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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

 


AIDS/HIV & Hepatitis:
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Main topics can be found within the left column; sub-topics and/or research reports can be found near the bottom of this page.  Thank you

"Our nation has been in the fight against HIV/AIDS for over 20 years now. The government pours millions of dollars into care, treatment and prevention. Why are there still so many Black people becoming infected and dying from this virus? We know from reports that there are health disparities between communities of color and the white population. We also know that in communities of color there is an inherited mistrust of the system. Do these reasons equate to the disproportionate amount of black people infected by this disease? Yes, they do play a part, but only a part. African Americans have other obstacles, which put them on the frontline of this virus.

Many people in Black communities are under the misguided perception that AIDS is a disease that only affects the gay population and those people who misuse drugs. In the 1980s, the gay and lesbian community did a great job of putting a face on this horrific virus, and should be commended. They refused to let their brothers die in silence. Now the time has long passed for the other faces of AIDS to be brought to the forefront. Black communities around the country need to rise up and refuse to perish without a fight. We should not pass silently into the night.

Many of those who lose the battle to AIDS in the Black community are not counted as those who have fallen to this virus. Cancer, pneumonia, or heart attacks are causes of death that we tell our family and friends. Those who are infected still fear letting others know on the chance they may be ostracized from family, friends, and the community at large. Many continue to die alone with no one to hold their hands or wipe their brows. Far too many do not seek care fearing that family and neighbors will discover the secret. Still others do not test, wrongly believing that ignorance is bliss. Shame is robbing our community of its lifeline and its future.

Even our churches, which have been a bastion of support in the Black community for many worthy causes, have not risen to this fight in appropriate numbers. Ministers continue to blame those who are infected for being immoral and sinners. How sad it is that some of our churches take this view. Some of our politicians are saying teach abstinence-only in our schools. Abstinence-only has been taught for many years and we still have a problem in this country with teen pregnancy. We cannot allow our children to die using antiquated solutions, which have never proven effective. If we do not become educated about this disease, if we do not drag AIDS out of the shadows where it has been able to fester and grow in our communities, then we will perish. The shame and ignorance surrounding AIDS in Black America could lead to the demise of us all.

We are in a burning building and only a few are shouting for all of us to get out." Dying in Silence-African Americans

ADDITIONAL ARTICLES:

Document Name & Link to Document

Description

File Size /pdf

99% Of Patients on Pegasysâ Remain 'Cured' of Hepatitis C Virus When Tested Three Years Later

The first study evaluating the long-term effectiveness of PEGASYSâ, peginterferon alfa-2a (40KD), a promising new hepatitis C treatment, has found that 99% of patients remain viral free when examined two to three years later.

 

A Portrait of the HIV+ Population in America Despite the dramatic growth in our knowledge about HIV/AIDS treatment over the past 15 years, several fundamental questions about HIV care still exist: How many persons in the United States receive regular care for HIV infection? What are the characteristics of that population? How much care do HIV-infected individuals use, how much does it cost, and who pays for it? Policymakers, researchers, and the national community depend upon reliable answers to these questions to help guide their decisions in allocating future resources to HIV treatment and research.  
A violation of citizens’ rights: The health sector and tuberculosis The magnitude of the human problem caused by TB, especially with its current co-infection status with HIV is such that it is ethically imperative for all to respond in some measure. If morals do not convince, at least the instinct of self- preservation should. The spectre of drug resistant TB may touch anyone.  

ABC of diseases of liver, pancreas, and biliary system

Increases in portal pressure cause development of a portosystemic collateral circulation with resultant compensatory portosystemic shunting and disturbed intrahepatic circulation. These factors are partly responsible for the important complications of chronic liver disease, including variceal bleeding, hepatic encephalopathy, ascites, hepatorenal syndrome, recurrent infection, and abnormalities in coagulation. Variceal bleeding is the most serious complication and is an important cause of death in patients with cirrhotic liver disease.

 

A culture of safety

To err is human, but to report is no longer "divine" – it's expected. The AMA is working to reduce medical errors and improve reporting protocol

 

AASLD: Pegylated Interferon Alpha-2b Plus Ribavirin Provides Treatment Option for Patients with Hepatitis C Virus and Normal Liver

The combination achieved an overall virologic response rate of 68 percent at 12 weeks, including a 90 percent response rate in patients who had genotype non-1, said Dr. Steven Flamm, a hepatologist at Northwestern University, in Chicago, Illinois, United States.

 

