Racial differences in bone loss and relation to menopause among HIV-infected and uninfected women.

Objective: To characterize changes in bone mineral density (BMD) according to race among HIV-infected and uninfected women, and to evaluate the relationship between race and menopause-related bone loss.

Methods: Dual X-ray absorptiometry measured BMD on study entry and a minimum of 18 months later in 246 HIV-infected and 219 HIV-uninfected women in the Menopause Study. Linear regression analyses determined percent annual BMD change at the total hip (TH), femoral neck (FN), and lumbar spine (LS) after adjusting for potential confounders.

CD8+ T cells and risk for bacterial pneumonia and all-cause mortality among HIV-infected women.

Background: Bacterial pneumonia risk is disproportionately high among those infected with HIV. This risk is present across all CD4(+) T-cell levels (TCLs), suggesting that additional factors govern susceptibility. This study examines CD8(+) TCLs and risk for HIV-associated bacterial pneumonia and all-cause mortality.

Prospective evaluation of bone mineral density among middle-aged HIV-infected and uninfected women: Association between methadone use and bone loss.

Objective: We undertook a prospective study to assess the impact of HIV infection on BMD in a cohort of HIV-infected and uninfected women that included illicit drug users, and to measure the contribution of traditional risk factors as well as HIV-related factors to loss of BMD over time.

Methods: We analyzed BMD at baseline and after ≥18 months in 245 middle-aged HIV-infected and 219 uninfected women, and conducted linear regression analysis to determine factors associated with annual BMD change at the femoral neck, total hip and lumbar spine.

Results: HIV-infected women had lower baseline BMD at the femoral neck and total hip compared with controls; unadjusted rates of BMD change did not differ by HIV status at any site.

Incident hyperglycaemia among older adults with or at-risk for HIV infection.

Background: HIV infection has been associated with development of prediabetes and diabetes. Optimum screening practices for these disorders in HIV-infected populations remain unclear.

Methods: We screened 377 adults, with or at-risk for HIV infection, for incident hyperglycaemia (prediabetes or diabetes) using two oral glucose tolerance tests (OGTTs) a median of 18.

Defining translational research: implications for training.

Because translational research is not clearly defined, developers of translational research programs are struggling to articulate specific program objectives, delineate the knowledge and skills (competencies) that trainees are expected to develop, create an appropriate curriculum, and track outcomes to assess whether program objectives and competency requirements are being met. Members of the Evaluation Committee of the Association for Clinical Research Training (ACRT) reviewed current definitions of translational research and proposed an operational definition to use in the educational framework. In this article, the authors posit that translational research fosters the multidirectional and multidisciplinary integration of basic research, patient-oriented research, and population-based research, with the long-term aim of improving the health of the public.

Association of HIV viral load with monocyte chemoattractant protein-1 and atherosclerosis burden measured by magnetic resonance imaging.

Background: HIV-infected individuals may be at increased risk for atherosclerosis. Although this is partially attributable to metabolic factors, HIV-associated inflammation may play a role.

Objective: To investigate associations of HIV disease with serum monocyte chemoattractant protein-1/chemokine (C-C motif) ligand 2 (MCP-1/CCL2) levels and atherosclerosis burden.

Effects of hepatitis C virus infection on menopause status and symptoms.

Objective: To examine the relationship between hepatitis C virus (HCV) infection with menopause status and vasomotor symptoms among middle-aged, impoverished women.

Methods: The baseline interview and laboratory data from a study on menopause were used for a cross-sectional analysis of HCV antibody and HCV-RNA levels and their relationship to menopause status and symptoms, using logistic regression. For HCV-infected and HCV-uninfected women, menopause status was defined according to the World Health Organization criteria.

Attitudes toward menopause in HIV-infected and at-risk women.

Objective: To study attitudes toward menopause in women with or at risk of human immunodeficiency virus (HIV) aged 35 to 60 in New York City, NY, USA.

Design: Data were obtained at the baseline interview in a cohort study of menopause. Of 502 participating women, 92 were postmenopausal and 162 were perimenopausal.

Use of complementary and alternative medicine in inner-city persons with or at risk for HIV infection.

Previous studies have shown that use of complementary and alternative medicine (CAM) is prevalent among HIV-infected persons, but have focused primarily on men who have sex with men. To determine factors associated with CAM use in an inner city population, individuals (n = 93) recruited from two established cohort studies were interviewed between October and November 2004. The interview assessed the use of dietary supplements and other CAM therapies, reasons for CAM use, and use of prescription medications.

Attribution of menopause symptoms in human immunodeficiency virus-infected or at-risk drug-using women.

Objective: To examine the relationship of human immunodeficiency virus (HIV) and attribution of menopausal symptoms.

Design: Peri- and postmenopausal women participating in a prospective study of HIV-infected and at-risk midlife women (the Ms. Study) were interviewed to determine whether they experienced hot flashes and/or vaginal dryness and to what they attributed these symptoms.

Hepatitis C infection is associated with lower lipids and high-sensitivity C-reactive protein in HIV-infected men.

Increased cardiovascular risk has been linked to HIV infection and combination antiretroviral therapy, but the impact of hepatitis C virus (HCV) status on indices of cardiovascular risk has not been routinely assessed in the HIV-infected population. The objective of this study was to analyze associations of HCV, HIV, and combination antiretroviral therapy with lipid levels and C-reactive protein (CRP) among older men. We measured fasting total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride, and high-sensitivity CRP serum levels in a cross-sectional study of 108 HIV-infected and 74 HIV-uninfected at-risk older men.

Two-step tuberculin skin testing in drug users.

