Healthy Lifestyling: A Nontraditional Approach to Facilitating Health-Enhancing Behaviors in University Undergraduates

Abstract

“Should the Risk of Acquired Immunodeficiency Syndrome Deter Hepatitis B Vaccination? A Decision Analysis,” Henry S. Sacks, et al. The current epidemic of acquired immunodeficiency syndrome (AIDS) and fear that its causative agent contaminates the currently available hepatitis B vaccine may have deterred vaccine use. We formulated a decision-analytic model that compares the risk of death from hepatitis B and AIDS in those vaccinated with the risk of death from hepatitis B alone in those who wait two years for a synthetic vaccine. For individuals with 5% annual risk of hepatitis B, the best current estimate is that vaccination now would save 25 lives per 100,000. The best current estimate of the rate of vaccine-induced AIDS is zero, and one can be 95% confident that the rate is less than eight per 100,000. The rate would have to be considerably higher before postponement of vaccination would be rational for those for whom vaccination has been recommended. (Journal of the American Medical Association 1984;252:3375-3377.)

“Oral Candidiasis in High-risk Patients as the Initial Manifestation of the Acquired Immunodeficiency Syndrome,” Robert S. Klein, et al. We studied the frequency with which unexplained oral candidiasis led to unequivocal acquired immunodeficiency syndrome (AIDS) in patients at risk. Twenty-two previously healthy adults with unexplained oral candidiasis, of whom the 19 tested had a reversed T4/T8 ratio and 20 had generalized lympadenopathy, were compard with 20 similar patients with a reversed T4/T8 ratio and generalized lymphadenopathy who did not have oral candidiasis. All were intravenous-drug abusers, homosexual or bisexual men, or both. Thirteen of the 22 patients with oral candidiasis (59%) acquired a major opportunistic infection or Kaposi's sarcoma at a median of three months (range, 1 to 23) as compared with none of 20 patients with generalized lymphadenopathy and immunodeficiency but without candidiasis who were followed for a median of 12 months (range, 5 to 21) (P < 0.001). AIDS developed in 12 of 15 patients with candidiasis and T4/T8 ratios less than or equal to 0.51, as compared with none of four with ratios equal to or greater than 0.60 (P < 0.01). We conclude that in patients at high risk for AIDS, the presence of unexplained oral candidiasis predicts the development of serious opportunistic infections more than 50% of the time. Whether the remainder will have AIDS is not yet known. (New England Journal of Medicine 1984;311:354-8.)