Indian Journal of Sexually Transmitted Diseases and AIDS最新文献

National Human Immunodeficiency Virus (HIV) testing programs utilize antibody-based tests for confirming HIV diagnosis which has a diagnostic window period of 23-90 days. In Fiebig acute HIV Stage I-II, an individual has antibody-negative but RNA-positive test results. Here, we present a case of a 54-year-old complete remission acute myeloid leukemia patient, who was recently reported HIV negative by antibody-based tests used in National HIV testing programs. However, when his sample was further analyzed by more sophisticated HIV tests, there was the presence of early anti-HIV-1 gp160 antibodies in western blot and HIV-1 RNA in nucleic acid testing. Within 8 days of his HIV-negative result, his clinical condition deteriorated. Later, the patient expired despite the best of clinical efforts at the apex tertiary care center of India. The technical difficulty in confirming HIV diagnosis by antibody-based tests used in National HIV testing programs and thereby noninitiation of antiretrovirals in a case where cell-mediated immunity is already compromised by non-HIV reason could have serious consequences. There is a need to update the existing HIV testing strategies in National HIV testing programs to include the needs of special cases.

Lichen planus (LP) is a chronic inflammatory disorder primarily affecting the skin and mucous membranes, characterized by pruritic, violaceous papules often exhibiting a polygonal pattern. This dermatological disorder can affect various sites of the body, including the skin, nails, hair, and mucous membranes out of which the oral mucosa is the most commonly affected. We report a case of a 40-year-old female with a unique combination of cutaneous, nail, and mucosal LP manifestations coexisting with lichen planopilaris and vulvovaginal-gingival syndrome.

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.

Circinate balanitis, a common manifestation of reactive arthritis, is usually an associated finding seen with the clinical trial of arthritis, conjunctivitis, and urethritis. We hereby report a case of isolated circinate balanitis and its dermoscopic features in an adult patient. The patient responded successfully to treatment with topical tacrolimus 0.1% ointment.

Donovanosis is a rare bacterial sexually transmitted disease caused by Klebsiella granulomatis and has an indolent course. Clinically it manifests as an ulcer with exuberant granulation tissue most commonly in the genital and rarely in extragenital sites. Nowadays, case reports of Donovanosis are infrequent and are considered an ignored sexually transmitted infection in the current antibiotic era. Here, we are reporting three interesting case series of Donovanosis because of its rarity and clinical interest.

Circinate balanitis, although a common cutaneous manifestation of reactive arthritis (ReA), is usually an associated finding present along with the triad of arthritis, conjunctivitis, and urethritis. It is rarely seen as the only or the preceding manifestation of ReA. Here, we report three cases of circinate balanitis as stand-alone and initial presentation of probable ReA without any other symptoms of arthritis and conjunctivitis at the time of presentation.

Background: Rural population constitutes a significant population of our country. According to the regions, the sexual behavior and pattern of sexually transmitted infections (STIs) changes because of variation in health facilities, education, and sociocultural belief.

Objective: To study the sociodemographic profile, sexual behavior, and pattern of STIs based on the syndromic approach in the rural population attending STIs clinic from the east-central zone of India.

Materials and methods: Between January 2020 and July 2022, a retrospective study was carried out in a STIs clinic at a tertiary care facility in India's east-central region. Data included demographics, clinical profiles (syndromic approach), and sexual behavior from all the rural population suffering from STIs. The data were corroborated using the proper statistical tools.

Results: Seven hundred and twenty-two (63.6%) of the 1135 STI cases were from the rural population. The gender ratio was 17:1, with 333 (46.1%) patients between the ages of 20 and 30 years. Four hundred and ninety-four (68.4%) of the rural population had education qualifications below the 10^th class. The predominant occupation was a homemaker (582; 80.6%). Drug abuse was noted in 13 (1.8%) cases. Lower abdominal pain was the most clinical manifestation seen in 441 (61%) cases, followed by vaginal discharge in 89 (12.3%) cases. The majority of the patients presented with the first episode of symptoms and had a single regular partner with no symptoms in a partner. In 22.9% of cases, the partner had a history of frequent travel. In 94.1% of cases, protective measures were not used.

Conclusions: Young married adults, female partners, lower education, and low-income classes were among those who had STIs, with frequent unprotected sexual activity. Lower abdominal pain is the most common symptom in this area.