Advances in sexually transmitted infections of the gastrointestinal tract.
The gastrointestinal mucosa is a target of many sexually transmitted infections, and major advances have increased our understanding of the consequences of such infections within the gastrointestinal system. HIV-1 is associated with a marked loss of mucosal CD4(+) T cells that express CC-chemokine receptor 5. This process seems to be more rapid and more severe in mucosa-associated lymphoid tissue than in the peripheral blood. Mechanistic insights into the underlying cause of acute and chronic gastrointestinal damage with HIV infection-microbial translocation, defects in intestinal epithelial barrier function and activation of a systemic immune response-have also been achieved. Increased understanding of the pathogenesis of mucosal HIV-1 infection may identify therapeutic targets to restore immunological function and the integrity of the intestinal mucosal epithelial barrier. The increasing prevalence of lymphogranuloma venereum in Europe, mostly in HIV-positive men who have sex with men, suggests a change in the epidemiology of what was previously considered to be a 'tropical' disease. The increasing incidence of acute HCV infection transmitted via sexual contact has also been fueled by high-risk sexual behaviors among men who have sex with men, many of whom are also HIV-positive. The first part of this Review discusses the pathogenesis and gastrointestinal complications of HIV infection, and the second part summarizes advances in our understanding of other sexually transmitted infections of the gastrointestinal system.
Ng
Siew C
SC
Department of Gastroenterology, Chelsea and Westminster Hospital, London, UK.
Gazzard
Brian
B
D005767:Gastrointestinal Diseases / Q000503:physiopathology / Q000821:virology*; D041981:Gastrointestinal Tract / Q000503:physiopathology / Q000821:virology; D015658:HIV Infections / Q000150:complications* / Q000209:etiology / Q000635:transmission; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D007413:Intestinal Mucosa / Q000503:physiopathology / Q000821:virology; D012725:Sexual Behavior / Q000502:physiology; D015229:Sexually Transmitted Diseases, Viral / Q000150:complications* / Q000209:etiology / Q000635:transmission
JAMA. 1990 Sep 19;264(11):1413-7
2144026
Cochrane Database Syst Rev. 2009 Apr 15;(2):CD006085
19370624
J Infect Dis. 2001 Jul 1;184(1):93-7
11398115
Nat Med. 2006 Dec;12(12):1365-71
17115046
FASEB J. 2004 Jan;18(1):155-7
14630697
Dis Colon Rectum. 1990 Dec;33(12):1048-62
2242700
Gut. 1985 Sep;26(9):869-75
3896960
AIDS Read. 1999 May-Jun;9(3):167-9
12728901
Bull World Health Organ. 1999;77(8):651-66
10516787
N Engl J Med. 1978 Mar 2;298(9):490-5
340953
J Infect Dis. 2008 Jun 1;197(11):1558-66
18419344
J Clin Microbiol. 2007 Mar;45(3):1029-31
17251405
Gastroenterology. 2003 Feb;124(2):368-76
12557143
Nat Med. 2008 Apr;14(4):421-8
18376406
Clin Gastroenterol. 1975 Sep;4(3):659-69
810279
J Exp Med. 2004 Nov 15;200(10):1299-314
15545355
J Immunol. 2003 Dec 1;171(11):6164-72
14634132
Sex Transm Dis. 2008 Jul;35(7):637-42
18520976
AIDS. 2006 Jan 9;20(2):233-40
16511416
Curr Opin Infect Dis. 2005 Oct;18(5):427-35
16148530
Clin Infect Dis. 2007 Feb 1;44(3):335-7