Abstinence-Only Education Policies and Programs: A Position Paper of the Society for Adolescent Medicine The Society for Adolescent Medicine (SAM) supports abstinence from sexual intercourse as “a healthy choice for teenagers” but critiques government policies and programs that promote abstinence-only or abstinence until marriage as the only prevention message for teenagers.  SAM recommends that “ ‘Abstinence-only’ as a basis for health policy and programs should be abandoned.”    
Access to Condoms and HIV/AIDS information HIV/AIDS is a preventable disease, yet approximately 5 million people were newly infected with HIV in 2003, the majority of them through sex.  Many of these cases could have been avoided, but for state-imposed restrictions on proven and effective HIV prevention strategies, such as latex condoms…scientific data “overwhelmingly confirm that male latex condoms are highly effective in preventing sexual HIV transmission.  Many governments around the world either fail to guarantee access to condoms or impose needless restrictions on access to condoms and related HIV/AIDS information Pdf 293 kb
Acute HIV Syndrome HIV syndrome is a name for the early stage of HIV infection, when you first get infected with the HIV virus. HIV stands for human immunodeficiency virus. These are some of the symptoms of acute HIV syndrome  
ADDRESSING HIV TESTING, INFORMED CONSENT AND COUNSELING In an effort to reduce the number of people unaware of their positive status, and in hope of preventing future transmissions by this population, the CDC has developed a number of new recommendations to encourage and increase HIV testing around the country.  
Adolescent Women 
Face Triple Jeopardy: 
Unwanted Pregnancy,
 HIV/AIDS
New HIV infections and AIDS cases continue to increase in 
most developing countries, while the AIDS epidemic has most 
recently reached a plateau or shown signs of a slight overall 
decline in much of the developed world.  Where AIDS is 
increasing, new HIV infection is disproportionately
high among young women who contract the virus through sexual
 intercourse…This same group has the highest rate worldwide of 
unwanted pregnancy, pointing to a potentially significant 
epidemiological overlap of reproductive health risk.
 
Advocates for Youth-Press Release Leading Medical Association Rejects Abstinence-Only Policies – Programs at odds with medical ethics and basic human rights  

Advances in Liver Disease

Highlights from the 54th Annual Meeting of the American Association for the Study of Liver Diseases: Nonalcoholic fatty liver disease, Nonalcoholic steatohepatitis, Portal hypertension, Hepatocellular carcinoma, Primary biliary cirrhosis, Hepatitis, Obesity, Variceal bleeding, Methotrexate, Lamivudine, Perinatal transmission, Adefovir

424 kb pdf

Aerobic exercise safe for HIV patients

Exercise has been shown to benefit sufferers of some chronic health conditions, yet it can also be contraindicated in some cases of illness or chronic infection. Researchers tested an exercise intervention course in 52 individuals with confirmed HIV infection but no AIDS-defining symptoms

 

Agent Summary Statement for Human Immunodeficiency Viruses (HIVs)

These Guidelines are based on combinations of standard and special practices, equipment, and facilities recommended for use in working with infectious agents in various laboratory settings. The recommendations are advisory; they provide a general code for operating microbiologic and biomedical laboratories.

 

AIDS-Dementia complex

AIDS dementia complex is a complication of HIV/AIDS that occurs in some people, usually those with advanced disease.  HIV affects the functioning of the normal brain leading to difficulty with concentration, memory, and speed of thought along with a change in personality usually manifesting as a lack of interest in previously pleasurable activities.

35 kb pdf

AIDS AND AFRICA: A CASE OF RACISM VS SCIENCE? Western scientists have promoted the hypothesis that the AIDS epidemic began in Africa, arguing that either AIDS had existed for many years in an African "lost tribe" or that a retrovirus crossed the species barrier from monkey to man. The scientific evidence in support of this hypothesis has included AIDS-like cases from Africa that predated the epidemic in the West, seroepidemiological evidence for early African infection, and the isolation of retroviruses from African monkeys considered similar to the human immunodeficiency virus. Yet when the scientific literature supporting an African origin is examined it is found to be contradictory, insubstantial or unsound, whilst the possibility that AIDS was introduced to Africa from the West has not been seriously investigated.  
AIDS epidemiology: Inconsistencies with human immunodeficiency virus and with infectious disease AIDS diseases that are not Male-Specific show a 10-fold preference for Males.  The distribution of conventional sexually transmitted diseases is almost even between the sexes 1358 kb pdf
AIDS-Oncology Resources Handbook-2003 Identifying hypotheses-driven therapeutic approaches for the treatment of malignancies associated with AIDS, including buy not limited to non-Hodgkin’s lymphoma, primary central nervous system lymphoma, Kaposi’s sarcoma, anogenital dyplasis and cancer. 1139 kb pdf

AIDS Patients Homecare Health Indicators.

Form for ranking need for Home Health care for AIDS patients

Pdf 10 kb

AIDS Patients, Program Unable to Afford Meds

 

"We're living longer, we're living healthier--if you can get the medicines,"… "It's very telling that we didn't have a waiting list at this time last year," said Carmen Julious, Director of Palmetto AIDS Life Support Services. "Because of cuts in funding and because of budget decisions we had to make, we all of a sudden have one of the largest waiting lists in the country." Pdf 10 kb
AIDS Patients to Receive Free Treatment in Gov’t Hospitals The Health Ministry announced yesterday that 1,201 new AIDS cases had been discovered and reported in the Kingdom. According to the ministry, among the new cases reported by the end of 2005, 311 were Saudi nationals and 890 were foreigners. It said that from 1984 to the end of 2005, 10,120 AIDS cases were reported in the Kingdom. Saudis accounted for 2,316 cases representing 22.9 percent of the total number while non-Saudis accounted for 7,804 cases representing 77.1 percent.  
AIDS TESTING AND MEDICAL INFORMATION Legal Issues The Connecticut General Assembly established protections regarding the confidentiality of individuals with HIV infection or AIDS in 1989. Below is the current language, which was updated in 1997 and again in 1999.  

