Association between HIV-1 infection, the etiology of genital ulcer disease, and response to syndromic management.

BACKGROUND

Reports on the effect of HIV-1 infection on healing rates of ulcers are conflicting.

GOAL: The goal was to determine the etiology and response to treatment of genital ulcer disease (GUD) in relation to HIV-1 infection.

STUDY

DESIGN

This was a cohort study of patients with GUD treated with local syndromic management protocols.

RESULTS

Among the 587 recruited, the prevalences of infections due to HSV, Treponema pallidum, Chlamydia trachomatis (lymphogranuloma venereum [LGV]), Haemophilus ducreyi, Calymmatobacterium granulomatis, and HIV-1 were 48%, 14%, 11%, 10%, 1%, and 75%, respectively. The prevalence T. pallidum of was higher among men (P = 0.03), and an association was seen among HIV-1-seronegatives on univariate and multivariate analyses (P < 0.001; = 0.01). The prevalence of C trachomatis (LGV) was higher among females (P = 0.004), and an association was seen among HIV-1-seropositives on univariate analysis (P = 0.04). At follow-up, 40/407 (10%) showed a decreased healing tendency, not associated with ulcer etiology or HIV-1 seropositivity.

CONCLUSION

Response to syndromic management of GUD was acceptable and not associated with HIV-1 coinfection.