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

The effect of HIV-1 on other infectious diseases in Africa is an increasing public health concern. In this review, we describe the role that three major infectious diseases--malaria, sexually transmitted diseases (STDs), and tuberculosis--have had in the HIV-1 epidemic. The high prevalence of untreated STD infections has been a major factor facilitating the spread of HIV-1 in Africa; with the synergistic interaction between HIV-1 transmission and genital herpes being of special concern for control of both diseases. Increased susceptibility to tuberculosis after infection with HIV-1 has led to a rising incidence and threat of increased transmission of tuberculosis. Clinical malaria occurs with an increased frequency and severity in HIV-1-infected individuals, especially during pregnancy. As with tuberculosis, STDs, and other communicable HIV-1-associated diseases, the net effect of HIV-1 might include increased rates of malaria transmission across communities. In addition to enhancing access to HIV-1 prevention and care, public health surveillance and control programmes should be greatly intensified to cope with the new realities of infectious disease control in Africa.
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PMID:HIV-1/AIDS and the control of other infectious diseases in Africa. 1242 12

A number of studies have shown that the seroprevalence of herpes simplex virus type 2 (HSV-2) is higher among persons attending clinics for sexually transmitted diseases (STD) than among the general population. The HSV-2 seroprevalence among STD patients, however, varies greatly among studies, possibly reflecting differences in the baseline prevalence of the infection among different general populations or in the distribution of risk factors. A cross-sectional study was carried out to determine the seroprevalence of and the risk factors for HSV-2 infection among 776 HIV-negative persons attending an STD clinic in Milan, Italy. All samples were tested with a commercial HSV type-2 specific gG ELISA test. The HSV-2 seroprevalence was 29.5% (95% CI: 26.3-32.7%). The seroprevalence increased with age, yet it did not differ by gender. Among persons with a current STD, the seroprevalence was 44.3%. At the multivariate analysis, older age was independently associated with HSV-2 infection. A self-reported history of genital herpes was predictive of HSV-2 infection. The agreement between history of genital herpes and HSV-2 seroprevalence was poor, however, stressing that in clinical practice, caution should be used in interpreting the presence or absence of a history of genital herpes as an indicator of the presence or absence of HSV-2 infection. Our data show that HSV-2 seroprevalence among persons attending an STD clinic in Italy is high; thus serological screening for HSV-2 might be advisable for STD patients.
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PMID:Seroprevalence and determinants of herpes simplex type 2 infection in an STD clinic in Milan, Italy. 1211 25

Genital herpes is one of the most widespread sexually transmitted diseases in the world. HSV2 predominates (60-80 p. 100), but the prevalence of HSV1 genital herpes is rising (20-40 p. 100). Erosive lesions of the genital organs due to HSV infection are a factor favoring HIV contamination and other sexually transmitted diseases. The main factor of transmission is asymptomatic viral excretion. Aciclovir, valaciclovir and famciclovir are effective treatment for genital herpes (primary infection, curative and preventive treatment of recurrence), but none of these compounds alters the natural history of the infection. Aciclovir given as a preventive measure reduces the load of asymptomatic viral excretion. Information and education of patients with genital herpes are key elements for prevention. Use of preservatives appears to be effective. New vaccine strategies favoring humoral and cellular response should be studied.
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PMID:[Genital herpes: epidemiology, transmission, clinic, asymptomatic viral excretion, impact on other sexually transmitted diseases, prevention, and treatment]. 1212 19

Both Herpes simplex viruses HSV1 and HSV2 are transmitted by direct mucosal or cutaneo-mucosal contact between individuals. HSV1 is the leading cause of orofacial herpes and HSV2 the most frequently encountered cause of genital herpes. There are however a number of environmental and behavioral factors that modify the epidemiological pattern in both infections. These factors also affect virus dynamics and spread. In developing countries, HSV1 infections continues to be acquired in early childhood. In developed countries, displacement of this acquisition towards adolescence and adulthood explains, in part, the increase in genital herpes caused by HSV1. HVS2 infection progresses in the sexually active population worldwide. Although the rate of seroprevalance varies greatly from one continent to another, women are still more often infected than men. HSV2 genital infection is a cofactor for transmission and acquisition of HIV, which, in certain African regions where the two infections are highly prevalent, explains in part the progression of the HIV epidemic. Until a vaccine becomes available, the prevention depends on abstention from all oral and genital contact during periods of active disease. For genital herpes, use of a preservative has only a relative protective effect and the contribution of suppressive treatment in potentially contaminated subjects is under evaluation.
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PMID:[Natural history of HSV1 and HSV2 transmission modes and epidemiology consequences of HSV infection on HIV infection. Prevention]. 1212 26