17205437
Sex Transm Dis. 2005 Apr;32(4):220-6
15788919
Ann Intern Med. 1996 Aug 15;125(4):257-64
8678387
JAMA. 1977 Nov 7;238(19):2046-7
578904
J Exp Med. 2003 Sep 15;198(6):963-9
12963696
Sex Transm Infect. 2007 Apr;83(2):120-5; discussion 125
17090569
Scand J Gastroenterol. 2007 Dec;42(12):1422-7
17994468
BMC Infect Dis. 2008 Nov 13;8:156
19014537
AIDS. 1996 Oct;10(12):1385-91
8902068
J Infect Dis. 2008 Jan 1;197(1):126-33
18171295
Ann Clin Lab Sci. 1976 Mar-Apr;6(2):184-92
946385
Int J STD AIDS. 2007 Aug;18(8):514-20
17686211
J HIV Ther. 2007 Mar;12(1):3-6
17589389
Sex Transm Infect. 2005 Dec;81(6):448-52
16326843
Medicine (Baltimore). 1982 Nov;61(6):390-405
6815407
Sex Transm Dis. 2009 Jun;36(6):331-5
19556925
Nat Med. 2008 Oct;14(10):1077-87
18806803
Curr Opin Immunol. 2005 Aug;17(4):366-73
15955686
AIDS. 1992 Mar;6(3):307-9
1567575
Genitourin Med. 1995 Jun;71(3):150-4
7635489
Nat Med. 2002 Feb;8(2):150-6
11821899
Euro Surveill. 2006 Sep;11(9):152-4
17075161
Science. 1983 May 20;220(4599):865-7
6601823
Gut. 2006 Aug;55(8):1188-96
16120756
Science. 1983 May 20;220(4599):868-71
6189183
J Infect Dis. 2008 Feb 1;197(3):420-9
18199035
J Dtsch Dermatol Ges. 2008 Nov;6(11):935-40
18992036
J Clin Gastroenterol. 2004 Oct;38(9):733-40
15365396
Nat Immunol. 2005 Nov;6(11):1133-41
16200068
AIDS. 1998 Jan 1;12(1):43-51
9456254
Sex Transm Infect. 2009 Oct;85(6):447-51
19497918
Lancet. 2000 Nov 25;356(9244):1800-5
11117912
Postgrad Med J. 1998 Mar;74(869):168-9
9640444
Emerg Infect Dis. 2005 Jul;11(7):1090-2
16022786
Gut. 1995 Oct;37(4):524-9
7489940
Trans R Soc Trop Med Hyg. 1995 Jul-Aug;89(4):403-5
7570880
Sex Transm Infect. 2004 Aug;80(4):255-63
15295121
Clin Infect Dis. 2004 Oct 1;39(7):996-1003
15472852
Scand J Gastroenterol. 1995 Sep;30(9):909-14
8578192
J Infect Dis. 2002 Oct 1;186(7):1019-22
12232844
Nat Rev Immunol. 2005 Oct;5(10):783-92
16200081
J Immunol. 1999 Sep 15;163(6):3539-48
10477629
N Engl J Med. 2006 Jan 19;354(3):284-9
16421370
J Acquir Immune Defic Syndr. 2004 Oct 1;37(2):1228-36
15385729
Curr HIV/AIDS Rep. 2007 Feb;4(1):10-5
17338855
N Engl J Med. 1983 Apr 14;308(15):868-71
6300674
Br J Vener Dis. 1976 Oct;52(5):348-50
1036464
Sex Transm Dis. 1984 Apr-Jun;11(2):59-63
6087479
Lancet. 2003 Mar 22;361(9362):1025-34
12660071
J Antimicrob Chemother. 2006 Sep;58(3):587-93
16816397
AIDS. 2008 Jul 11;22(11):1287-92
18580607
Int J Colorectal Dis. 2006 Jan;21(1):71-8
15856265
Clin Infect Dis. 2005 Jul 1;41(1):67-74
15937765
Parasite Immunol. 2005 Jan-Feb;27(1-2):1-8
15813717
Ann Intern Med. 1988 Mar;108(3):328-33
2829677
J Endotoxin Res. 2000;6(3):205-14
11052175
Biochem Biophys Res Commun. 2004 Nov 12;324(2):518-28
15474458
Sex Transm Infect. 2004 Dec;80(6):451-4
15572612
Sex Transm Infect. 2003 Dec;79(6):456-9
14663120
Euro Surveill. 2005 Dec 22;10(12):E051222.4
16794303
J Immunol. 2007 Sep 1;179(5):3026-34
17709517
Sex Transm Dis. 1981 Jan-Mar;8(1):16-7
6784255
J Acquir Immune Defic Syndr. 2006 Jan 1;41(1):31-6
16340470
Sex Transm Dis. 2008 Oct;35(10):845-8
18607315
J Virol. 1996 Jun;70(6):3545-50
8648688
Sex Transm Infect. 2007 Jul;83(4):330-4
17475689
Immunity. 2004 Oct;21(4):527-38
15485630
Gastroenterology. 2001 Dec;121(6):1428-36
