Indian Journal of Sexually Transmitted Diseases and AIDS最新文献

Behcet syndrome (BS) is a chronic relapsing multisystem vasculitis with skin findings with an important contribution of genetics. Here, we present a case of a 16-year-old male with a complaint of recurrent genital, and oral ulceration with skin lesions and a history of recurrent thrombophlebitis at the sites of venepuncture. There were no systemic manifestations. Pathergy test and HLA-B51 were negative. The diagnosis was confirmed based on the International Criteria for Behcet disease (ICBD) for BS. Tapering doses of systemic corticosteroid and colchicine showed promising response and regression of lesions.

Syphilis and other bacterial sexually transmitted infections (STIs) are on the verge of resurge throughout the world. Coinfection of syphilis and HIV is quite common as they both share a common mode of transmission. The behavior of syphilis is quite altered in the presence of HIV. Relapse of secondary syphilis after the recommended treatment is quite unusual. One such case has been reported, and possible pathogenesis was discussed.

The appearance of antiviral therapy has led to a change in the prognosis and clinical manifestations of patients with human immunodeficiency virus infections and Kaposi's sarcoma. However, there are still countries in which access is inadequate and the disease progresses toward disseminated forms with an unfavorable outcome. We present two patients who presented with skin lesions that progressed for a month, compatible with disseminated Kaposi's sarcoma in the context of HIV. One month after starting treatment, they were admitted for multi-organ failure associated with an Immune reconstitution inflammatory syndrome and eventually died.

Background and objectives: Anorectal and pharyngeal infections with Neisseria gonorrhoeae (NG) are common in men who have sex with men (MSM). However, they are often asymptomatic and found in the absence of reported risk behavior and concurrent genital infection. These serve as a hidden reservoir for ongoing transmission and may cause complications. Additionally, they drive the transmission of other sexually transmitted infections (STIs) including HIV and may contribute to the development of antimicrobial resistance. The current study was undertaken to study the anatomic site distribution of gonococcal infection in MSM as limited data are available from India.

Materials and methods: A total of 127 MSM patients attending the STI clinic Dermatology Outpatient Department of AIIMS were included in the study. A duplex polymerase chain reaction (PCR) targeting opa and porA psuedogene targets using in-house primers was standardized and used for testing. In addition, all samples were processed by conventional methods, i.e., microscopy and culture.

Results: A total of 26 patients were found to be positive for NG by PCR with a prevalence rate of 20%. The prevalence rate for urethral, rectal, and pharyngeal gonorrhea was 8.7%, 9.4%, and 4.7% respectively. Out of the 26 positives, 15 patients, i.e., 57.7%, had only extragenital infections and none were positive at all three sites. On the other hand, only three patients were culture positive at the urethral site.

Discussion: We would have missed approximately 60% of the infections if the testing was restricted to genital sites only.

Conclusion: An expanded testing including extragenital sites for screening of gonococcal infection in MSM will have clinical and public health benefits.

Vestibular papillomatosis (VP) is an uncommon benign condition. This condition is very rare; hence, its incidence is difficult to estimate. It has been recorded in healthy young women in the range of 1%-33%. Owing to the papillomatous appearance of the lesion, it is often misdiagnosed as condyloma acuminatum, resulting in unnecessary investigations and multitude of treatments, which adds to the physical and economical burden on patients. We present three cases of VP.

Background and objectives: The advent of highly active antiretroviral therapy has increased the longevity in children living with HIV (CLHIV), which has brought forth new concerns related to status disclosure and adherence to treatment. Information regarding this is limited in Punjab; hence, this study was done to find the relation of disclosure with sociodemographic factors and the problems faced in adhering to antiretroviral therapy (ART) in this region.

Materials and methods: An observational cross-sectional study was conducted on CLHIVs aged 18 months to 15 years visiting the ART center of a tertiary hospital from June to December 2021. Willing caregivers were approached with semistructured validated pretested questionnaire developed for the study.

Results: Ninety-eight caregivers of CLHIV were interviewed and 25% were found to be aware of their serostatus. Children between 5 and 12 years comprised the largest group (57%) and this was also the statistically significant age group in whom the status was not disclosed. Disclosure was more in children having single parents. The low economic status, rural background, and low education status of the caregivers were inversely related to disclosure. Sixty-five percent of the caregivers believed that the appropriate age for status disclosure should be 14-18 years. Adherence was optimal in 85% CLHIVs and distance was the foremost challenge.

Conclusion: The mean age for disclosure was found to be higher than the World Health Organization guidelines in this study; hence, there is a need to encourage caregivers for timely and systematic disclosure and motivate them for maintaining optimal adherence in CLHIV which is important for the success of ART program.

Over the past decade, there has been a significant increase in cases with syphilis and HIV coinfection. Concordant infection with HIV can alter the clinical course and response to treatment in syphilis. Variable and unusual presentations of syphilis in HIV disease can make early diagnosis and treatment challenging. We, herein, report four cases of atypical manifestations of syphilis in patients with HIV coinfection.

Sexually transmitted infections (STIs) are increasing throughout the world including India at present. In 1960s and 70s, the bacterial STIs were predominant than the viral STIs. The discovery of human immunodeficiency virus (HIV) and its rampant spread changed the situation with the increase of viral STIs in 1980s and 90s. There was a declining trend of viral and bacterial STIs in late 1990s to 2010. During the past two decades, HIV infection is on the declining trend, but other viral STIs are widely prevalent with insufficient decline. Currently, there is resurgence of syphilis and emergence of drug-resistant Neisseria gonorrhea. The interplay of various factors may have a role in this resurgence and this may act as an alarming sign of an impending epidemic. Hence, stringent monitoring of the trend of STIs including antibiotic resistance, appropriate management of STIs, and proper implementation of STI control program is needed. This will tackle the current situation and prevent the further spread of STIs.