhood controls were compared with cases and with antibody-positive neighborhood controls, respectively. Odds ratios were only 2.9 and 3.4 when antibody-negative clinic controls were compared with cases and with antibody-positive clinic controls, respectively. Odds ratios of 4.6-7.3 for rectal receptivity with most or all partners versus none or one partner were statistically significant, independent of the number of partners. Douching before sex was independently associated with odds ratios of 2.2-2.8. There was no evidence for oral-genital, oral-anal, or other sexual transmission of AIDS. In multivariate analysis, independent odds ratios of 2.4-6.0 for prior syphilis and 10.8-27.9 for prior giardiasis were statistically significant or marginally significant in all comparisons. There was a moderate association with nitrite use. No other drugs were consistently associated with clinical AIDS or HIV seropositivity. Odds ratios associated with AIDS and seropositivity were closely comparable except for number of partners.
Acquired Immunodeficiency Syndrome↗
Human immunodeficiency virus infection in heterosexual intravenous drug users in San Francisco.
To investigate the risk of infection with the human immunodeficiency virus (HIV) in San Francisco, the prevalence of antibodies to HIV was determined in 281 heterosexual intravenous drug users recruited from community-based settings. Ten per cent of subjects had ELISA and Western blot confirmed seropositivity for antibodies (95 per cent CI 6.8-14.2 per cent). Analysis of behavioral factors revealed an increased risk of seropositivity in addicts who reported regularly sharing needles when injecting, particularly those sharing with two or more persons (odds ratio = 5.43; 95 per cent CI 1.08-52.5). Blacks and Latinos also had a greater prevalence of seropositivity than Whites, and this finding persisted after adjustment for needle sharing (adjusted odds ratio = 2.8; 95 per cent CI .84-8.59). Seropositivity was not associated with age, sex, duration of drug use, or history of prostitution. These data indicate that a new epidemic of AIDS (acquired immunodeficiency syndrome) in intravenous drug users, similar to that which has occurred among homosexuals in San Francisco, is possible. The relatively low seroprevalence in 1985 provides health officials an important opportunity to intervene and attempt to prevent widespread infection of drug users with HIV.
Acquired Immunodeficiency Syndrome↗
Exposure to hair dyes and polychlorinated dibenzo-p-dioxins in AIDS patients with Kaposi sarcoma: an epidemiological investigation.
Fifty male AIDS patients with Kaposi sarcoma and 50 matched controls were interviewed about occupation, exposure to pesticides, Vietnam service, smoking habits, etc. No difference in use of pesticides was seen. One case but no control had served in Vietnam and was thereby exposed to agent orange. Dioxins are known to be immunosuppressive in animals. No significant difference in exposure to dioxin-containing products was found between cases and controls, however. Of interest was the fact that four cases but no control were occupationally exposed to hair dyes, some of which have been reported to be carcinogenic.
Acquired Immunodeficiency Syndrome↗
Hormonal risk factors in testicular cancer. A case-control study.
The authors interviewed 273 northern California testicular cancer cases aged 40 and under diagnosed between 1976 and 1981, their mothers, and matched peer controls and their mothers on prenatal hormone exposure and other variables. Included was a population-based substudy (1979-1981) of all interviewable cases reported to the San Francisco Bay Area Surveillance, Epidemiology, and End Results registry. They found odds ratios (OR) of from 8.3 (sons' report) to 4.5 (mothers' report) associated with cryptorchidism, but found no association with mothers' hormone exposure or diethylstilbestrol exposure in pregnancy. They also found a significant association with lower age at puberty (OR = 2.0); a marginally significant association with mothers' breast cancer (OR = 2.9, p = 0.054); and a significant protective effect of reported mononucleosis (OR = 0.6). These associations remained strong in the population-based substudy. When cases were divided by histology, strong and specific associations of earlier puberty (OR = 2.3) and mothers' breast cancer (OR = 4.4) with nonseminomatous cancer, and of reported mononucleosis (OR = 0.3) with seminomatous cancer, were found. These observations suggest that 1) prenatal exogenous hormone exposure does not account for a significant fraction of testicular cancer, 2) a cluster of "breast-cancer-like" risk factors are associated with nonseminomas, and 3) there is some genetic risk of nonseminomas.
Adult↗
Risk of seroconversion for acquired immunodeficiency syndrome (AIDS) in San Francisco health workers.
The occupational risk of acquiring acquired immunodeficiency syndrome (AIDS) virus infection in health workers exposed to AIDS patients and specimens was assessed by a serologic study at San Francisco General Hospital and collaborating research laboratories. A total of 101 medical workers without risk factors for AIDS were examined for antibodies to two isolates of the AIDS retrovirus (AIDS-associated retrovirus 2[ARV-2] and human T cell lymphotropic virus III). Most had heavy, long-term exposure to AIDS patients and 29 had been exposed by needlestick or mucocutaneous accident. None of the 101 had antibodies to ARV-2 by immunofluorescence or to HTLV-III by enzyme-linked immunosorbent assay and Western Blot.
Acquired Immunodeficiency Syndrome↗
Incidence of the acquired immunodeficiency syndrome in San Francisco, 1980-1983.
Incidence data for the acquired immunodeficiency syndrome (AIDS) are presented on the basis of a surveillance file maintained by the San Francisco Bureau of Communicable Disease Control. The incidence of AIDS among residents of San Francisco rose steadily from the first case diagnosed in the last quarter of 1980 through the last quarter of 1983. New cases were diagnosed at a rate of 25 per month in the last quarter of 1983. Reported incidence declined in mid-1983, but the decline was probably a case-finding artifact. Smoothed incidence rates show a steady progressive rise, which is approximated equally well by quadratic or exponential curves. Among the patients diagnosed in San Francisco, 99% were homosexual or bisexual men. The cumulative incidence rate among homosexual or bisexual men was estimated to be 770 per 100,000 in the last quarter of 1983. The incidence rate of AIDS increased with age, and the increase was greater than that found with other sexually transmitted diseases. The difference in the age distributions between cases of AIDS and syphilis suggests either that susceptibility to AIDS increases with age or that the average latency associated with AIDS is longer than previously thought.
Acquired Immunodeficiency Syndrome↗
Effect of new AIDS case definition on numbers of cases among homosexual and bisexual men in San Francisco.
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Acquired Immunodeficiency Syndrome↗