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HIV-1 subtype B appears to be the predominant strain of HIV-1 in Indonesia although subtype E may also occur. Researchers used various tests to determine the viral subtype in 19 HIV-positive people. Twelve were infected with subtype B and 7 were infected with subtype E. However, 6 of the 7 infected with subtype E had been on a peacekeeping mission in Cambodia. Their viral strain was neutralized by antibodies against the Thailand E subtype. It is possible that they contracted the infection while in Thailand.

HIV-positive Filipina female commercial sex workers appear to have shorter survival times than HIV-positive persons in more developed countries. Fifty-four female commercial sex workers were followed for an average of 50.4 months. They were examined at the beginning of the study and then quarterly until the end of the study or until they died. The women were between 16 and 32 years old at the time of their first positive HIV test. None of the women were treated with antiretroviral drugs. The risk of developing AIDS within five years was 52.9%. The risk of dying within 6.5 years was 52.1%. Tuberculosis was the most common cause of death among the women. However, because tuberculosis is common in the Philippines many of the women may have had the disease before contracting HIV. The pervasiveness of chronic bacterial, parasitic and viral infections in the Philippines may increase the risk of contracting HIV and may explain the shorter time lag between testing positive for HIV and the progression to AIDS and death.

The Peruvian female prostitute population appears to have a high incidence of human T-cell lymphotropic virus type I (HTLV-I) and hepatitis B virus (HBV) infection due to heterosexual contact. HTLV-I infection is a viral disease that affects the immune system. HBV infection is characterized by inflammation of the liver. Researchers evaluated 333 prostitutes for 38 months, 209 for 18 months and 424 just once to determine the incidence and risk of HTLV-I and HBV transmission. Three women had antibodies against HIV-I and 170 had antibodies against HTLV-I. Seventeen of 425 women who were negative for HTLV-I antibodies became HTLV-I-positive, bringing the average incidence of HTLV-I to 1.6% per year. Initial tests showed that 578 prostitutes had HBV and seven had hepatitis C virus antibodies. Twenty-four of 185 HBV-negative women became HBV-positive, bringing the average annual incidence of HBV to 4.7%.

A serosurvey of United States military personnel presenting to a sexually transmitted diseases (STD) clinic or reporting for routine physical examination in the Philippines was conducted to determine the risk factors for hepatitis B (anti-HBc), hepatitis C (anti-HCV), and cytomegalovirus (anti-CMV) infection. Among 470 male study subjects, 74 (15.7%) were positive for anti-HBc, five (1.1%) were positive for anti-HCV, and 232 (49.4%) were positive for anti-CMV. A history of a STD (odds ratio [OR] = 7.7) and contact with a female prostitute (OR = 2.3) were significantly associated with anti-HBc seropositivity after adjusting for age, race/ethnicity, foreign birth, and classification as either a STD or routine examination patient. Anti-CMV seropositivity was significantly associated with a history of a STD (adjusted OR = 2.0). These data suggest that in this military population, heterosexual activity was a risk factor for acquiring hepatitis B and CMV infection. United States military personnel stationed in high-risk areas of the western Pacific, particularly patients presenting to STD clinics, may need to be targeted for hepatitis B vaccination., Male US military personnel stationed in the western Pacific may have an increased risk of contracting hepatitis B or cytomegalovirus (CMV) infection from heterosexual activity. Hepatitis B and CMV can be both be transmitted sexually. Among 470 male US military personnel in the western Pacific who were tested for hepatitis B, hepatitis C virus (HCV) or CMV infection, 355 were patients at a clinic for sexually transmitted diseases (STD) and 115 were undergoing a routine physical examination. Sixteen percent of the men had developed antibodies to the hepatitis B virus, 1% to HCV and 49% to CMV. Men who had been previously diagnosed with a STD had a higher risk of hepatitis B or CMV infection than those who had not been. Men who had had sexual intercourse with a female prostitute were more likely to be diagnosed with hepatitis B than those who had not.

* Twenty (18%) of 111 Peruvian men with sexually acquired human immunodeficiency virus infection were found also to be infected with human T-lymphotrophic virus type I or II in a retrospective study. At the time of data evaluation, 75 patients had reached Centers for Disease Control stage IV (clinical acquired immunodeficiency syndrome) and had not received antiviral medication; mortality in this group was 63.3% (38/60) among patients infected with human immunodeficiency virus alone and 80% (12/15) in the dually infected group. Of the 50 patients who had died, survival time from onset of stage IV to death was shorter in the dually infected group (5.02 [+ or -] 3.27 months) than in those with human immunodeficiency virus infection alone (10.07 [+ or -] 4.42 months). In Peru, sexually acquired human immunodeficiency virus infection in men is often accompanied by human T-lymphotrophic virus type I/II infection, and dual retrovirus infection is associated with a shorter survival after onset of clinical acquired immunodeficiency syndrome. (Arch Intern Med. 1992; 152:1429-1432)

Leishmaniasis a disease caused by infection with the tropical parasitic organism leishmania (generally transmitted by sandfly bites), which can result in acute lesions of the lining (mucosa) of the nose and mouth. If untreated, this condition can cause progressive erosion of the nasal and oral mucosa leading to perforation of the nasal septum, narrowing of the oral canal, hoarseness, and suffocation. The World Health Organization (WHO) has recommended antimony (a metallic element) injections for the treatment of this disease, but little is known of the efficacy and toxicity of this regimen. To evaluate this, 29 consecutive and otherwise healthy patients referred to a Peruvian regional hospital for leishmaniasis infection were treated with daily intravenous infections of antimony for 28 days in the form of sodium stibogluconate. Immediately following therapy, 88 percent (63 of 72) lesions were healed or greatly improved, none of the lesions tested positive for parasitic infestation, and 18 of 29 patients showed complete clinical remission. At the 12-month follow-up visit, 37 lesions had reappeared, 8 new lesions had developed, and 8 of the patients remained symptom-free. Mildly afflicted patients responded better to the therapy than did severely afflicted ones. Side effects consisted of electrocardiographic abnormalities (T-wave inversion in four patients), abnormal liver function (10 patients), and muscular pain (24 patients). These acceptable levels of toxicity, and the limited efficacy of the WHO-recommended treatment regimen, suggests that either longer treatment periods or combining antimony treatment with other antileishmanial agents should be considered. (Consumer Summary produced by Reliance Medical Information, Inc.)