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Sinha S, Sardana K, Agarwal A, Ahuja A. Relapsing donovanosis rhyming with unexplained decline in CD4 count in a person living with HIV/AIDS: Long-term follow up and therapeutic outcome. Int J STD AIDS 2023; 34:423-426. [PMID: 36802827 DOI: 10.1177/09564624231156205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Donovanosis is a chronic genital ulcerative disease caused by the intracellular Gram-negative bacterium Klebsiella granulomatis, reported more frequently in people living with HIV/AIDS (PLHA). Here we present a case of relapsing donovanosis in a PLHA on second line antiretroviral therapy who had episodes of transient unexplained decrease in CD4 counts associated with rapid growth of the lesion and non-responsiveness to treatment followed by clinical resolution coinciding with recovery of the CD4 count.
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Affiliation(s)
- Surabhi Sinha
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
| | - Kabir Sardana
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
| | - Aastha Agarwal
- Department of Dermatology, Venereology and Leprosy, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
| | - Arvind Ahuja
- Department of Pathology, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
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Abstract
Donovanosis is a chronic, progressive, and indolent bacterial disease that affects the skin and mucous membranes of the genital and perigenital regions, often associated with sexual transmission, and with low infectivity. The malignant transformation of donovanosis lesions occurs exceptionally, as is usually seen in long-term ulcerations.
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Affiliation(s)
- Walter Belda Junior
- Department of Dermatology, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
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[School-based prevention programmes for adolescents: HIV, sexually transmitted infections, and pregnancy]. Urologe A 2019; 57:723-726. [PMID: 29744555 DOI: 10.1007/s00120-018-0659-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Bremer V, Dudareva-Vizule S, Buder S, An der Heiden M, Jansen K. [Sexually transmitted infections in Germany : The current epidemiological situation]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 60:948-957. [PMID: 28741188 DOI: 10.1007/s00103-017-2590-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Sexually transmitted infections (STIs) can impair sexual health. Surveillance and study data were used to provide an overview over STIs in Germany. We estimated 3900 new HIV diagnoses in 2015. Of newly diagnosed infections, 57% were attributed to men who have sex with men (MSM). It was further estimated that there were 3200 new HIV infections and 84,700 people living with HIV in 2015. A total of 6834 syphilis infections were recorded in 2015, which corresponds to an increase of 149% since 2009. The incidence in men was 16-times higher than in women. Of syphilis infections, 85% could be attributed to MSM. Antimicrobial resistance of gonococci against the broad-spectrum antibiotic cefixime decreased between 2014 and 2016 after a change of therapy guidelines and remained stable on a low level regarding the antibiotic ceftriaxone. After an increase of resistance against the antibiotic azithromycin to 11.3% in 2015, we observed a decreasing trend in 2016. Between 2013 and 2015, 2,355,336 chlamydia tests were reported through the chlamydia sentinel network. Of these, 92.5% of samples were from women. Uptake for screening for women <25 years was 11.3% in 2015, with 5.0% positive chlamydia tests. In a cross-sectional study among women aged 20-25 years, a prevalence of human papilloma virus (HPV) of 38.1% was observed. A total of 30.5% of 15-year-old women were vaccinated against HPV in 2014. Data suggest that STIs represent a high burden of disease. Knowledge of STI prevention should be improved by targeted education campaigns. Extending existing offers for counselling and testing through cooperation between different health sectors would improve early diagnosis and treatment of STIs.
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Affiliation(s)
- Viviane Bremer
- Abt. für Infektionsepidemiologie, Robert Koch-Institut, Seestraße 10, 13353, Berlin, Deutschland.
