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M94A2399.TXT
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1994-10-25
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Document 2399
DOCN M94A2399
TI Comparative analysis of HIV infection in men and women.
DT 9412
AU Kadree M; Clark J; Division of Infectious Diseases, Morehouse School of
Medicine,; Atlanta, GA 30310.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):313 (abstract no. PC0182). Unique
Identifier : AIDSLINE ICA10/94370176
AB OBJECTIVE: To determine those differences in the clinical manifestations
of HIV infection in females (F) and males (M), which may have
substantial implications regarding clinical management. METHOD:
retrospective chart review of 216 HIV-infected patients[pts]; pts.
stratified by mean CD4 counts expressed in number/cu.mm; the number of
OI events were reported as a function of the mean CD4 values; major
criterion for inclusion: consistent follow-up over a minimum of 1 year.
RESULTS: Seventy-eight pts met the inclusion criterion, F = 36, M = 42;
mean length of time known to be HIV+: F = 2.2 years, M = 2.4 years; mean
period of active clinical follow-up: F = 1.6 years, M = 1.4 years; F =
28%, M = 43% were injection drug users [IDUs]; 91 OI events were
recorded, F = 34, M = 57; oral candidiasis [OC]: M = 53%, F = 24%; for
females--vaginal candidiasis = 20%; esophageal candidiasis: M = F = 9%.
PCP: M = 25%; F = 27%. Surprising findings were: 1) the high percentage
of OIs occurring at CD4 counts > 500 [F = 26%, M = 14%] and 2) the low
frequency of OIs in females with CD4 values between 100-200 when
compared with the 200-300 group [3% vs. 26%], a trend not observed in
males. For both sexes, all the AIDS-defining OIs [ADOIs] in pts with CD4
values > 500 occurred exclusively in IDUs. DISCUSSION AND CONCLUSION:
The high number of OIs/ADOIs in IDUs with CD4 counts > 500 [range
516-756], suggest that IDUs may have 1 degree CD4 dysfunction, another
immune system derangement, or a higher systemic viral load [perhaps due
to ongoing opiate use--morphine, in vitro, enhances HIV replication].
The decrease in OIs in females following introduction of
Trimethoprim/Sulfa [TMP/SX] may reflect a positive benefit from TMP/SX,
a trend that was not noted for males. This may be due to gender
differences in the pharmacokinetics and/or metabolism of TMP/SX. The
results of this study raises important questions on the immunological
impact of IDU on HIV infection in both sexes and possible gender
differences in the frequency of certain OIs and metabolism of certain
drugs, all of which have significant clinical ramifications and need to
be explored prospectively.
DE AIDS-Related Opportunistic Infections/IMMUNOLOGY Comparative Study
Female Human *HIV Infections/COMPLICATIONS/IMMUNOLOGY Leukocyte Count
Male Retrospective Studies Substance Abuse, Intravenous/COMPLICATIONS
T4 Lymphocytes MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).