All About Hepatitis C

Hepatitis C is a liver disease caused by the hepatitis C virus and affects approximately 4 million Americans, making it more common than HIV infection. Because hepatitis C often has no symptoms, many people do not know they have the disease and may be infecting others.

 

AMA CODE OF MEDICAL ETHICS This edition of Code of Medical Ethics: Current Opinions with Annotations of the Council on Ethical and Judicial Affairs replaces all previous editions and includes Opinions based on Reports adopted through December 2001. It is one component of the American Medical Association (AMA)'s Code; the other components are the Principles of Medical Ethics, and the Reports of the Council on Ethical and Judicial Affairs. The Principles precede the Opinions in this volume. Reports are available separately. The Principles of Medical Ethics are the primary component of the Code. They establish the core ethical principles from which the other components of the Code are derived. Most recently, the Principles were revised in 2001.  
Are Vaccines Causing More Disease Than They Are Curing? Barbara Loe Fisher, president  of the National Vaccine Information Center, a consumer's group based in Vienna, Virginia, claims vaccines are responsible for  the increasing numbers of children and adults who suffer  from immune system and neurologic disorders, hyperactivity, learning disabilities, asthma, chronic fatigue syndrome, lupus, rheumatoid arthritis, multiple sclerosis, and seizure disorders. She calls for studies to monitor the long-term effects of mass vaccination and Fisher wants physicians to be absolutely sure these vaccines are safe and not harming people.  

Assess the Value of American Investment in Medical Research

How does a venture capitalist decide where to invest his money? He compares the potential for return against the risk, and when the return appears to be significant and the risk isn't too great, he invests. As our country makes decisions about its future investment in medical research, it might apply a similar standard.

 

Associated Health Costs - United States

 

Although few prospective long-term survival and health care cost studies are available for hepatitis C, it has been possible to estimate the life-long economic impact of the disease for both the individual patient and for the U.S. population with chronic hepatitis B. Lifetime health care costs for a patient with chronic hepatitis B has been estimated at $65,000 in the absence of liver transplantation. For the 150,000 HBV carriers with significant liver damage, the lifetime health care costs in the U.S. have been estimated to be $9 billion. Assuming an estimated survival of 25 years, the annual health care costs for the affected U.S. population with chronic hepatitis B is $360 million. Based on the same economic analysis, treatment of chronic hepatitis B with interferon is projected to increase life expectancy by about three years and reduce the aggregate health care costs.  

At least five related, but distinct Hepatitis C viral genotypes exist

Hepatitis C virus, the major causative agent of blood-borne non-A, non-B hepatitis in the world, has been the subject of considerable nucleic acid sequence analysis.

1,379 kb pdf

Attitudes to & management of HIV/AIDS among health workers in Ghana: the case of Cape Coast municipality Health Care Workers as key players in the prevention and management of diseases and important opinion and community leaders have become targets for studies, more so with the outbreak of HIV.  Their perceptions, attitudes and practices have implications for the management of diseases in both health centres and communities. 39 kb pdf
Attitudes and Training of Health Care Workers on AIDS in Hong Kong Health care workers' (HCW) avoidance of persons with HIV/AIDS has been a common concern both in the field of medical services and in the research literature. Such an attitude is not uncommon in Western countries The attitude is problematic because it undermines effective and non-discriminatory medical services, as well as being contradictory to the professional ethic of caring for AIDS patients. As a result, HCW's avoidance of AIDS patients will be detrimental to those who need the services. To assess and reduce the attitude among HCW in Hong Kong, the present study examines the plausible causes of the attitude of avoidance, including perceived susceptibility to HIV infection at work, lack of knowledge, training, and experience in caring for AIDS patients  

Australian discovery may lead to a hepatitis C vaccine

Researchers in Australia have discovered an antibody that has helped some people develop immunity against hepatitis C, and they hope to use the discovery as the foundation for an HCV vaccine

 

Australia Occupational Exposure

The data on occupational injuries and diseases contained in the National Workers' Compensation Statistics database have been compiled by the National Occupational Health and Safety Commission (NOHSC) from information supplied by Commonwealth, State and Territory workers' compensation authorities. These agencies processed workers' compensation claims received from insurance companies, self-insurers and some government departments

 

Bacterial Infections Associated with HIV Infections with opportunistic pathogens have been one of the hallmarks of the acquired immunodeficiency syndrome since the beginning of the epidemic. An abundance of research and literature has been dedicated to these opportunistic fungi, viruses, and parasites. Less attention has been given to the bacterial infections complicating the course of persons infected with HIV. Even before HIV was found to be the causative agent of the syndrome, however, case reports appeared describing fulminant bacterial infections in these immunocompromised patients. It is now recognized that bacterial pneumonia and bacteremia occur at a higher frequency among HIV-infected patients compared to age-matched controls. Diseases caused by bacteria are responsible for a significant proportion of the morbidity and mortality seen in this population. Bacterial infections were the leading cause of death in HIV-infected patients in Rhode Island over a two and half year period.(3) One study of 46 autopsy cases found evidence of bacterial infection in 83%.  
BASIC CONCEPTS OF SOCIAL WELFARE “Social welfare generally denotes the full range of organized activities of voluntary and governmental agencies that seek to prevent, alleviate, or contribute to the solution of recognized social problems, or to improve the well-being of individuals, groups, or communities.”  