| | - Sandra Dudareva-Vizule
- Abt. für Infektionsepidemiologie, Robert Koch-Institut, Seestraße 10, 13353, Berlin, Deutschland.,Charité Universitätsmedizin, Berlin, Deutschland
| | - Susanne Buder
- Konsiliarlabor für Gonokokken, Vivantes-Klinikum Neukölln, Berlin, Deutschland
| | - Matthias An der Heiden
- Abt. für Infektionsepidemiologie, Robert Koch-Institut, Seestraße 10, 13353, Berlin, Deutschland
| | - Klaus Jansen
- Abt. für Infektionsepidemiologie, Robert Koch-Institut, Seestraße 10, 13353, Berlin, Deutschland
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Castro ELD, Caldas TAD, Morcillo AM, Pereira EMDA, Velho PENF. [Awareness and education regarding sexually transmitted diseases among undergraduate students]. CIENCIA & SAUDE COLETIVA 2018; 21:1975-84. [PMID: 27276546 DOI: 10.1590/1413-81232015216.00492015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 09/02/2015] [Indexed: 11/21/2022] Open
Abstract
Sexually transmitted diseases (STDs) are the main global cause of acute illness and death and represent a high socioeconomic cost. Undergraduate students are highly exposed to STDs. The research developed at UNICAMP sought to quantify and generate self-perception of knowledge(or lack thereof) about STDs, as well as evaluate the interest of the students in a course on the topic. The data collection instrument was a questionnaire sent electronically to students about to graduate at the end of 2011 and to freshmen in 2012. The questionnaire was answered by 1,448 seniors and 371 freshmen. Twenty percent of seniors and 38% of freshmen had no sexual activity. Among sexually active students, 26.9% had no regular partner and 28.2% more than two partners per year. The condom was used by 99% of students, but less than 20% used them appropriately. About 80% were unaware that condoms do not provide protection outside the barrier area; they intended to read more about STDs and learnt something about the subject. Nearly half of the students considered that a course should be offered to all undergraduates. These findings will be of use in defining strategies for prevention and the teaching tool could be used in other learning environments.
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Affiliation(s)
- Eneida Lazzarini de Castro
- Universidade Estadual de Campinas, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas SP , Brasil, Departamento de Clínica Médica, Área de Ensino, Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (Unicamp). R. Tessália Vieira de Camargo 126, Cidade Universitária "Zeferino Vaz". 13083-887 Campinas SP Brasil. eneida_lazzarini@ yahoo.com.br
| | - Tânia Alencar de Caldas
- Universidade Estadual de Campinas, Faculdade de Educação, Unicamp, Campinas SP , Brasil, Grupo de Estudos e Pesquisas em Educação Superior, Faculdade de Educação, Unicamp. Campinas SP Brasil
| | - André Moreno Morcillo
- Universidade Estadual de Campinas, Departamento de Pediatria, FCM, Unicamp, Campinas SP , Brasil, Departamento de Pediatria, FCM, Unicamp. Campinas SP Brasil
| | - Elisabete Monteiro de Aguiar Pereira
- Universidade Estadual de Campinas, Faculdade de Educação, Unicamp, Campinas SP , Brasil, Grupo de Estudos e Pesquisas em Educação Superior, Faculdade de Educação, Unicamp. Campinas SP Brasil
| | - Paulo Eduardo Neves Ferreira Velho
- Universidade Estadual de Campinas, Departamento de Clínica Médica, FCM, Unicamp, Campinas SP , Brasil, Departamento de Clínica Médica, FCM, Unicamp. Campinas SP Brasil
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Velho PENF. Sexually transmitted infections and PRO-LIVES: based on a clinical report. An Bras Dermatol 2017; 92:279-280. [PMID: 28538901 PMCID: PMC5429127 DOI: 10.1590/abd1806-4841.20175433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 02/18/2016] [Indexed: 11/21/2022] Open
Abstract
Physicians are also responsible for the increase in sexually transmitted
infections. We report a case of patient inadequately monitored, that shows the
importance of physicians to take basic measures with any individual at risk of
acquiring such infections. We propose the following mnemonic acrostic: PRO-LIVES
(Protection: usual and proper codom use, Responsibility, Other orientations,
Laboratory tests -HIV infection, syphilis and B and C hepatitis-, Immunization:
B hepatitis vaccination, Various: at least two patients, Ensure: case history
and physical examination, Single dose treatment: whenever possible). Clinicians
should take these measures when treating any patient who has been exposed to
risk or with a diagnosis of sexually transmitted infections.