Valaciclovir is an aciclovir pro-drug considerably improving its oral availability. Its antiviral activity in vivo is related to that of aciclovir, the principle target of which is the herpes virus. Following digestive absorption, valaciclovir is rapidly transformed into aciclovir. The mean absolute bioavailability of aciclovir is of 54.2% after a single oral dose of 1,000 mg of valaciclovir, i.e., a bioavailability 3 to 5-fold greater than after oral ingestion of aciclovir. The plasma pharmacokinetic profile of valaciclovir and aciclovir observed in volunteers infected by HIV is superimposable on that of healthy subjects. In elderly patients, exposure to aciclovir is enhanced, probably because of the alteration in glomerular filtration. In patients exhibiting agranulocytosis following poly-chemotherapy, the pharmacokinetic parameters are superimposable on those observed in healthy patients. In patients with hepatic failure, there appears no need to adapt the dose, since exposure to aciclovir does not appear altered. However, the dose of valaciclovir must be adapted to renal function. During the first-episode of herpes genitalis, valaciclovir, at the dose of 500 or 1,000 mg twice daily, is as effective as 200 mg of aciclovir five times per day. In recurrent herpes genitalis, 500 mg twice daily of valaciclovir is as effective as 1,000 mg twice daily or 200 mg five times a day of aciclovir. Valaciclovir prevents recurrence herpes genitalis with a dose-dependent effect, and doses of 500 and 1,000 mg/day are as effective as 400 mg twice daily of aciclovir. There are few studies on the efficacy of valaciclovir in the treatment of oro-facial herpes. In the treatment of herpes zoster in patients aged over 50, the principle benefit provided by valaciclovir at the dose of 1,000 mg twice daily, is the decrease in the percentage of patients presenting post-zoster pain and its duration. High doses of valaciclovir (8 capsules/day) provide efficient prevention of infections related to the cyto-megalo-virus (CMV) in immunodepressed patients due to HIV infection or following renal transplantation. Tolerance to valaciclovir, like its active metabolite aciclovir, is generally good. Central neurological toxicity is frequently observed with high doses, but regresses on withdrawal. The official indications in France are the curative and preventive treatment of herpes genitalis infections, the prevention of post-zoster pain and the ocular complications of ophthalmologic herpes in immunocompetent adults, and the prevention of CMV infections after organ grafting.
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PMID:[Valaciclovir]. 1212 13

In order to plan a health education programme in high schools in Southern Latium, a survey on knowledge, attitude and behaviour about Sexually Transmitted Diseases and AIDS was carried out among students of three high schools in Cassino. An anonymous, self-administered questionnaire was submitted to all students of the last two years in those schools. The results show a good knowledge of Cassino's students about HIV transmission, in similar or higher proportion respect to analogous surveys conducted in Italy or abroad. We found a good knowledge only about AIDS, Herpes genitalis and Syphilis, while knowledge about Hepatitis B, Condyloma acuminatum and Gonorrhoea is not satisfactory. Considering that 38% of male and 17% of female students declared to have already had their first sexual intercourse, the results suggest that there is a strong need to implement an educational intervention on sexuality and STD.
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PMID:[Knowledge, attitudes, and practices regarding sexually transmitted diseases among students in 3 high schools in Cassino]. 1216 21

Recent trends in sexually transmitted diseases (STDs) in the U.S., and their bearing on pelvic inflammatory disease (PID) and infertility are evaluated. STDs have increased 12-fold in the last decade, in comparison with a 200-fold rise in AIDS. While the total gonorrhea rate fell 10% last year, the incidence of gonorrhea resistant to penicillin or to all drugs is mounting. Syphilis increased 25% last year, probably because resources for contact-tracing were devoted to HIV infection, because of increasing incidence in crack users, and because new drugs, such as spectinomycin, used for resistant gonorrhea, are not effective against early syphilis. Chancroid, an easily diagnosed, treated, and traced disease, is appearing in the U.S. Genital herpes now infects 40 million, and attacks 400,000 new Americans yearly. Pelvic infections in the form of salpingitis, endometritis, and peritonitis were thought to be caused by gonorrhea in 90% of cases 10 years ago. Now a third are due to gonorrhea, a third are due to chlamydia, and the rest are due to mycoplasma and anaerobes. PID is so difficult to diagno se that 35% of diagnoses are false positives, and perhaps 25% of asymptomatic infertility patients have subclinical chlamydia. Yet the rate of PID seems constant, while STDs multiply. Reported infertile couples are also higher than ever. Whether this increased infertility is a result of tubal infections with STD organisms is not known. Physicians should be aware of the possibility of STD infection in any sexually active patient, and recommend that all women use spermicides. Spermicides are possibly more effective than condoms against STDs, and are under the control of women who suffer the consequences of STDs.
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PMID:Fallout from the STD epidemic: salpingitis, ectopic pregnancy, and infertility. 1228 94

