Association between HIV-1 infection, the etiology of genital ulcer disease, and response to syndromic management.
BACKGROUND
Reports on the effect of HIV-1 infection on healing rates of ulcers are conflicting.


OBJECTIVE
The goal was to determine the etiology and response to treatment of genital ulcer disease (GUD) in relation to HIV-1 infection.


METHODS
This was a cohort study of patients with GUD treated with local syndromic management protocols.


RESULTS
Among the 587 recruited, the prevalences of infections due to HSV, Treponema pallidum, Chlamydia trachomatis (lymphogranuloma venereum [LGV]), Haemophilus ducreyi, Calymmatobacterium granulomatis, and HIV-1 were 48%, 14%, 11%, 10%, 1%, and 75%, respectively. The prevalence T. pallidum of was higher among men (P = 0.03), and an association was seen among HIV-1-seronegatives on univariate and multivariate analyses (P < 0.001; = 0.01). The prevalence of C trachomatis (LGV) was higher among females (P = 0.004), and an association was seen among HIV-1-seropositives on univariate analysis (P = 0.04). At follow-up, 40/407 (10%) showed a decreased healing tendency, not associated with ulcer etiology or HIV-1 seropositivity.


CONCLUSIONS
Response to syndromic management of GUD was acceptable and not associated with HIV-1 coinfection.
Moodley
Prashini
P
Africa Centre for Health and Population Studies, Nelson R. Mandela School of Medicine, University of Natal, Durban, South Africa.
Sturm
Patrick D J
PD
Vanmali
Trusha
T
Wilkinson
David
D
Connolly
Cathy
C
Sturm
A Willem
AW
D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D004917:Erythromycin / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005831:Genital Diseases, Female / Q000188:drug therapy / Q000821:virology*; D005832:Genital Diseases, Male / Q000188:drug therapy / Q000821:virology*; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology; D015497:HIV-1; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000209:etiology; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013577:Syndrome; D014456:Ulcer / Q000188:drug therapy / Q000821:virology*
D000890:Anti-Infective Agents; D010406:Penicillins; D004917:Erythromycin