Balancing Act-drugs that can Help & Hurt

You’ve seen the headlines: "Tylenol overdoses linked to liver failure." "Diabetes drug causes liver disease." "Ibuprofen [causes liver] toxicity in patients with chronic hepatitis C."

 

Bangui Definitions-HIV/AIDS surveillance in Europe

A case of AIDS in a child is defined as an illness characterized by one or more of the following ‘indicator’ diseases

Pdf 3,319 kb

Bangui Definitions-Bangui 1985 report

Good clinical definitions of AIDS is of great importance in Africa, where adequate laboratory facilities are often lacking, to enable medical practitioners to arrive at a diagnosis with maximum precision.  In the absence of such lab testing abilities, the use of symptoms exhibited by patients can also be used

Pdf 900 kb

Bangui Definitions-CDC Guidelines for Surveillance 1999.

This report provides a revised case definition for HIV infection in adults and children, recommended program surveillance by local, state, and territorial health departments.

Pdf 348 kb

Bangui Definitions-Concept of Health & Disease.

This set of definitions and commitments, universally accepted as normative, has posed, to those who work in the health field, limitations on the theoretical and methodological bases traditionally utilized and has shown the need for new developments, that make it possible to treat the health and disease problem as an expression of the living conditions of different population groups and to understand the relationship between these and the most general social processes.

Pdf 910 kb

Bangui Definitions-Current Trends Update-1982.

The eventual case-mortality rate of AIDS, a few years after diagnosis, may be far greater than the 41% overall case-mortality rate noted

Pdf 19 kb

Bangui Definitions-Surveillance Case Definition for AIDS-1993.

Revised HIV classification system for adolescents and adults

Pdf 63 kb

Bangui Definitions-WHO Definitions for AIDS surrveilance-1986.

For surveillance purposed, a relatively precise case definition is required that includes the most characteristic manifestations of LAV/HTLV-III infections.

Pdf 624 kb

Bangui Definitions-WHO Definitions for AIDS surveillance-1988.

The clinical and laboratory definition of AIDS has changed as documentation of the wide spectrum of clinical manifestations due to HIV has accumulated, and as specific laboratory tests to detect HIV infection and immune deficiency have been developed

Pdf 742 kb

Bangui Definitions-WHO Definitions for AIDS surveillance-1988.

This is a method in which the prevalence of HIV infection is measured in specific populations whose blood has been obtained in the health care setting for other purposes and then tested for antibody to HIV after all patient identifiers have been removed

Pdf 536 kb

Bioethics for clinicians: Conflict of interest in research, education and patient care

A conflict of interest occurs in a situation in which professional judgment regarding a primary interest, such as research, education or patient care, may be unduly influenced by a secondary interest, such as financial gain or personal prestige. Conflicts of interest exist in every walk of life, including medicine and science. There is nothing inherently unethical in finding oneself in a conflict of interest. Rather, the key questions are whether one recognizes the conflict and how one deals with it. Strategies include disclosing the conflict, establishing a system of review and authorization, and prohibiting the activities that lead to the conflict.

 

Blood Borne Liver Disease: Hepatitis C

Hepatitis C used to be called Non A Non B hepatitis in the early 1970s because we had blood tests for Hepatitis A and B so anything left over was Non A Non B.

 

Bowling Green State University Bloodborne Pathogen Program Power Point Presentation 338 kb

Breastfeeding and HIV/AIDS: is there a conflict?

“The HIV pandemic and the risk of mother-to-child transmission of HIV through breastfeeding continues to pose unique challenges to the promotion of breastfeeding, even among unaffected families. Accurate information, disseminated widely, about breastfeeding’s benefits for the majority of children and mothers is essential for preventing baseless doubts in this connection. Support for HIV-positive women should include counseling about appropriate infant-feeding options”.

 

Chlamydial Infection and Gonorrhea in Teenage Women With the highest rate of sexually transmitted diseases (STDs) in the developed world, the United States is in the throes of a "hidden epidemic," according to a recent report from the Institute of Medicine.1 In addition to the high human cost to the victims of these diseases and their families, the authors of the report estimate that the financial burden of this epidemic to US taxpayers is at least $10 billion per year - not including the costs of HIV infection.  

Can Liver Fibrosis be Reversed

Treatment gives the liver a vacation or rest from inflammation caused by Hepatitis C Virus.  Providing that the cirrhosis is not at such an advanced stage that treatment is not an option, treatment is often used to improve the health of the liver even if the disease cannot be eradicated

17 kb pdf

Can the Model for End-Stage Liver Disease (MELD) Predict Post-Transplantation

Can indicators of liver disease severity before liver transplantation (OLT) predict the outcome following OLT? Can pretransplant data predict post-OLT outcomes? The researchers compared three indices of liver disease severity as predictors of posttransplant outcome:

 

Capillus HIV Rapid Test Kit

Gives a break-down of the HIV rapid test kit with several indicators for use

1,205 kb pdf

Cardiac surgeon likely source of hepatitis in patients

A cluster of seven cases has been diagnosed in people who have only the physician in common.