To assess the utility of booster testing and to identify factors associated with a positive booster test, two-step tuberculin testing was performed in drug users recruited from methadone treatment. Participants also received a standardized interview on demographics and testing for HIV and CD4+ lymphocyte count. Of 619 enrollees completing the protocol, 174 (28%) had a positive PPD and 24 of the remaining 445 (5%) had a positive booster test.

Factors affecting reproductive hormones in HIV-infected, substance-using middle-aged women.

Objective: To determine whether reproductive hormone levels are affected by human immunodeficiency virus (HIV) and drug use.

Design: HIV-infected and uninfected women (N=429), median age 45, were interviewed on menstrual frequency, demographic and psychosocial characteristics, and drug use behaviors. Serum was obtained on cycle days 1 to 5 in women reporting regular menses.

Hepatitis C virus infection is associated with insulin resistance among older adults with or at risk of HIV infection.

Objectives: To determine the associations of hepatitis C virus (HCV) infection with insulin resistance and abnormal glucose tolerance in a cohort of older adults with or at risk of HIV infection.

Design: A cross-sectional study of 267 HIV-infected and 179 at-risk-uninfected adults without a history of diabetes mellitus.

Methods: HCV antibody assays and RNA levels were performed to assess HCV status.

On-site medical care in methadone maintenance: associations with health care use and expenditures.

To evaluate whether long-term drug treatment with on-site medical care is associated with diminished inpatient and outpatient service use and expenditures, we linked prospective interview data to concurrent Medicaid claims of drug users in a methadone program with comprehensive medical services. Patient care was classified as follows: long-term (>/=6 months) drug treatment with on-site usual source of medical care (linked care), long-term drug treatment only, or neither. Multivariate analyses adjusted for visit clustering within patients (n = 423, with 1,161 person-years of observation).

Gender differences in illicit substance use among middle-aged drug users with or at risk for HIV infection.

Objective: The objective of the present study was to examine gender differences and other factors associated with current heroin and cocaine use among middle-aged drug users.

Methods: Baseline data were merged from 2 studies of men and of women with or at risk for HIV infection. Analysis was restricted to study participants who had ever used heroin or cocaine and who were 49-60 years of age at the time that they were interviewed.

Bacterial pneumonia, HIV therapy, and disease progression among HIV-infected women in the HIV epidemiologic research (HER) study.

Background: To determine the rate and predictors of community-acquired bacterial pneumonia and its effect on human immunodeficiency virus (HIV) disease progression in HIV-infected women, we performed a multiple-site, prospective study of HIV-infected women in 4 cities in the United States.

Methods: During the period of 1993-2000, we observed 885 HIV-infected and 425 HIV-uninfected women with a history of injection drug use or high-risk sexual behavior. Participants underwent semiannual interviews, and CD4+ lymphocyte count and viral load were assessed in HIV-infected subjects.

Aging and HIV infection.

With the advent of highly active antiretroviral therapy (HAART) in mid-1995, the prognosis for HIV-infected individuals has brightened dramatically. However, the conjunction of potent antiviral therapy and longer life expectancy may engender a variety of health risks that, heretofore, HIV specialists have not had to confront. The long-term effects of HIV infection itself and exposure to antiretroviral agents is unknown.

HIV infection and bone mineral density in middle-aged women.

Background: Osteopenia is prevalent in persons with human immunodeficiency virus (HIV) infection and is part of a normal sequence of aging in women. Most studies of bone mineral density (BMD) and HIV infection have focused on men or have lacked a comparison group of individuals without HIV infection with similar behavioral risk factors.

Methods: We analyzed BMD in 495 middle-aged women (defined as women > or =40 years of age); 263 women had HIV infection, and 232 women were HIV-negative with behavioral risk factors similar to those of the HIV-positive group.

Adherence to zidovudine for the prevention of perinatal transmission in HIV-infected pregnant women: the impact of social network factors, side effects, and perceived treatment efficacy.

Adherence to zidovudine (ZDV) prophylaxis among 78 pregnant HIV-infected women was measured with 2 physiologic markers. Long-term adherence was measured with blood assays for macrocytosis, a clinical indicator of ZDV use; 53 women (67.9%) were adherent.

Impact of street drug use, HIV infection, and highly active antiretroviral therapy on reproductive hormones in middle-aged women.

Objective: To assess the impact of street drug use and HIV infection on reproductive hormones in 82 women aged 28?56 and 15 HIV-uninfected, regularly cycling premenopausal historical controls.

Methods: Prospective, pilot cohort study. Baseline blood samples were assayed for follicle stimulating hormone (FSH), human chorionic gonadotropin (hCG), prolactin (PRL), thyroid stimulating hormone (TSH), and estradiol (E(2)).

HIV infection, drug use, and onset of natural menopause.

Objective: To study the relationship of HIV infection and drug use with the onset of natural menopause.

Methods: Our analyses used the World Health Organization's definition of menopause (i.e.

Mortality in an urban cohort of HIV-infected and at-risk drug users in the era of highly active antiretroviral therapy.

Background: Mortality trends among drug users in the era of highly active antiretroviral therapy (HAART) remain unclear.

Methods: We examined mortality rates, causes of death, and predictors of mortality in 398 human immunodeficiency virus (HIV)-infected and 656 at-risk drug users for the period of 1996-2001. National death index reports were used to confirm deaths, and causes of death were derived from medical records.

Menopause symptoms in HIV-infected and drug-using women.

Objective: To examine the association of HIV infection, drug use, and psychosocial stressors with type and frequency of menopause symptoms.

Design: In a cross-sectional study, HIV-infected and HIV-uninfected midlife women underwent standardized interviews on menopause status and symptoms, demographic characteristics, depressive symptoms, negative life events, and substance abuse. Body mass index (BMI), HIV serostatus, and CD4 count were measured.