BackgroundMucocutaneous manifestations such as oral candidiasis (OC) and seborrheic dermatitis (SD) are very common HIV-related opportunistic events and are usually initial markers of immunodeficiency. AimThe purpose of this study was to evaluate the efficacy of highly active antiretroviral therapy (HAART) in the regression of HIV-associated OC and SD. MethodsIn a prospective study, 120 HIV-infected patients with OC and SD were divided into two groups: HAART-treated patients (group 1, n 5 76) and non-HAART-treated patients (group 2, n 5 44). Non-HAART-treated patients were given antimicrobial therapy. Study subjects were matched for sex, age, risk, and stage of HIV infection. The results were analysed by w 2 test and the Kaplan-Meier method. ResultsAt baseline, OC was evident in 59 (77.7%) of the HAART-treated patients and in 34 (77.3%) of the non-HAART-treated patients, while SD was present in 19 (25.0%) of the HAART-treated patients and in 17 (38.6%) of the non-HAART-treated patients. After a median follow-up period of 22 months, regression of OC and SD occurred in 49 (83.1%) and 16 (84.2%) of the HAART-treated patients, respectively. In the control group, regression of OC and SD occurred in only five (14.7%) and seven (41.2%) patients, respectively, during the same period. ConclusionsHAART showed greater efficacy than standard antimicrobial therapy for the treatment of OC and SD in HIV-infected patients. Oral candidiasis is the most common oral feature of opportunistic fungal infection, occurring in 90% patients during the course of HIV disease, and is an important criterion in most clinical staging systems for HIV infection [4,7]. SD is a common skin condition among HIV-infected persons, with a prevalence of 7-50%, and is also closely related to the stage of HIV infection [6,8].The introduction of highly active antiretroviral therapy (HAART) has resulted in a dramatic decline in the incidence of opportunistic infections. HAART has led to reductions in disease progression and mortality [5,[9][10][11][12][13].The aim of the study was to evaluate the efficacy of HAART regarding the regression of HIV-associated OC and SD. A total of 120 HIV-infected patients (53 women and 67 men; ages ranging from 9 to 67 years) with mucocutaneous manifestations were divided into two groups: 76 patients treated with HAART (59 OC and 19 SD) and 44 non-HAART-treated patients (34 OC and 17 SD; control group) treated with antimicrobial therapy.Diagnoses of OC and SD were based on clinical manifestations (Figs 1 and 2) and confirmed using smears taken from lesions and examined by potassium hydroxide preparation for Candida albicans, plus fungal cultures to identify the causitive organism, and for Pityrosporum ovale, at the beginning of the study and during the follow-up period.The HAART regimen consisted of one protease inhibitor (saquinavir, nelfinavir, ritonavir or indinavir) and two reverse transcriptase inhibitors (zidovudine, didanosine, stavudine, lamivudine or abacavir). The HAART-treated patients did not receive standard derm...
A prospective study to evaluate the incidence of herpes zoster (HZ) as an immune restoration disease in patients with AIDS during highly active antiretroviral therapy (HAART) was conducted in a series of 115 patients diagnosed with AIDS initiated on HAART between 1 January 2000 and 31 July 2001. Of these, a single dermatomal HZ episode occurred in 14 (12%) patients within one and 15 months of HAART (median eight months). The HZ patients were similar to the non-HZ patients in age, sex, and HIV transmission risk factor, but had a more advanced disease. Compared with the baseline values, the viral loads significantly (P<0.01) decreased, while the mean CD4+ T-cell counts increased by almost four-fold (P<0.01) in both groups at the time of the HZ episode (or equivalent in non-HZ), but remained below 400/mL in the HZ patients. HZ during HAART is an immunopathological consequence of the improvement of the host immuneresponse, correlating with the beginning of immune restoration.
Results point out the need for community efforts to promote knowledge about HPV, anal carcinoma, and anal Pap screening among men who have sex with men and their healthcare providers, and to increase the acceptance of HPV vaccine by the population.
Penis size is a major body image concern for the majority of men in western nations, while in gay culture the penis has become a body part linked to sexual attractiveness and viability. The aim of this study was to reveal influence of the perceived penis size on sexual behaviour, condom use, sexually transmitted infections and men’s sexual positioning among men who have sex with men. In this cross-sectional study, the data were collected from consecutive men who have sex with men who attended Counselling for Sexually Transmitted Diseases at the City Institute for Skin and Venereal Diseases in Belgrade, Serbia. Out of 319 participants, 6.6% perceived their penis as "below average", 71.5% as "average", and 21.9% as "above average". In comparison with men with an average penis, men with below average penis were more frequently unsatisfied with their penis size (p < 0.05), more frequently lied to others about their penis size (p < 0.001) and took more frequently the passive sexual role (p < 0.05). Men with above average penis were more frequently satisfied with their penis size (p < 0.001), took more frequently the active sexual role (p < 0.01), they had more sexual partners (p < 0.05), more problems with a tight condom (p < 0.001) and more gonorrhoea/Chlamydia infections (p < 0.001) than men with an average penis. Perception of one’s penis size was associated with some aspects of sexual behaviour and the frequency of sexually transmitted diseases.
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