 

Caring for HIV Patients The good news about HIV care in the United States is that treatment costs are not prohibitive--the average cost per patient equals about $20,000 a year. Although these costs represent a growing burden on the public sector, they are still smaller than the costs of treating some other major diseases. The bad news, however, is that one-half to two-thirds of American adults infected with HIV do not get regular care, and even fewer receive the most advanced anti-HIV therapy.  

CDC Urges annual STD Testing

New testing guidelines released by the Centers Disease Control and Prevention urge doctors to make "frank inquiries about their patients' sexual histories and other potential risk factors." The new guidelines, which are not mandatory, apply to all "sexually active men who have sex with men."

 

CDC- Hepatitis A through E

Power Point presentation

 

CHILDHOOD EXPOSURE TO SIMIAN VIRUS 40-CONTAMINATED POLIOVIRUS VACCINE AND RISK OF AIDS-ASSOCIATED NON-HODGKIN’S LYMPHOMA Our study included 56,808 adults with AIDS: 39,468 SV40-exposed (who were born in 1958–61) and 17,340 SV40-unexposed (born 1964–67). These 2 cohorts differed significantly in composition (Table I). Specifically, although the cohorts had the same proportion of homosexual men, the exposed cohort had more nonhomosexual men (25.6% vs. 20.7%) and fewer women (18.8% vs. 23.7%). Also, the exposed cohort had more whites than the unexposed cohort (44.4% vs. 37.8%), with correspondingly reduced proportions from other ethnic groups. As a direct result of the differences in birth years in the 2 cohorts, SV40-exposed subjects were older (mean age at AIDS onset, 32.0 vs. 27.2 years) and developed AIDS earlier (mean year of AIDS onset, 1991.9 vs. 1992.8; p [1] 0.0001) than SV40-unexposed subjects. Registry areas differed between SV40-exposed and -unexposed subjects, most notably with SV40-exposed subjects being more frequently from New York and less frequently from Florida Pdf 80 kb

Chronic Hepatitis C: Current Disease Management

The hepatitis C virus (Hepatitis C Virus) is one of the most important causes of chronic liver disease in the United States. It accounts for about 15 percent of acute viral hepatitis, 60 to 70 percent of chronic hepatitis, and up to 50 percent of cirrhosis, end-stage liver disease, and liver cancer.

 

Circumcision seen as method to block HIV infection

A recent study shows that circumcised men are less likely to contract HIV for biological, not behavioral, reasons. Previous studies have shown that men whose foreskin was removed are six to eight times less likely to become HIV-positive

 

Cirrhosis

The onset of cirrhosis is often 'silent' with few specific symptoms..."

 

Clearer Liver Warning Urged for Painkillers

Experts are urging the federal government to mandate clearer and more consistent warning labels for acetaminophen, and the nation's leading maker of the pain and fever remedy has announced it is ready to do so.

 

Clinical Features of Hepatitis C-Infected Patients With Persistently Normal Alanine Transaminase Levels in the Southwestern United States

Approximately one third of patients with chronic hepatitis C virus (Hepatitis C Virus) infection have normal alanine transaminase (ALT) levels.

 

College Student s Engage in 'Risky Business,' Exposing themselves to the Dangers of STDs

College students across the country are engaging in activities that may put them at risk for contracting serious infectious diseases, according to a national survey released today by the Society for Adolescent Medicine (SAM). According to the survey of college students living away from home, more than half (56 percent) have been sexually active while at college. Of these, a majority (73 percent) reported having unprotected sex,

 

Common Lab tests for liver disease

The diagnosis of liver diseases depends upon a combination of history, physical examination, laboratory testing and sometimes radiological studies and biopsy. Only a physician who knows all of these aspects of a specific case can reliably make a diagnosis.

 

Comparing Health Systems in Four Countries: Lessons for the United States

The Rekindling Reform initiative examined the health systems of 4 countries: Canada, France, Germany, and Great Britain (United Kingdom). From the 4 country reports published in this issue of the American Journal of Public Health, 10 crosscutting themes emerge: (1) coverage, (2) funding, (3) costs, (4) providers, (5) integration, (6) markets, (7) analysis, (8) supply, (9) satisfaction, and (10) leadership.

 

Complications of Cirrhosis

Listing of the various health complication associated with Hepatitis C

 

Complications of Liver Cirrhosis Series of different reports on cirrhosis of the liver  

Condoms in Schools Don't Affect Teen Sex Rate

The study compared rates of condom use and sexual activity by high school students in New York City and Chicago. Both school systems offer AIDS prevention and education courses, but whereas students in New York schools are given easy access to condoms, Chicago students are not.

 

Conductors on a One-Way Track: Do Medical Authorities Really Get to Decide Policy About Medical Screening Tests?

It is commonly believed that doctors, individually and collectively, decide which medical tests a healthy person ought to undergo and how often. The prudent person then complies with standard medical advice as a part of preventive medical care.

 

Confidentiality Considerations When Your Patient Has HIV or AIDS+

The following case study focuses on a variety of common issues and scenarios related to HIV/AIDS confidentiality which could arise over the course of a patient’s care.

Pdf 135 kb
Confidentiality Vs the Duty to Warn HIV-Disclosure Guidelines for Social Workers Mental health professionals often feel caught in a legal dilemma with respect to a client’s HIV status. On one hand, there is the basic duty to keep client information confidential. This is especially true of information about HIV-infection, which can be embarrassing or harmful to the client if revealed to others. On the other hand, there may be a duty to warn others if the client poses some threat to them.  

