Indian Journal of Sexually Transmitted Diseases and AIDS最新文献

Pregnancy with systemic lupus erythematosus (SLE) requires special attention in view of the enhanced risks to the fetus and the aggravation of SLE during pregnancy. Human immunodeficiency virus infection can further complicate the course of pregnancy as well as the outcome. We present a case of a 28-year-old primigravida who was diagnosed case of people living with HIV/AIDS and presented with SLE at 34 weeks of gestation. Subsequent evaluation of the patient revealed latent tuberculosis also. Cutaneous lesions responded well to oral corticosteroids, however, the outcome of pregnancy was hydrops fetalis. This report highlights the complex interplay of multiple comorbidities and their adverse impact on pregnancy outcome.

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.

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.

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.

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.

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.

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.