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Affiliation(s)
- Paulo Eduardo Neves Ferreira Velho
- Division of Dermatology and Division of Medical Education of the School of Medical Sciences - Universidade Estadual de Campinas (FCM-UNICAMP) - Campinas (SP), Brazil
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Oramasionwu CU, Brown CM, Ryan L, Lawson KA, Hunter JM, Frei CR. HIV/AIDS disparities: the mounting epidemic plaguing US blacks. J Natl Med Assoc 2010; 101:1196-204. [PMID: 20070007 DOI: 10.1016/s0027-9684(15)31130-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The human immunodeficiency virus (HIV)/AIDS epidemic presents a formidable challenge for the black community. Blacks, although a small proportion of the US population, are overrepresented, not only in the number of people living with HIV, but also in the categories of new diagnoses and AIDS-related deaths. Fortunately, national initiatives are in place to slow and ultimately reverse these racial inequities. While these disparities may be widely recognized, their causes are not clearly understood. A variety of underlying issues exist for blacks in the United States that may also contribute to these growing disparities. These include transmission risk factors, socioeconomic factors, underrecognition, delayed presentation, and other comorbid conditions. We present a review of the literature regarding the potential causes of racial disparities and how they may contribute to health outcomes for blacks with HIV/AIDS in the United States. We also identify possible gaps in knowledge and offer future directions for research of HIV/AIDS racial disparities.
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Lee PK, Wilkins KB. Condyloma and Other Infections Including Human Immunodeficiency Virus. Surg Clin North Am 2010; 90:99-112, Table of Contents. [DOI: 10.1016/j.suc.2009.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Oramasionwu CU, Hunter JM, Skinner J, Ryan L, Lawson KA, Brown CM, Makos BR, Frei CR. Black race as a predictor of poor health outcomes among a national cohort of HIV/AIDS patients admitted to US hospitals: a cohort study. BMC Infect Dis 2009; 9:127. [PMID: 19671170 PMCID: PMC2736968 DOI: 10.1186/1471-2334-9-127] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Accepted: 08/11/2009] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In general, the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) population has begun to experience the benefits of highly active antiretroviral therapy (HAART); unfortunately, these benefits have not extended equally to Blacks in the United States, possibly due to differences in patient comorbidities and demographics. These differences include rates of hepatitis B and C infection, substance use, and socioeconomic status. To investigate the impact of these factors, we compared hospital mortality and length of stay (LOS) between Blacks and Whites with HIV/AIDS while adjusting for differences in these key characteristics. METHODS The 1996-2006 National Hospital Discharge Surveys were used to identify HIV/AIDS patients admitted to US hospitals. Survey weights were incorporated to provide national estimates. Patients < 18 years of age, those who left against medical advice, those with an unknown discharge disposition and those with a LOS < 1 day were excluded. Patients were stratified into subgroups by race (Black or White). Two multivariable logistic regression models were constructed with race as the independent variable and outcomes (mortality and LOS > 10 days) as the dependent variables. Factors that were significantly different between Blacks and Whites at baseline via bivariable statistical tests were included as covariates. RESULTS In the general US population, there are approximately 5 times fewer Blacks than Whites. In the present study, 1.5 million HIV/AIDS hospital discharges were identified and Blacks were 6 times more likely to be hospitalized than Whites. Notably, Blacks had higher rates of substance use (30% vs. 24%; P < 0.001), opportunistic infections (27% vs. 26%; P < 0.001) and cocaine use (13% vs. 5%; P < 0.001). Conversely, fewer Blacks were co-infected with hepatitis C virus (8% vs. 12%; P < 0.001). Hepatitis B virus was relatively infrequent (3% for both groups). Crude mortality rates were similar for both cohorts (5%); however, a greater proportion of Blacks had a LOS > 10 days (21% vs. 19%; P < 0.001). Black race, in the presence of comorbidities, was correlated with a higher odds of LOS > 10 days (OR, 95% CI = 1.20 [1.10-1.30]), but was not significantly correlated with a higher odds of mortality (OR, 95% CI = 1.07 [0.93-1.25]). CONCLUSION Black race is a predictor of LOS > 10 days, but not mortality, among HIV/AIDS patients admitted to US hospitals. It is possible that racial disparities in hospital outcomes may be closing with time.
