title: Association between HIV-1 infection, the etiology of genital ulcer disease, and response to syndromic management.
abstract: 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.
authors.affiliation: Africa Centre for Health and Population Studies, Nelson R. Mandela School of Medicine, University of Natal, Durban, South Africa.
authors.forename: Prashini
authors.initials: P
authors.lastname: Moodley
authors.forename: Patrick D J
authors.initials: PD
authors.lastname: Sturm
authors.forename: Trusha
authors.initials: T
authors.lastname: Vanmali
authors.forename: David
authors.initials: D
authors.lastname: Wilkinson
authors.forename: Cathy
authors.initials: C
authors.lastname: Connolly
authors.forename: A Willem
authors.initials: AW
authors.lastname: Sturm
mesh_terms: 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*
chemical_list: D000890:Anti-Infective Agents; D010406:Penicillins; D004917:Erythromycin