11729122
JAMA. 2006 Sep 27;296(12):1498-506
17003398
Sex Transm Dis. 2008 May;35(5):495-8
18354345
Euro Surveill. 2004 Dec;9(12):21-5
15677851
J Virol. 2008 Feb;82(3):1155-65
18045946
Gut. 1995 Nov;37(5):623-9
8549936
Euro Surveill. 2005 May;10(5):115-7
16077209
N Engl J Med. 1984 Jun 14;310(24):1545-50
6328297
Int J STD AIDS. 2008 Nov;19(11):729-40
18931264
Proc Natl Acad Sci U S A. 2007 Feb 27;104(9):3396-401
17360657
J Infect Dis. 1999 Apr;179(4):859-70
10068581
Gut. 2003 Feb;52(2):224-30
12524404
AIDS. 2007 Oct 1;21(15):2112-3
17885306
Nat Rev Immunol. 2006 Feb;6(2):148-58
16491139
Parasite Immunol. 1996 Oct;18(10):491-8
9226686
Clin Infect Dis. 2009 Mar 1;48(5):e53-6
19191633
J Clin Pathol. 1989 Mar;42(3):275-81
2703544
Adv Immunol. 1999;72:209-53
10361577
Rev Infect Dis. 1986 Mar-Apr;8(2):228-38
2871619
AIDS. 2004 Jan 23;18(2):303-9
15075549
Gastroenterology. 1999 May;116(5):1115-23
10220503
JAMA. 1982 Sep 3;248(9):1041-9
7109193
FASEB J. 2000 Sep;14(12):1749-53
10973924
Int J STD AIDS. 2004 Aug;15(8):533-7
15307964
Gut. 1999 Aug;45(2):191-8
10403730
Gut. 1995 Feb;36(2):283-6
7883231
Sex Transm Infect. 2009 Jun;85(3):173-5
19221105
Gastroenterology. 2005 Aug;129(2):550-64
16083712
J Clin Gastroenterol. 1993 Mar;16(2):109-12
8463612
Ann N Y Acad Sci. 2000;915:293-303
11193591
Sex Transm Dis. 1977 Jul-Sep;4(3):89-91
337539
Nature. 2005 Apr 28;434(7037):1093-7
15793563
Am J Physiol Gastrointest Liver Physiol. 2006 Apr;290(4):G827-38
16537974
Gastroenterology. 1992 Sep;103(3):919-33
1499943
Dis Colon Rectum. 2009 Mar;52(3):507-12
19333054
J Exp Med. 2007 Sep 3;204(9):2171-85
17724130
Curr Pharm Des. 2008;14(3):237-44
18220834
Dig Dis Sci. 1993 Jun;38(6):1119-27
8508707
Biochem Biophys Res Commun. 2005 Nov 18;337(2):505-9
16198312
Vet Parasitol. 2004 Dec 9;126(1-2):121-44
15567582
AIDS. 2007 Feb 19;21(4):433-9
17301561
Euro Surveill. 2005 Mar 03;10(3):E050303.3
16702633
Gastroenterology. 2001 Feb;120(3):607-21
11179239
Inflamm Bowel Dis. 2006 Aug;12(8):758-65
16917232
Cell. 2000 Mar 3;100(5):587-97
10721995
N Engl J Med. 1983 Apr 21;308(16):916-21
6339923
J Gastroenterol Hepatol. 2009 Jan;24(1):167
19196401
Ann Intern Med. 1984 Oct;101(4):421-8
6476631
Sex Transm Dis. 2008 Apr;35(4):377-82
18209688
AIDS. 2007 May 11;21(8):983-91
17457092
J Exp Med. 1999 Nov 1;190(9):1241-56
10544196
Am J Gastroenterol. 2000 May;95(5):1277-83
10811339
Euro Surveill. 2005 Sep 29;10(9):E050929.3
16788240
Clin Infect Dis. 2007 Jan 1;44(1):26-32
17143811
Clin Sci (Lond). 1991 Sep;81(3):327-34
1655333
Gut. 1996 Dec;39(6):824-32
9038664
Clin Infect Dis. 2004 Jan 15;38(2):300-2
14699467
Postgrad Med J. 2006 Nov;82(973):733-6
17099092
Nat Immunol. 2008 Mar;9(3):301-9
18264102
Nature. 2003 Jul 3;424(6944):88-93
12840763
Ann N Y Acad Sci. 2006 Aug;1072:288-99
17057208
Hepatology. 1997 Sep;26(3 Suppl 1):15S-20S
9305658
AIDS. 2005 Jun 10;19(9):969-74
15905679
Curr Opin HIV AIDS. 2008 Sep;3(5):541-7
19373019
Sex Transm Infect. 2004 Dec;80(6):492-7
15572622
J Infect Dis. 1989 Jun;159(6):1126-8
2656880
Arch Intern Med. 2005 Feb 28;165(4):409-15
15738369
N Engl J Med. 1974 Nov 28;291(22):1194
4608062
Clin Infect Dis. 2001 Aug 15;33(4):562-9
11462196
Emerg Infect Dis. 2005 Nov;11(11):1787-8