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Affiliation(s)
- Christine U Oramasionwu
- College of Pharmacy, The University of Texas, Austin, TX, USA
- Department of Medicine, The University of Texas Health Science Center, San Antonio, TX, USA
| | - Jonathan M Hunter
- Department of Medicine, The University of Texas Health Science Center, San Antonio, TX, USA
| | - Jeff Skinner
- The National Institute of Allergy and Infectious Diseases, The National Institutes of Health, Bethesda, MD, USA
| | - Laurajo Ryan
- College of Pharmacy, The University of Texas, Austin, TX, USA
- Department of Medicine, The University of Texas Health Science Center, San Antonio, TX, USA
| | | | - Carolyn M Brown
- College of Pharmacy, The University of Texas, Austin, TX, USA
| | - Brittany R Makos
- College of Pharmacy, The University of Texas, Austin, TX, USA
- Department of Medicine, The University of Texas Health Science Center, San Antonio, TX, USA
| | - Christopher R Frei
- College of Pharmacy, The University of Texas, Austin, TX, USA
- Department of Medicine, The University of Texas Health Science Center, San Antonio, TX, USA
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Borges MC, Colares JKB, Lima DM, Fonseca BAL. Haemophilus ducreyi detection by polymerase chain reaction in oesophageal lesions of HIV patients. Int J STD AIDS 2009; 20:238-40. [DOI: 10.1258/ijsa.2008.008317] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
HIV patients frequently have opportunistic oesophageal infections. We report Haemophilus ducreyi genetic material detected by polymerase chain reaction in biopsies of oesophageal lesions in three HIV-1-infected patients. This finding may be an indication of its aetiopathological role in oesophageal lesions of HIV patients.
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Affiliation(s)
- M C Borges
- Department of Internal Medicine, University of São Paulo Medical School at Ribeirão Preto
- Department of Medicine, University of São Carlos, SP, Brazil
| | - J K B Colares
- Department of Internal Medicine, University of São Paulo Medical School at Ribeirão Preto
| | - D M Lima
- Department of Internal Medicine, University of São Paulo Medical School at Ribeirão Preto
| | - B A L Fonseca
- Department of Internal Medicine, University of São Paulo Medical School at Ribeirão Preto
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Bonnetblanc JM. [Soft chancre]. Ann Dermatol Venereol 2007; 134:405-6. [PMID: 17483768 DOI: 10.1016/s0151-9638(07)89203-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- J-M Bonnetblanc
- Service de Dermatologie, CHRU Dupuytren, 2, avenue Martin Luther King, 87042 Limoges Cedex.
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Montano M, Rarick M, Sebastiani P, Brinkmann P, Skefos J, Ericksen R. HIV-1 burden influences host response to co-infection with Neisseria gonorrhoeae in vitro. Int Immunol 2005; 18:125-37. [PMID: 16352629 DOI: 10.1093/intimm/dxh355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
There is considerable evidence that co-infection with the sexually transmitted pathogen Neisseria gonorrhoeae (Gc) can increase the likelihood of both transmitting and acquiring HIV-1 worldwide. However, less information is available on how host immune response to co-infection differs with immune response to HIV-1 infection alone. To evaluate HIV-1 burden effects on host response to co-infection with Gc, we performed gene-expression profiling of human PBMCs infected over a broad range of viral titers (HIV-1 series) and upon exposure to a single infectious dose of Gc (HIV-1/Gc series). The transcriptional profiles differed substantially between each series (P < 0.0001). Major shifts in the transcriptional landscape were identified in contour plots based on fold stimulation and hierarchical clustering. Prominent regions of transcriptional activity were evaluated for statistical enrichment to identify up-regulated pathways associated with immune response, infection and T-cell stimulation. Notably, gene enrichment was dependent on HIV-1 burden and shifted during co-infection to reveal a disproportionate effect on lymphocyte signaling, apoptosis and proteasome activity. Further evaluation of these findings may help to better understand the role of viral burden in defining cellular contribution to host immune response upon co-infection with secondary sexually transmitted pathogens.
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Affiliation(s)
- Monty Montano
- Department of Medicine, Section of Infectious Diseases, Center for HIV-1/AIDS Care and Research, Boston University School of Medicine, USA
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