Connection between Hepatitis C & Anger?

I don't know about you, but I've never run into a group of "unreasonably" angry people in my life like some of those I have encountered in Hep C support groups, both "live" and on the internet.

 

Controversial Issues in Hepatitis C

Hepatitis C, its pathogenesis, natural history, and approaches to treatment were certainly a focal point of this year's meeting of the American Association for the Study of Liver Diseases in Dallas, Texas.

 

Controversial Issues in Sexually Transmitted Disease Testing

Presentation

 

Coping and Safer Sex Maintenance Intervention for Men and Women Living with HIV-AIDS People living with HIV/AIDS endure numerous challenges.  HIV-related stressors include dealing with complex medical and health choices, coping with chronic symptoms, dealing with disability, and grief and bereavement of multiple losses.  Among the most stressful situations for many men and women living with HIV infection, are those that stem from close and intimate relationships, namely decisions of when and how to disclose their HIV serostatus to others and maintaining safe sex practices.  
Cost of unsafe injections Unsafe injection practices are associated with substantial morbidity and mortality, particularly from hepatitis B and C and human immunodeficiency virus infections.  These inadvertently transmitted bloodborne diseases become manifest some considerable time after infection and hence may not be appropriately accounted for.  Annually more than 1.3 million deaths and US$ 535 million are estimated to be due to current unsafe injection practices. 85 kb pdf

Counseling Patients with Genital Herpes

Basic Questions About Confronting Herpes

 

Counteracting Stigma in Sexual Health Care Settings Sexual health clinics and the people who visit them commonly face stigma. Sexually transmitted infections have historically been used to divide people into "clean" and "dirty". A grounded theory study of the work of sixteen nurses in six Sexual Health services in New Zealand was undertaken to explore the management of sexual health care. The study uncovered the psychological impact of negative social attitudes towards the people who visit sexual health services and to the staff who work there. Sexual health nurses manage the results of stigma daily and reveal in their interactions with clients a process of destigmatisation.  

Countries struggle with hepatitis C contamination.

Examines how France, Germany, Australia, the United States and Great Britain are tackling hepatitis C contamination through blood and blood products. Screening of blood donations; Recipients of blood transfusions; Questions on legal responsibility; Compensation for patients; Intravenous drug use.

 

Current Concepts in HIV-Associated Nephropathy In the early years of the HIV pandemic there was speculation that the kidney may be spared from major complications. By 1984, however, a broad spectrum of renal disease was reported in patients with AIDS, including a distinctive form of sclerosing glomerulopathy found predominantly among inner-city black injection drug users (IDU). HIV-associated nephropathy (HIVAN) is now a well-defined variant of focal segmental glomerulosclerosis which has characteristic clinical and histopathologic features and which now develops in 5-10% of patients infected with HIV [D'Agati VD, et al. J Am Soc Nephrol 1997;8:138]. Although it shows a remarkable predilection for black patients, HIVAN has been demonstrated in all subsets of HIV-infected patients regardless of age, sex, race, and mode of HIV acquisition. The nephropathy typically follows a fulminant course and progresses to end-stage renal disease (ESRD) in essentially all untreated cases. More importantly, despite remarkable advances in the treatment of HIV infection and its attendant complications, the incidence and prevalence of HIVAN have steadily increased. Urgent attention is needed to better define the pathogenesis of the disease and to evaluate potential treatment strategies  

Death: A result of Insufficient Care

Poor staffing was the reason cited for the death of Mike Hurewitz, the living liver donor at Mount Sinai Hospital, New York, who died after a portion of his liver was transplanted into his brother. According to a Reuters Health article, The State Department of Health report determined that poor postoperative follow-up care may have been a contributing factor that led to Hurewitz’s death.

 

Dentists shun HIV patients Many dentists are refusing to treat people with HIV even though there is no risk of transmitting the disease if safety procedures are correctly followed. Experts have warned that continuing discrimination may force people with HIV to keep their condition hidden - which could cause problems if dentists fail to take adequate care. Research conducted by BBC News Online found seven out of 30 dentists contacted refused to commit to treating a person with HIV.  

Developing and Implementing a Program of Grand Rounds for Internists that is Free of Commercial Bias

Grand rounds are a time-honored tradition. However, pharmaceutical companies frequently sponsor continuing medical education (CME) presentations for physicians at community hospitals. The subject matter and content of such presentations are often biased toward the sponsor’s products and are limited in scope

 

Developing Web site for Transplant Patients

As the number of transplant patients continues to grow and posttransplant patients begin to live longer, meeting their educational needs creates an ongoing challenge.

 

Diagnosis, management, and treatment of hepatitis C Set of guidelines and methods of treatment for each of the various classifications of HCV  

Diagnostic Tests for Liver and Gall Bladder Disorders

Laboratories can carry out a variety of tests that help doctors assess disorders of the liver, gallbladder, and biliary tract. Among the most important are a group of blood tests known as liver function tests.

 

Dirty Needles Blamed for HIV

Children in South Africa are being infected with HIV through dirty needles, experts have claimed.

