Genital ulcer disease in women infected with human immunodeficiency virus Journal Article
| Authors: | LaGuardia, K. D.; White, M. H.; Saigo, P. E.; Hoda, S.; McGuinness, K.; Ledger, W. J. |
| Article Title: | Genital ulcer disease in women infected with human immunodeficiency virus |
| Abstract: | OBJECTIVE: The purpose of this study was to determine the prevalence and microbiologic characteristics of genital ulcer disease in a population of human immunodeficiency virus-infected women. STUDY DESIGN: A retrospective cohort study was performed in university-affiliated, hospital-based women's human immunodeficiency virus clinics. A total of 307 women with human immunodeficiency virus infection were followed up during 20 months. There were no interventions. Age, race, CD4+ cell counts, bacteriologic and virologic analyses in cases of ulcers, serologic testing for syphilis, and histopathologic examination in selected case (n = 6). RESULTS: Among 307 women followed up over a 20-month period, 43 ulcers were detected with a prevalence of 14%. Among the ulcer cases the average absolute CD4+ lymphocyte number was 210/mm3. Diagnostic evaluation yielded no proven etiologic agent in 26 (60%) of the cases. Twelve of the 43 cases (28%) were positive for hepres simplex-2. Five cases (12%) yielded unusual or mixed bacteriologic types. No cases were attributable to primary syphilis infection. One case each of an ulcer infected with cytomegalovirus, Chlamydia trachomatis, and Gardnerella vaginalis, as well as three unusual presentations of herpetic ulcers, is analyzed in detail. CONCLUSION: These cases exemplify the often dramatic presentation of human immunodeficiency virus-related genital ulcers and the clinical complexity of both diagnosis and management. The frequent lack of an infectious or neoplastic cause in human immunodeficiency virus-infected women with genital ulcer disease suggests that human immunodeficiency virus may play a local role in causation or exacerbation. Biopsies of atypical genital ulcers should be considered to aid diagnosis. Further studies are needed to elucidate the pathogenesis of genital ulcer disease in human immunodeficiency virus-infected women. © 1995. |
| Keywords: | adolescent; adult; human tissue; retrospective studies; major clinical study; pathogenesis; human immunodeficiency virus infection; cohort studies; prevalence; cohort analysis; outpatient clinics, hospital; new york city; human immunodeficiency virus; cd4 lymphocyte count; ulcer; hiv infections; middle age; sexually transmitted disease; aids-related opportunistic infections; sexually transmitted diseases; herpes genitalis; human; female; priority journal; article; support, non-u.s. gov't; support, u.s. gov't, p.h.s.; genital ulcer; genital ulcers; vulvar diseases |
| Journal Title: | American Journal of Obstetrics and Gynecology |
| Volume: | 172 |
| Issue: | 2 Pt. 1 |
| ISSN: | 0002-9378 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1995-02-01 |
| Start Page: | 553 |
| End Page: | 562 |
| Language: | English |
| DOI: | 10.1016/0002-9378(95)90572-3 |
| PUBMED: | 7856685 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 28 August 2018 -- Source: Scopus |
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