Association between HIV-1 infection, the etiology of genital ulcer disease, and response to syndromic management.

Sex Transm Dis

Africa Centre for Health and Population Studies, Nelson R. Mandela School of Medicine, University of Natal, Durban, South Africa.

Published: March 2003

Background: Reports on the effect of HIV-1 infection on healing rates of ulcers are conflicting.

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

Study Design: 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.

Conclusion: Response to syndromic management of GUD was acceptable and not associated with HIV-1 coinfection.

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http://dx.doi.org/10.1097/00007435-200303000-00013DOI Listing

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