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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To determine if infection with herpes simplex virus (HSV) type 2 is associated with human immunodeficiency virus (HIV) type 1 infection among patients attending sexually transmitted diseases clinics, a case-control study was done on coded sera from 179 HIV-1-infected patients and 367 age-, race-, and gender-matched HIV-1-seronegative patients. Although only 13 (2.3%) of 546 patients had a history of genital herpes treatment, 72% and 56.6%, respectively, had serologic evidence of prior infection with HSV-1 and -2. HSV-1 antibody prevalence was similar among both patient groups; however, HSV-2 antibodies were more common among those infected with HIV-1. Among heterosexual men, 62.7% of those infected with HIV-1 had HSV-2 antibodies compared with 46.7% of those not infected (P less than .01). The HSV-2 seroprevalence among women with or without HIV infection was 78.1% and 57.7%, respectively (P less than .02). A history of intravenous drug use and a reactive serologic test for syphilis were each independently associated with HIV-1 infection in heterosexuals. These data suggest that the two most common causes of genital ulcerative disease in the United States, genital herpes and syphilis, may contribute to increased risk for HIV-1 infection among heterosexuals.
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PMID:Herpes simplex virus infection as a risk factor for human immunodeficiency virus infection in heterosexuals. 844 Sep 48

This review discusses current reports on herpes simplex virus infections as they relate to the use of laboratory testing, infections in the neonate, herpes simplex virus association with human immunodeficiency virus infection, and updating the current therapy and management of genital herpes. Findings over the past year are important in the clinical management of patients with genital herpes. All health care workers who manage patients with genital herpes need to know the limitations of serologic testing. Current information suggests that serologic commercial testing that is most commonly available cannot discriminate between infections caused by herpes simplex virus type 1 and type 2. Laboratory methods still rely on culturing herpes simplex virus in living cells in vitro. However, the availability of monoclonal antibodies allows for rapid assays for the confirmation of cultured herpes simplex virus. In addition, assays have been developed and tested, suggesting that perhaps antigen-detection systems may be available that could replace culturing the virus in living cells. New information on neonatal herpes points out the predictors of morbidity and mortality in newborns who contract herpes within the first few weeks of life. Information concerning asymptomatic shedding in labor will provide the clinician with a better understanding of this disease entity in the pregnant woman. Several studies have confirmed that herpes simplex virus infection is a risk factor for developing human immunodeficiency virus infection. A new study clearly shows that treatment using daily acyclovir therapy over a prolonged period of time can control and may modify herpesvirus infection.
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PMID:Herpes simplex virus infections. 132 52

In recent years, the antiviral armamentarium has expanded considerably. Currently available agents are virustatic, inhibiting specific steps in the process of viral replication. No agent is active against nonreplicating or latent viruses. Acyclovir is useful in the treatment of genital herpes, herpes simplex encephalitis, mucocutaneous herpetic infection, varicella infection in the immunosuppressed host, and herpes zoster infection in the normal and the immunosuppressed host. It can also be used for prevention of herpesvirus infection in immunocompromised patients. Ganciclovir is indicated for the treatment of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome (AIDS) and is effective in the management of organ-specific cytomegalovirus infection in other immunocompromised patients. Chronic hepatitis C and condyloma acuminatum due to human papillomavirus respond to therapy with interferon alfa-2b. Patients with human immunodeficiency virus infection and CD4 lymphocyte counts of less than 500 cells/mm3 should be treated with zidovudine. Amantadine is useful in a therapeutic and prophylactic role in the management of influenza A virus infection. With the expanded use of and indications for antiviral therapy, clinically significant resistance to these agents has been encountered with increasing frequency.
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PMID:Antiviral agents. 134 78

Chancroid is a mucocutaneous infection caused by Haemophilus ducreyi that produces ulcerative lesions and enhances the efficiency of transmission of human immunodeficiency virus (HIV). Confirmation of infection by culture of H. ducreyi is essential in therapeutic trials. Minimal inhibitory concentrations of antibiotics for the isolate should be determined by agar dilution. Patients should be evaluated by appropriate laboratory tests for syphilis, infection with herpes simplex virus, gonorrhea, and (in North America) infection with Chlamydia trachomatis. The clinical history of the disease should be recorded and ulcers, buboes, and lymphadenitis mass described. Whenever possible, study participants also should be tested for HIV infection. Randomized, prospective, double-blind, active-control comparative clinical trials are preferred for evaluation of the safety and efficacy of new anti-infective drugs. Otherwise-healthy men and women should be enrolled in these studies. Patients with active syphilis or genital herpes should be excluded. Microbiological and clinical outcomes are paramount.
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PMID:Evaluation of new anti-infective drugs for the treatment of chancroid. Infectious Diseases Society of America and the Food and Drug Administration. 147 17

Major advances in molecular virology have led to the development of new antiviral compounds. These drugs include ribavirin, used in the treatment of severe respiratory syncytial virus infection in children; amantadine, used in the prophylaxis and treatment of influenza A infection; acyclovir, used in a variety of herpesvirus infections, including primary gingivostomatitis, genital herpes and herpes zoster; ganciclovir, used in the treatment of retinitis due to cytomegalovirus, and zidovudine, used in the prophylaxis and treatment of human immunodeficiency virus infection.
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PMID:Antiviral drug therapy. 198 88