16318741
Curr Pharm Des. 2008;14(17):1690-7
18673193
Int J STD AIDS. 2009 May;20(5):300-9
19386965
J Infect Dis. 2002 Apr 15;185(8):1043-50
11930313
Expert Rev Anti Infect Ther. 2008 Jun;6(3):337-49
18588498
J Clin Invest. 1981 Nov;68(5):1305-13
6271810
Hepatology. 2007 Oct;46(4):1016-25
17668881
Am J Epidemiol. 1974 Nov;100(5):414-23
4371067
Clin Infect Dis. 2007 Feb 1;44(3):327-34
17205436
J Virol. 2007 Jan;81(2):599-612
17065209
N Engl J Med. 1984 Jun 14;310(24):1551-6
6328298
Gastroenterology. 2003 May;124(5):1465-75
12730885
Infect Dis Clin North Am. 1988 Jun;2(2):475-84
3060531
J Leukoc Biol. 2003 Nov;74(5):642-9
12960227
Ann Intern Med. 1991 Mar 1;114(5):366-72
1992878
JAMA. 1988 Sep 9;260(10):1429-33
3404600
Nat Immunol. 2006 Mar;7(3):235-9
16482171
J Infect Dis. 2000 Dec;182(6):1625-35
11069233
Curr Opin Immunol. 2009 Jun;21(3):274-80
19524429
Lancet. 1998;351 Suppl 3:5-7
9652712
J Immunol. 2007 Sep 1;179(5):3035-46
17709518
AIDS Rev. 2008 Jan-Mar;10(1):36-46
18385779
Proc Natl Acad Sci U S A. 2005 Jul 12;102(28):9860-5
15980151
AIDS. 2002 May 3;16(7):983-91
11953464
Future Microbiol. 2009 Feb;4(1):105-18
19207103
Clin Infect Dis. 2006 Jan 15;42(2):186-94
16355328
Genitourin Med. 1989 Aug;65(4):239-43
2807281
Emerg Infect Dis. 1999 Nov-Dec;5(6):820-3
10603219
Euro Surveill. 2006 Sep;11(9):155-6
17075158
Nat Med. 2005 May;11(5):469-70
15875046
Ann Intern Med. 1977 Mar;86(3):340-6
402879
Expert Rev Mol Med. 2008 Oct 20;10:e30
18928579
N Engl J Med. 1981 Jul 23;305(4):195-200
7017409
Lancet. 1996 Aug 10;348(9024):379-83
8709738
Interdiscip Perspect Infect Dis. 2009;2009:547090
19584941
Virology. 2003 Jul 20;312(1):84-94
12890623
Gut. 1999 Jul;45(1):70-6
10369707
Gastroenterology. 2009 May;136(5):1609-17
19422083
Sex Transm Infect. 2004 Aug;80(4):326-7
15295139
Sex Transm Dis. 2007 Oct;34(10):783-90
17495592
Gut. 2007 Jan;56(1):61-72
16822808
Sex Transm Infect. 2007 Apr;83(2):106-12
17020893
N Engl J Med. 1978 Feb 23;298(8):428-35
340951
Ann N Y Acad Sci. 1998 Nov 17;859:139-48
9928377
Science. 1998 Apr 17;280(5362):427-31
9545219
JAMA. 1988 Feb 19;259(7):1048-50
2828700
Nat Med. 1997 Jan;3(1):42-7
8986739
Gastroenterology. 2005 May;128(5):1258-67
15887109
Emerg Infect Dis. 2007 Mar;13(3):516-7
17552123
AIDS. 2003 Sep 5;17(13):1881-8
12960820
N Engl J Med. 1983 Sep 8;309(10):576-82
6308444
AIDS. 2006 Jan 2;20(1):5-10
16327313
Genome Res. 2008 Jan;18(1):161-71
18032721
MMWR Recomm Rep. 2006 Aug 4;55(RR-11):1-94
16888612
Eur J Immunol. 2002 May;32(5):1445-54
11981833
Am J Med. 1991 Feb;90(2):269-71
1996598
Gut. 2009 Feb;58(2):220-7
18936106
Sex Transm Infect. 2005 Feb;81(1):91-2
15681732
Sex Transm Infect. 1999 Feb;75(1):3-17
10448335
Sex Transm Dis. 2009 Aug;36(8):507-11
19455081
AIDS. 2007 Oct 18;21(16):2177-82
18090044
Euro Surveill. 2006 Sep;11(9):150-2
17075162
PLoS Negl Trop Dis. 2008 Feb 27;2(2):e175
18301730
J Endotoxin Res. 2002;8(6):441-8
12697087
J Acquir Immune Defic Syndr (1988). 1991;4(8):760-5
1856788
Nature. 2005 Apr 28;434(7037):1148-52
15793562
J Immunol. 1993 Mar 15;150(6):2356-63
8450217
CMAJ. 2005 Jun 21;172(13):1674-6
15928239
J Exp Med. 2005 Oct 17;202(8):1063-73
16216890
J Dtsch Dermatol Ges. 2004 Aug;2(8):676-80
16279230