Journal of acquired immune deficiency syndromes : JAIDS
-
J. Acquir. Immune Defic. Syndr. · Mar 2008
Multicenter StudyLongitudinal anthropometric patterns among HIV-infected and HIV-uninfected women.
Previous studies suggest that indicators of central adiposity such as waist-to-hip ratio (WHR) and waist circumference may be altered by HIV infection, antiretroviral treatment, or both. ⋯ HIV-infected women had higher WHRs compared with HIV-uninfected women, despite lower BMIs and waist and hip measurements. BMI and waist and hip circumference increased over 5 years among the HIV-uninfected women but remained stable in the HIV-infected women. Among HIV-infected women, PI use was associated with a larger WHR, although HAART use itself was not appreciably associated with BMI or WHR.
-
J. Acquir. Immune Defic. Syndr. · Mar 2008
Incidence of visits for health care worker blood or body fluid exposures and HIV postexposure prophylaxis provision at Rhode Island emergency departments.
To compare the incidence and types of emergency department (ED) visits for blood or body fluid exposures sustained by health care workers (HCWs) in Rhode Island and to identify factors predictive of HIV postexposure prophylaxis (PEP) utilization for these exposures. ⋯ The IRs of ED visits for exposures varied by occupation, and there were clear temporal trends for these visits. Despite the existence of federal guidelines for HIV PEP for occupational blood or body fluid exposures, factors other than characteristics of the exposure, such as type of hospital, occupation, and gender, may be influencing HIV PEP utilization.
-
J. Acquir. Immune Defic. Syndr. · Dec 2007
Routine HIV screening in the emergency department using the new US Centers for Disease Control and Prevention Guidelines: results from a high-prevalence area.
In 2006, the US Centers for Disease Control and Prevention (CDC) released new recommendations for routine HIV testing. Among these were recommendations that emergency departments (EDs) offer routine opt-out HIV screening to their patients. We established a screening program implementing these recommendations at an urban university hospital ED in Washington, DC. We report the results of this program. ⋯ The implementation of the CDC recommendations establishing routine opt-out HIV screening programs in EDs is feasible. Further efforts to establish routine ED HIV testing are therefore warranted.
-
J. Acquir. Immune Defic. Syndr. · Aug 2007
Randomized Controlled Trial Clinical TrialDronabinol and marijuana in HIV-positive marijuana smokers. Caloric intake, mood, and sleep.
Individuals with HIV constitute the largest group using cannabinoids for medicinal reasons; yet, no studies have directly compared the tolerability and efficacy of smoked marijuana and oral dronabinol maintenance in HIV-positive marijuana smokers. This placebo-controlled within-subjects study evaluated marijuana and dronabinol across a range of behaviors: eating topography, mood, cognitive performance, physiologic measures, and sleep. ⋯ These data suggest that for HIV-positive marijuana smokers, both dronabinol (at doses 8 times current recommendations) and marijuana were well tolerated and produced substantial and comparable increases in food intake.
-
J. Acquir. Immune Defic. Syndr. · Aug 2007
Transient viremia, plasma viral load, and reservoir replenishment in HIV-infected patients on antiretroviral therapy.
When antiretroviral therapy (ART) is administered for long periods to HIV-1-infected patients, most achieve viral loads that are "undetectable" by standard assay methods (ie, HIV-1 RNA <50 copies/mL). Despite sustaining viral loads lower than the level of detection, a number of patients experience unexplained episodes of transient viremia or viral "blips." We propose that transient activation of the immune system by infectious agents may explain these episodes of viremia. ⋯ This effect can be more profound than is predicted by simply lowering the baseline viral load from which blips originate. Finally, we suggest that sporadic immune activation may elevate the level of chronically infected cells and replenish viral reservoirs, including the latent cell reservoir, providing a mechanism for recurrent viral blips and low levels of viremia under ART.