The association of genital ulcer disease and HIV infection at a dermatology-STD clinic in Uganda

Article Abstract:

In Africa, infection with the human immunodeficiency virus (HIV) is most frequently transmitted through heterosexual relationships. Studies from East Africa have shown a link between the presence of genital ulcers and HIV infection. Genital ulcers may be caused by syphilis, genital herpes, or gonorrhea. The association between genital ulcer diseases and HIV infection was studied in 270 patients who came to the dermatology and sexually transmitted disease (STD) clinic at Mulago Hospital in Kampala, Uganda. Individuals who had a history of an STD in the past five years were more likely to be infected with HIV (43 percent were HIV-positive) compared with those who did not have a recent history of STD (26 percent). In both male and female patients, there was a significant association between the existence of genital ulcers and HIV infection. It is possible that HIV has an effect on the clinical history and expression of genital ulcer disease, as a large percentage of those with genital ulcers also had HIV infection. Genital ulcers result from microorganisms that cause chancroid (gonorrhea), syphilis, and genital herpes; HIV infection was not associated with the existence of other STD syndromes, such as urethritis (inflammation of the urethra) or vaginal discharge. This may indicate that the association of genital ulcers with HIV infection is more than just a marker of high-risk sexual activity. Methods to prevent transmission of STDs, such as the use of condoms and not having relationships with prostitutes, must be utilized to reduce HIV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Sexually transmitted diseases, Risk factors, Herpes genitalis, Genital herpes, Gonorrhea, Uganda

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High-titer positive nontreponemal tests with negative specific treponemal serology in patients with HIV infection and/or intravenous substance use

Article Abstract:

Individuals are screened for the sexually transmitted disease syphilis by testing for antibodies to nontreponemal syphilis. The number of false-positive results (which show a positive result when it is really negative) is small in the general population, in fact, it is less than one percent. When positive test results are reported, treatment for syphilis is quickly initiated; it is standard practice to administer antibiotic therapy even before the results of a confirmatory test are known. However, in patients with chronic infections, autoimmune diseases, including infection with HIV (human immunodeficiency virus), and/or a history of intravenous drug use, the number of false-positive test results is higher. Eight cases of individuals with false-positive tests are described. Seven of these patients were intravenous drug users, six were infected with HIV, and two were homosexual. Therefore, with an increased rate of false-positive test results in individuals with HIV infection and/or intravenous drug use, the practice of rapid treatment for syphilis, without a confirmatory test, should be re-evaluated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Testing, Antibodies, Intravenous drug abuse, False positive reactions

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Enteropathy in HIV infection

Article Abstract:

Enteropathy frequently occurs in HIV patients and is often debilitating. Enteropathy refers to any disease of the gastrointestinal tract and can have numerous causes that are difficult to identify and treat. In HIV patients, esophageal symptoms such as difficulty swallowing are most commonly caused by Candida esophagitis. Except in some cases of HIV-related Kaposi's sarcoma, the stomach is rarely the site of enteropathy in HIV infection. Diseases affecting the small intestine are the most difficult to diagnose, due largely to limitations of testing procedures. Cytomegalovirus is the main cause of HIV-related colonic disease, which is characterized by bloody diarrhea and pain in the colon. Infections of the anal canal and rectum are often found in HIV patients. There is increasing evidence suggesting HIV may directly infect intestinal cells, altering their structure and contributing to enteropathy.

Gastrointestinal diseases

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