 

CALIFORNIA DISCLOSURE LAWS That's a matter of state law.  Arkansas, for example (Ark. Code Ann Sec. 20-15-903) makes it a misdemeanor for people who are HIV+ to fail to inform their health care provider, which would include an orthodontist; California does not.  The Law and Sexuality journal did a very comprehensive survey of state HIV laws, most recently updated in 2004, that is helpful for this sort of question  

Discovery of immune group in Uganda raises Aids vaccine hopes

Scientists believe an effective Aids vaccine may be a step closer after studying an unexpected response to the HIV virus in individuals in Uganda who appear immune.

 

Discriminatory Attitudes and Practices by Health Workers toward Patients with HIV/AIDS in Nigeria Nigeria has an estimated 3.6 million people with HIV/AIDS and is home to one out of every 11 people with HIV/AIDS worldwide. This study is the first population-based assessment of discrimination against people living with HIV/AIDS in the health sector of a country. The purpose of this study was to characterize the nature and extent of discriminatory practices and attitudes in the health sector and indicate possible contributing factors and intervention strategies. The study involved a cross-sectional survey of 1,021 Nigerian health-care professionals (including 324 physicians, 541 nurses, and 133 midwives identified by profession) in 111 health-care facilities in four Nigerian states.  

Disruption of the diurnal rhythm of plasma melatonin in liver cirrhosis

Time of onset of melatonin rise was displaced from 19:50 plus or minus 26 min in the controls to 21:30 plus or minus 13 min (p=0.013) in patients with liver cirrhosis

 

Do we have enough condoms? The shortage of contraceptive supplies

Now that appropriations committees in both houses of Congress have passed foreign assistance legislation, the stage is set once again for a difficult tug of war over spending and policy for U.S.-funded international family planning and related programs. Proposed overall spending on foreign economic and military assistance differs by about $200 million, with the higher, House version of the bill coming in at $16.55 billion.

 

Drug Middlemen Are Facing Pressure Over Rising Prices

…employers, consumers and government officials grow increasingly frustrated by upwardly spiraling drug costs, pressure is building against a handful of powerful companies that have prospered for years as middlemen between drug manufacturers and those who pay for medicines.

 

Drug Resistant Staph Strikes in LA

Public health officials in San Francisco said this week they are alerting local clinics and labwork facilities to watch for a virulent, drug-resistant strain of staph that has shown up in gay men in Los Angeles.

 

Dying in Silence-African Americans

HIV/AIDS is the number one cause of death for both Black males and females, between the ages of 22–45. In the U.S. African Americans make up about 14% percent of the population, yet they comprise over 50% of the newly infected.

 

Effects of Systemic Vascular Problems on the Liver

There is a striking effect on the liver in situations where significant cardiac dysfunction occurs. These effects will vary greatly depending on how acutely the hemodynamic changes occur and whether or not they are predominantly affecting the right or left side of the circulation (Figure 3-1). In most instances there will be a combination of events affecting the entire circulation occurring over a variable period of time, perhaps modified by pre-existing conditions in the host liver

 

Elements of the Professional Life of James V. Neel as Reflected in the Declassified Literature on Human Radiation Experimentation Review of the Atomic Bomb Casualty Commission Archives materials relating to James V. Neel.   Archive: National Academy of Science, 2001 Constitution N.W., Washington DC Archive Review Date: March 14, 2001. Review of Department of Energy Human Radiation Experiment files relating to James V. Neel, Marcel Roche, and other biomedical research projects sponsored by the AEC  

Emerging Viruses: AIDS & Ebola. Nature, Accident or Intentional?

They were not emerging from the wild, so today the Blacks have been blamed for AIDS. The gays have been blamed for AIDS. The monkeys have been blamed for AIDS & Ebola, and you know what? That is a bunk, complete bull. The truth of the matter is that the NCI researchers in co-operation with a narrow network of virologists who are being paid by the Dept of Defense to investigate these types of viruses, and the viral vaccines made from them. Their biohazard and containment in their facilities were abysmal, and just like the recent Texas outbreak of Ebola, the other outbreaks---we have had monkey AIDS outbreaks over half a dozen times in the major vaccine production labs, as well as the research labs---the reason for this is because once you create these viruses they are very easily transmitted from one animal to the other in these facilities, and that as I see it is where viruses are emerging from  
Epidemiological Fact Sheet on HIV/AIDS and sexually transmitted infections – 2000 Update Global Surveillance of HIV/AIDS and sexually transmitted infections is a joint effort of WHO and UNAIDS…The primary objective of the working group is to strengthen national, regional and global structures and networks for improved monitoring and surveillance of HIV/AIDS and STIs. 410 kb pdf

Esophageal varices

Large collateral veins located in the submucosa of the esophagus and stomach, most prominent in the distal esophagus, connecting the portal vein with the superior vena cava. These veins result from chronic high pressure in the portal vein and are particularly prone to rupture with associated gastrointestinal bleeding and often exsanguinations and death. Bleeding from varices is the single most common cause of death in cirrhosis of the liver.

