HTLV-Iii Antibody in Edinburgh Drug Addicts

Peutherer, J F; Edmond, Elizabeth; Simmonds, Peter; Dickson, J.; Bath, George E.

doi:10.1016/s0140-6736(85)90721-4

Cited by 71 publications

(14 citation statements)

References 5 publications

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“…Following the introduction of the HIV antibody test that year, HIV was discovered among drug injectors in several parts of the country. But the explosive evidence emerged from Edinburgh and the East of Scotland [5][6][7]12]. Roy Robertson, a general practitioner, conducted HIV tests on samples of stored blood, and found that 51% of the drug injecting patients known in his general practice population were HIV positive [6].…”

Section: The Situation In 1986 and 1987mentioning

confidence: 99%

Aids and injecting drug use in the United Kingdom, 1987–1993: The policy response and the prevention of the epidemic

Stimson

1995

Social Science & Medicine

200

105

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Abstract--This paper assesses policy development, service changes and trends in HIV infection and risk behaviour among injecting drug users (IDUs) in the United Kingdom. In 1986, the U.K. was faced with the possible rapid spread of HIV infection among IDUs. The combination of an outbreak of HIV infection with prevalence levels of 50% or more in Edinburgh, the recent diffusion of drug injecting, and high levels of syringe-sharing risk behaviour, suggested that HIV infection might spread rapidly through IDU populations. HIV prevention activities commenced in 1986 and developed in 1987. The first report on AIDS and Drugs Misuse by the Advisory Council on the Misuse of Drugs in 1988 was a major catalyst for change. It supported and legitimized emergent views on new ways of working with drug users. Between 1988 and 1993 innovative public health projects increased the ability to target vulnerable populations through syringe distribution, expansion of methadone treatment and outreach to hard-to-reach populations. There were major changes in service philosophy and practices, as ideas of harm minimization, accessibility, flexibility and multiple and intermediate goals were developed. There is evidence that these public health projects encouraged extensive changes in the health behaviour of IDUs. There have been major reductions in syringe-sharing risk behaviour and sharing syringes is no longer the norm. Evaluation of specific interventions (e.g. syringe-exchange) shows their importance in encouraging reductions in risk behaviour. Levels of HIV infection in IDUs remain low by international standards. Outside of London rates of about 1% have been reported; London has a low and declining prevalence of infection to around 7% in 1993; previous high levels in Edinburgh (55%) have since declined to 20%. Britain has to date avoided the rapid increase in HIV infection among injectors that has occurred in many parts of the world. The same period saw the continuation of high prevalence levels in New York and many European cities, and the explosive spread of HIV in many countries in south-east Asia. This paper acknowledges the difficulties is proving links between social interventions and epidemic prevention. It argues that there is prima facie evidence for the success of public health prevention, that the collection of intervention approaches in the U.K. had a significant impact on IDUs behaviour, and that this has helped prevent an epidemic of HIV infection among IDUs. The U.K. experience adds to the growing evidence of the significance of early interventions in encouraging behaviour change and in limiting the spread of HIV infection.

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Section: The Situation In 1986 and 1987mentioning

confidence: 99%

Aids and injecting drug use in the United Kingdom, 1987–1993: The policy response and the prevention of the epidemic

Stimson

1995

Social Science & Medicine

200

105

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“…One sample from a Scottish homosexual was negative for vpr despite repeated isolation attempts, so for vpr only four Scottish homosexual samples were available. Two Scottish samples from heterosexual women were assigned to the drug user group, because the Scottish epidemic is most severe among drug users (Brettle et al, 1987;Peutherer et al, 1985), and because in northern Europe the largest risk factor for women who do not use intravenous drugs is sexual contact with a drug user. Both samples yielded a V3 sequence that was unmistakably of the drug user type.…”

Section: Other Northern European Samplesmentioning

confidence: 99%

Consistent risk group-associated differences in human immunodeficiency virus type 1 vpr, vpu and V3 sequences despite independent evolution

Kuiken

Cornelissen

Zorgdrager

et al. 1996

Journal of General Virology

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Human immunodeficiency virus type 1 vpr, vpu and V3 sequences from 15 homosexual men and 19 intravenous drug users in the Amsterdam Cohort studies were analysed. Previously, we reported that V3 domains of viruses from drug users are distinguishable from those of homosexual men on the basis of two silent mutations. Phylogenetic analysis of vpr, vpu and V3 shows that differences in all three regions correlate with risk group. Two positions in both vpr and vpu were found to differ significantly between the risk groups. The distinguishing positions were confirmed for sequences from 11 Scottish and four German samples. The three regions show relatively independent evolution patterns; they resulted in different phylogenies, the only stable clustering being that based on the risk group distinction. Pairwise differences between sequences of the genes were moderately correlated (around 0.30). Surprisingly, when only silent changes were counted, the correlations dropped almost to zero, indicating that the evolution towards independence was more advanced in the silent than in the non-silent positions. This suggests that selection at the amino acid level is not the primary driving force for the independent evolutionary behaviour of the genes. Recombination, combined with restrictions on certain amino acids because of epistatic interactions between the genes, could be an alternative explanation of this phenomenon.

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“…Sera from the 73 patients in the immunohistochemical study were tested for antibody against HIV using ELISA or indirect immunofluorescence methods with confirmation of positive results by western blotting (Peutherer et al 1985). Unfortunately, it was possible to undertake retrospective testing of only a few sera from patients in the earlier part of the study.…”

Section: Materials From the Anorectum Was Cultured For Neisseria Gonormentioning

confidence: 99%

A histological and immunocytochemical study of lymphoid tissue in rectal biopsies from homosexual men

Bishop

McMillan²,

Gilmour

1987

Histopathology

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A histological study of the lymphoid tissue of the rectums of 323 homosexual and 30 heterosexual men (including five intravenous drug users seropositive for human immunodeficiency virus, HIV) was undertaken. Marked lymphoid hyperplasia (germinal centre greater than 680 microns in diameter) was found in 13 men, nine of whom had a sexually transmitted infection of the rectum. Immunocytochemical studies showed that the germinal centres contained B-cells and follicular dendritic cells, surrounded by CD4+ and CD8+ T-cells in a ratio of between 5:1 and 10:1. In HIV-infected men there were decreased numbers of CD4+ cells and increased numbers of CD8+ cells, resulting in a ratio of between 0.8:1 and 2:1. In biopsies from four of seven HIV-infected men the follicular dendritic cell processes appeared shorter and fragmented. The pathogenesis of HIV infection is discussed in the light of these findings.

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HTLV-Iii Antibody in Edinburgh Drug Addicts

Cited by 71 publications

References 5 publications

Aids and injecting drug use in the United Kingdom, 1987–1993: The policy response and the prevention of the epidemic

Aids and injecting drug use in the United Kingdom, 1987–1993: The policy response and the prevention of the epidemic

Consistent risk group-associated differences in human immunodeficiency virus type 1 vpr, vpu and V3 sequences despite independent evolution

A histological and immunocytochemical study of lymphoid tissue in rectal biopsies from homosexual men

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