Background Antiretroviral therapy that reduces viral replication could limit the transmission of human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples. Methods In nine countries, we...

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Prevention of HIV-1 Infection with Early Antiretroviral Therapy

Lionel A. Mandell, Richard G. Wunderink, Antonio Anzueto, John G. Bartlett, G. Douglas Campbell, Nathan C. Dean, Scott F. Dowell, Thomas M. File, Jr. Daniel M. Musher, Michael S. Niederman, Antonio Torres, and Cynthia G. Whitney McMaster University Medical School, Hamilton, Ontario, Canada; Northwestern University Feinberg School of Medicine, Chicago, Illinois; University of Texas Health Science Center and South Texas Veterans Health Care System, San Antonio, and Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas; Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Mississippi School of Medicine, Jackson; Division of Pulmonary and Critical Care Medicine, LDS Hospital, and University of Utah, Salt Lake City, Utah; Centers for Disease Control and Prevention, Atlanta, Georgia; Northeastern Ohio Universities College of Medicine, Rootstown, and Summa Health System, Akron, Ohio; State University of New York at Stony Brook, Stony Brook, and Department of Medicine, Winthrop University Hospital, Mineola, New York; and Cap de Servei de Pneumologia i Allergia Respiratoria, Institut Clinic del Torax, Hospital Clinic de Barcelona, Facultat de Medicina, Universitat de Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer, CIBER CB06/06/0028, Barcelona, Spain.

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Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults

Publisher Summary This chapter discusses the role of free radicals and catalytic metal ions in human disease. The importance of transition metal ions in mediating oxidant damage naturally leads to the question as to what forms of such ions might be available to catalyze radical reactions in vivo . The chapter discusses the metabolism of transition metals, such as iron and copper. It also discusses the chelation therapy that is an approach to site-specific antioxidant protection. The detection and measurement of lipid peroxidation is the evidence most frequently cited to support the involvement of free radical reactions in toxicology and in human disease. A wide range of techniques is available to measure the rate of this process, but none is applicable to all circumstances. The two most popular are the measurement of diene conjugation and the thiobarbituric acid (TBA) test, but they are both subject to pitfalls, especially when applied to human samples. The chapter also discusses the essential principles of the peroxidation process. When discussing lipid peroxidation, it is essential to use clear terminology for the sequence of events involved; an imprecise use of terms such as initiation has caused considerable confusion in the literature. In a completely peroxide-free lipid system, first chain initiation of a peroxidation sequence in a membrane or polyunsaturated fatty acid refers to the attack of any species that has sufficient reactivity to abstract a hydrogen atom from a methylene group.

Role of free radicals and catalytic metal ions in human disease: an overview.

1. Introduction and Overview. 2. Detecting Influential Observations and Outliers. 3. Detecting and Assessing Collinearity. 4. Applications and Remedies. 5. Research Issues and Directions for Extensions. Bibliography. Author Index. Subject Index.

Regression Diagnostics: Identifying Influential Data and Sources of Collinearity

The MMWR series of publications is published by the Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA 30333.

/pdf/sexually-transmitted-diseases-treatment-guidelines-4zaqk3joit.pdf

Sexually transmitted diseases treatment guidelines.

In recent years spin trapping techniques have been used extensively to better understand the free radical biology of phagocytic cells. These results demonstrate that spin trapping is of adequate sensitivity to detect superoxide and/or hydroxyl radical generated by these cells, and that spin trapping is capable of measuring phagosomal radicals as well. However. neither neutrophils. monocytes. nor monocyte derived macro-phages generate hydroxyl radical in the absence of exogenous iron. Furthermore. neutrophil lactoferrin and myeloperoxidase limit the magnitude (and in the case of lactoferrin the duration) of hydroxyl radical formed by neutrophils in an iron catalyzed system. Since monocytic phagocytes posxss no lactoferrin, and limited myeloperoxidase, hydroxyl radical may play an important role in the inflammatory behavior of mononuclear phagocytes.

Application of spin trapping to human phagocytic cells: insight into conditions for formation and limitation of hydroxyl radical.

Background
Syphilis is prevalent among men who have sex with men (MSM) in China. Syphilis partner notification (PN) programs targeting MSM has been considered as one of effective strategies to prevention and control of the infection in the population. We examined willingness and preferences for PN among MSM to measure feasibility and optimize uptake.

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Optimizing Partner Notification Programs for Men Who Have Sex with Men: Factorial Survey Results from South China.

Gonococcal pathogenesis: Adaptation and immune evasion in the human host

Publisher Summary
This chapter describes the ways in which antiretrovirals (ART) can be used for prevention as well as treatment of HIV. ART has drastically reduced HIV-associated mortality and improved the quality of lives of those living with HIV infection. More recently, global initiatives to expand the use of ART in resource poor countries have achieved some degree of success. The transmission of HIV depends on the infectiousness of the host and the susceptibility of the partner. The likelihood of transmission can be described in terms of “efficiency,” which varies greatly by the route of transmission and, for sexual transmission, the details of the sexual behavior. Transmission of HIV by all routes has been most strongly associated with HIV viral load in the blood. The association between HIV viral load and sexual transmission must reflect a correlation between the concentration of HIV in genital secretions and in blood. Antiretroviral agents differ greatly in their ability to penetrate the genital tract. Since highly protein-bound antiretroviral agents achieve lower concentrations in genital tract than in blood plasma, affinity for albumin and a 1–acid glycoprotein may prevent penetration of antiviral agents into genital secretions. There are three ways ART can be used to prevent HIV transmission: by reducing HIV viral load in people who know they are infected, as post-exposure prophylaxis, and as pre-exposure prophylaxis both orally and as a topical microbicide. Antiretroviral therapy will prolong survival, but at the same time will greatly increase the time available for viral transmission and the transmission of resistant isolates. The expanded use of ART for prevention in research, clinical, and casual practice seems inevitable.

Using antiretrovirals to prevent HIV transmission

Despite major obstacles, activities to control sexually transmitted diseases (STDs) were initiated in Haiti in 1992 in collaboration with local nongovernmental organizations. The approaches included review of available local data, assessment of STD case management practices and constraints, and development of specific STD control activities at the primary health care level, such as systematic screening of all pregnant women for syphilis and improved comprehensive syndrome-based STD case management. The activities included conduct of local studies, presentation and dissemination of results to key audiences, training of health care providers, improvement of local capacities, and consensus-building on implementation of STD control approaches. STD awareness and case management improved considerably; for example, 69% of the clinicians interviewed reported correct STD treatments in the north-eastern primary health care centres in 1995, compared with < 10% in 1992. At the end of the project, national STD case management guidelines were developed by consensus between the various organizations and the Ministry of Health. Lessons learned included the importance of local data generation and of communication and collaboration with various institutions for consensus-building, the need for continued training, and field supervision to ensure behaviour change among STD care providers. A national STD control programme should be implemented as soon as possible in both the public and private sector. External funding will remain critical to control this important public health problem in Haiti.

Myron S. Cohen

Papers

Application of spin trapping to human phagocytic cells: insight into conditions for formation and limitation of hydroxyl radical.

Optimizing Partner Notification Programs for Men Who Have Sex with Men: Factorial Survey Results from South China.

Gonococcal pathogenesis: Adaptation and immune evasion in the human host

Using antiretrovirals to prevent HIV transmission

Approaches to control sexually transmitted diseases in Haiti, 1992-95.