 

Ethical Considerations Regarding Access to Experimental Treatment and Experimentation on Human Subjects

One overall conclusion shared by everyone should be stressed at the beginning. There are interesting problems concerning fair distribution of experimental treatments (although no unanimity exists about whether persons’ interests in participating should be thought of as a right). As a practical matter, however, distribution of experimental treatment is a problem of much lesser importance than fair distribution of established treatments. This paper does not address the problem but that it is a much more important issue for political action is clear. Pdf 107 kb

Ethical conundrums: They just keep on coming

Could it be acceptable for the BMJ to continue to employ a statistical adviser who was to give evidence on behalf of the tobacco industry?

 

Evaluation of Specific Issues-Chronic Fatigue Syndrome

CFS is characterized by the presence of persistent unexplained fatigue and by the chronicity of other symptoms. The most prevalent symptoms include episodes of low-grade fever, myalgias, headache, painful lymph nodes, and problems with memory and concentration.

 

Factors related to staff stress in HIV/AIDS related palliative care Staff stress in HIV related palliative care has been identified as an important problem worldwide. This study aimed at estimating prevalence of staff stress and its correlates in a sample of palliative caregivers in HIV/AIDS in India.  

FDA Rethinking Tylenol Warnings

Millions of people take Tylenol every day and have no problems with it. But for those who drink alcohol while taking the drug, or who mix it with other acetaminophen-containing products, or simply take too many pills assuming that more is better, the consequences can be deadly.

 

Fibrosis & Cirrhosis

Definitions of both

 

Help us Win the Fight!ing Anemia's side Effects

A new form of oral iron chelation therapy removes excess iron in people with anemia who have had multiple blood transfusions.

 

Final Report- The Impact of HIV/AIDS on Health Service Personnel at Two Public Hospitals in Johannesburg Much has been written about the burden placed on the health sector in South Africa by HIV/AIDS.  Most of this work focuses on the increased demand for health services created by AIDS and the costs of providing hospital care to HIV-infected patients.  Little has been published about the impact of HIV/AIDS on nurses, doctors, and the other trained professionals who are responsible for keeping increasingly over-burdened public healthcare facilities functioning.  Little is known about the contribution of AIDS to the high attrition of healthcare personnel, the impact of HIV/AIDS on healthcare worker labour productivity, or the actual financial and human capital costs of the disease to the public health system  

Focus on the Liver

The most widely used biochemical blood test for liver cancer -  hepatocellular carcinoma (HCC) is alpha-fetoprotein (AFP), which is a protein normally made by the immature liver cells in the fetus

 

Frontline: Realities of stigma in health care settings While the majority of health care professionals comply with ethical guidelines and do not deny care or treatment to people living with HIV (PLHIV), a disturbing number of health care professionals engage in stigmatising and discriminatory behaviour, according to studies presented at the recent XVI International AIDS Conference in Toronto. Health care workers are also reported to engage in practices that contravene codes of professional ethics, including HIV testing without consent and disclosure of confidential medical information without prior permission. This was revealed by Takawira Moses, who works with Medicin Sans Frontiers (MSF) in rural Zambia.  

Gender, AIDS, and ARV Therapies-ensuring that women gain equitable access to drugs

Given limited resources, choices will inevitable be made about who 
will be treated and when, raising the issues of equity in access to
 treatment for sub-groups of those infected

181 kb pdf

Gender Differences in the Timing of First Intercourse: Data from 14 Countries Early initiation of intercourse and the context within which sexual activity begins are key indicators of adolescents' potential risk for unplanned pregnancy, abortion and sexually transmitted diseases. Comparative information on the sexual behavior of male and female adolescents in different countries assists health planners and service providers in meeting adolescents' needs.  

Gifts from drug companies in developing countries

Sponsorship comes from overseas development aids (with its strings attached and covert benefits to institutions and businesses in donor countries), or the drugs companies who are pushing their drugs.

 

Global prevalence & incidence est. curable STDs

To update the SHO global and regional estimates of the prevalence and incidence of syphilis, gonorrhea, chlamydia, and trichomoniasis

690 kb pdf

Glossary of HIV/AIDS-related Terms

Dictionary of terms

  pdf

GUIDELINES for HIV/AIDS interventions in emergency settings During a crisis, the effects of poverty, powerlessness and social instability are intensified, increasing people’s vulnerability to HIV/AIDS. As the emergency and the epidemic simultaneously progress, fragmentation of families and communities occurs, threatening stable relationships.The social norms regulating behaviour are often weakened. In such circumstances, women and children are at increased risk of violence, and can be forced into having sex to gain access to basic needs such as food, water or even security. Displacement may bring populations, each with different HIV/AIDS prevalence levels, into contact. This is especially true in the case of populations migrating to urban areas to escape conflict or disaster in the rural areas. Pdf 525 kb
Guidance on Management and Patient Notification HIV Infected Health Care Workers The document reflects the new policy on patient notification exercises when a health care worker is found to be infected with HIV, which was announced in November 2001. It follows expert advice from the Expert Advisory Group on AIDS (EAGA) and UK Advisory Panel for Health Care Workers Infected with Blood-borne Viruses (UKAP. They advise that it is no longer necessary to notify every patient who has undergone an exposure prone procedure by an HIV infected health care worker because of the low risk of transmission and the anxiety caused to patients and the wider public. However, the long-standing restriction on HIV infected health care workers carrying out exposure prone procedures remains. pdf 525 kb

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