In incidence and epidemiology of sexually transmitted disease (STD)s in Southeast Asia and the Western Pacific, with gonorrhea, chancroid, nongonococcal urethritis, syphilis, genital herpes and genital warts at the forefront, are reviewed. The bacterial STDs gonorrhea, chancroid and syphilis are the major problems. Gonorrhea is the most prevalent STD in the region, with a high incidence of chromosomally-mediated resistant and penicillinase-producing strains comprising 35-53% of isolates. Clinical treatment failures due to spectinomycin-resistant gonococci are reported as increasing. Uncontrolled antibiotic sales are blamed for these resistant strains. Syphilis has declined in the 1950s, but has re-emerged. Chancroid is declining, while herpes is making up a greater share of ulcer disease. nongonococcal genital infection and chlamydia are thought to be the 2nd most common infection, however most centers do not have the facilities to isolate chlamydia. Genital warts are becoming a common cause for attendance at STD clinics and are a concern for cervical cancer. Prostitutes are most often cited as the source of male STD infection. The anonymity and large number of contacts of the sex industry, and high mobility of the indigenous population and of tourists are considered central in STD transmission. The high incidence of STDs in this area is a harbinger of future trends of HIV/AIDS in Asia.
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PMID:The epidemiology of sexually transmitted diseases in Southeast Asia and the western Pacific. 211 64

This is a review of the implications of epidemiology of herpes simplex virus types 1 and 2 accrued over 19 years of use of an enzyme immunoassay on over 40,000 sera from 18 countries from 1964 to 1983. HSV-1, which typically causes intraoral ulcers and fever blisters, is usually acquired in childhood and adolescence, and more often by socioeconomically less advantaged populations. Genital HSV-1 when it occurs is usually a primary genital herpes, is more often acquired by sexual activity, and usually causes severe disease in neonates. Prior HSV-1 confers moderate protection against getting HSV-2, and reduces its severity. There were 2 national settings with a typical infection patterns, Brazzaville, Congo and Wuhan, China. Here a high percentage of HSV-2 antibodies alone suggested that primary, probably neonatal, HSV-2 protected from subsequent HSV-1 infection. The prevalence of HSV-2 antibodies in 18 countries was correlated with number of sexual partners, from zero in nuns and 0.3% in U.S. children, to 50% in pregnant Blacks from Haiti. Prevalence in African countries ranged from 6-97%. Studies showed that most HSV-2 infections were subclinical. 22-28% of pregnant women shed HSV-2 particles vaginally from micro-ulcers only detectable by colposcopy. An association between HSV-2 and HIV infections has been documented in several studies. HSV-2 infections increased in some populations in the 1960-1970s, notably in Western countries undergoing a sexual revolution. Many White Americans experienced severe HSV-2 symptoms possibly because of lack of protection from prior HSV-1.
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PMID:Sero-epidemiological and -sociological patterns of herpes simplex virus infection in the world. 217 39

In a prospective, systematic investigation, 2215 new patients with sexually transmitted diseases (STD) were screened for human immuno deficiency virus (HIV) infection during April 1986 to December 1988. Among them 9 were positive for HIV antibody giving a rate of 4/1000. In addition, 5 patients had been referred to our clinic with a diagnosis of HIV infection and STD. Among these 14, there was one married couple. Of the remaining 5 married individuals, 4 were men; the wives of 3 of them were infected but asymptomatic, and were not included in this report. The rate of conjugal infection was 71 per cent. Most (57%) patients belonged to poor socio-economic background; 78 per cent of patients were young, in the age group 15-25 yr. The presenting STD were syphilis, venereal warts, gonorrhoea, chancroid, genital herpes, non-gonococcal urethritis and candidiasis. It appeared that the course of associated STD had not been altered in these HIV infected individuals.
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PMID:HIV seropositivity among patients with sexually transmitted diseases in Vellore. 222 49

There has been a dramatic increase in patient visits to physicians for evaluation and treatment of genital herpes infections. This has resulted in part from an increase in genital herpes infections, particularly severe, first-episode genital herpes infections in adults without prior HSV-1 infection. Virus culture remains the most sensitive and specific method for diagnosis, and use of viral cultures is encouraged. Type-specific antibody tests have been employed in studies documenting the role of asymptomatic shedding of HSV in transmission of genital infections, the role of genital HSV in transmission of HIV, the predominance of asymptomatic and unrecognized infections in those infected with HSV-2, and the presence of past asymptomatic or unrecognized acquisition of HSV-2 in 25% of persons presenting with first-episode genital herpes. Unfortunately, commercially available serologic tests do not reliably differentiate between antibody to HSV-1 and HSV-2. Recent studies suggest that the annual risk of transmission from a sexual partner with genital herpes is about 10% in heterosexual couples. Currently, promotion of "safe sex" is the only available approach for prevention of transmission. However, ongoing research is focused on the development of an effective vaccine. Acyclovir should be used routinely in persons with first-episode genital herpes, but careful evaluation is needed in persons with recurrent genital herpes to determine whether episodic or suppressive treatment is indicated. Acyclovir should also be used routinely for episodic or suppressive treatment of HSV infections in persons with AIDS. Additional antiviral agents are needed for more effective suppressive therapy and for treatment of ACV-resistant HSV infections in the immunocompromised host.
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PMID:Genital herpes simplex virus infections. 224 48

The three major diseases characterized by genital ulcers--genital herpes, syphilis, and chancroid--are common, with genital herpes being most common in industrialized countries and chancroid being most common in developing countries. One fourth to one half of patients with genital ulcers have no diagnosed cause for their illness despite diagnostic efforts. The bulk of these cases is probably constituted by one of the three diseases for which diagnostic tests are falsely negative. There is accumulating evidence that genital ulcers facilitate the transmission of human immunodeficiency virus (HIV), and they may also be markers of high-risk behavior for acquisition of HIV. Appropriate therapy of patients with genital ulcers (as well as their sexual partners) depends on accurate diagnosis. Patients with genital ulcers, particularly those with syphilis or chancroid, should be encouraged to undergo testing for HIV infection.
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PMID:Approach to the patient with genital ulcer disease. 224 53


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