300 men and women attending a municipal sexually transmitted disease clinic in Guatemala City voluntarily participated in an anonymous and confidential study to determine HIV seroprevalence among patients with sexually transmitted diseases and to identify risk practices. Two cases were confirmed, for a seropositivity rate of 0.7%. Subjects were aged 6-62 years, with 45% between ages 21 and 30. 80% were male. 42% were married or in union. 26% of those in union reported occasional relations with other persons. 69% of subjects had never used condoms in occasional relations. 58% reported sex with prostitutes at least once a month. 97% reported they were heterosexual, 1.7% bisexual, and 0.3% homosexual, although 19% reported at least one past homosexual episode. 90% reported having had a sexually transmitted disease. 53.0% reported having had gonorrhea; 39.0%, pubic lice; 29.7%, human papillomavirus; and 27.3%, chancroid. At the time of the survey, 21.0% had gonorrhea, 13.7% had genital herpes, 13.3% had chancroid, and 12.0% had human papillomavirus. 9.0% reported receiving one or two blood transfusions between 1980 and 1988, when screening of the blood supply began in Guatemala. Among other risk factors, 89.3% reported using alcohol, tobacco, marijuana, or other drugs. 1.3% reported using intravenous drugs. 95.7% knew about AIDS, but only half perceived themselves to be at risk. 34.3% reported sexual relations before age 15; 9.7%, a history of sexual abuse; 65.7%, sexual promiscuity; 69%, nonuse of condoms; and 58%, contact with prostitutes.
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PMID:[Behaviors and risk factors in a population of patients with sexually transmitted diseases (STDs)]. 1229 Jun 18

Many individuals infected with STDs have their infections/diseases misdiagnosed and mistreated by people who are not qualified to practice medicine. This paper looks at HIV infection and treatment behavior in India. All STD patients attending the private clinic of a senior dermatologist and venereologist in Varanasi during a 6-month period were interviewed. There were 54 men and 6 women of mean age 27.5 years in the range of 18-52. 40 of the men were younger than age 30 years, while most patients had contracted infection from prostitutes. A fair number of more casual contacts were also reported. Infections among males came from known prostitutes in 22 cases, girlfriends in 13, relatives in 10, and a neighbor in 9. 69% of the men were married, with 40.6% of these men living with their wives at the time of exposure. Viral STDs such as herpes genitalis were common. 20 of the men consulted a qualified venereologist after the first exposure to infection. Indigenous "gupt rog" specialists in sexual medicine attracted the second largest number of patients after first exposure. On subsequent visit, however, none of the men returned to a gupt rog specialist. Good compliance as in the case of primary syphilis, gonorrhea, and non-gonococcal urethritis was probably due to good symptomatic response. Poor compliance in the case of herpes genitalis was probably the result of recurrence and inconvenient treatment regimens.
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PMID:Sexual and treatment behaviour of STD patients. 1229 Jun 76

Although considerable global attention and effort have been devoted to preventing and controlling the spread of HIV/AIDS, comparatively little focus has been given to controlling other sexually transmitted diseases (STD). However, since HIV, like other STDs, may be transmitted through unprotected sexual intercourse, measures implemented to check the spread of HIV through sexual contact also help to limit the transmission of other STDs. Gonorrhea, chlamydia, trichomoniasis, genital herpes, syphilis, and human papillomavirus infections cause infertility, cervical cancer, and adverse outcomes of pregnancy such as spontaneous abortion, prematurity, and stillbirth. Many people, however, remain unconvinced that STD infection has important adverse effects upon the health of women and their infants. There are enormous morbidity, mortality, and health care costs associated with these STDs. The author discusses how women are at increased risk relative to men, as well as primary, secondary, and tertiary prevention.
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PMID:Women, children and STDs: addressing the other STD epidemic. Opinion. 1229 53


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