The Etiology of Genital Ulcer Disease by Multiplex Polymerase Chain Reaction and Relationship to HIV Infection Among Patients Attending Sexually Transmitted Disease Clinics in Pune, India

Risbud, Arun; Chan-Tack, Kirk M.; Gadkari, Deepak A.; Gangakhedkar, Raman; Shepherd, Mary; Bollinger, Robert C.; Mehendale, Sanjay; Gaydos, Charlotte A.; Divekar, A; Rompalo, Anne; Quinn, Thomas C.

doi:10.1097/00007435-199901000-00009

Cited by 105 publications

(94 citation statements)

References 18 publications

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“…In Pune, India, H. ducreyi was also the most prevalent cause of GUD. It was found in 26% of the samples of STD patients as measured by M-PCR (19). In northern Thailand, however, where STD clinic attendees with genital ulcers were also studied with M-PCR, findings similar to those of our Amsterdam study were described: none of 38 specimens were positive for H. ducreyi, and the majority were positive for HSV (2).…”

Section: Discussionsupporting

confidence: 78%

Diagnosing Genital Ulcer Disease in a Clinic for Sexually Transmitted Diseases in Amsterdam, The Netherlands

Bruisten¹,

Cairo

Fennema

et al. 2001

J Clin Microbiol

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The most common etiologic agents of genital ulcer disease (GUD) are herpes simplex virus type 1 (HSV-1), HSV-2, Treponema pallidum, and Haemophilus ducreyi. In an outpatient clinic for sexually transmitted diseases in Amsterdam, The Netherlands, specimens from 372 patients with GUD were collected from February to November 1996. Sera were collected at the time of the symptoms and, for most patients, also during follow-up visits. Swabs in viral transport medium were used for HSV culture and for detection of DNA. The most prevalent pathogen found was HSV-2, which was detected by culture in 35% of the patients and by PCR in 48% of the patients. Also, HSV-1 infection was more often detected by PCR (7.8%) than by culture (5.6%). Evidence for an active infection with T. pallidum was found in 1.9% of the patients, using serological tests. A multiplex PCR for simultaneous T. pallidum and H. ducreyi DNA detection was positive for T. pallidum in 3.3% of the samples and for H. ducreyi in only 0.9% (3 out of 368) of the samples. The sensitivity of the PCR was superior to that of culture for HSV detection and to that of serology for T. pallidum detection. Specific H. ducreyi immunoglobulin G antibodies were detected in sera of 5.2% of the patients, with no concordance between serology and PCR. In 37% of the cases, none of the tested microorganisms was detected. Performance of PCR in addition to conventional techniques significantly improved the diagnosis of GUD.

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Section: Discussionsupporting

confidence: 78%

Diagnosing Genital Ulcer Disease in a Clinic for Sexually Transmitted Diseases in Amsterdam, The Netherlands

Bruisten¹,

Cairo

Fennema

et al. 2001

J Clin Microbiol

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“…53 In Pune, India, genital herpes was the most frequent infection (26%) followed by chancroid (23%) and syphilis (10%). 52 In Africa, 43% of subjects with genital ulcers in the Rakai mass treatment trial 49 and 26% in Maseru, Lesotho, were identified with genital herpes. 48 Initially, it was thought that, with the introduction of PCR, the numbers of cases with no known cause, previously around 20-30% in most studies, would be low.…”

Section: Testing With Multiplex Pcrmentioning

confidence: 99%

Increasing prevalence of genital herpes in developing countries: implications for heterosexual HIV transmission and STI control programmes

O’Farrell

1999

Sexually Transmitted Infections

100

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Background:The recognition that sexually transmitted infections (STI) facilitate HIV transmission among heterosexuals has led to a rejuvenated focus on improving STI control as a component of HIV prevention programmes in developing countries. While eVorts so far have focused mainly on all STI, there is increasing evidence that genital ulcers facilitate a considerable proportion of HIV transmission among heterosexuals and that this eVect has been underestimated. This paper focuses on the epidemiology of genital herpes in developing countries past and present. Objectives: To review the scientific literature about the epidemiology of genital herpes in developing countries and discuss the implications of the findings for STI control and HIV prevention programmes. Search methodology: A Medline search for June 1966 to August 1999 using the keywords, genital herpes, STD and developing countries, and genital ulcers in MeSH and free text. Abstract books from recent international AIDS conferences and other international STD conferences were reviewed. The annual reports of the medical oYcers of heath for Harare 1982 and Durban 1989 were reviewed to detect trends in genital herpes diagnoses. Findings: Genital herpes, formerly regarded as a minor STI in most developing countries, has now emerged as a leading cause of genital ulceration in many countries where syphilis and chancroid were more prevalent previously. This increased recognition of genital herpes reflects both a change in the pattern of STI epidemiology through a decline in syphilis and chancroid as a response to HIV control programmes and improved techniques for diagnosing herpetic infection. Countries with significant heterosexual HIV epidemics also appear to have rapidly increasing numbers of genital herpes cases. Conclusions:The emergence of this herpes epidemic must be addressed through innovative strategies that will be viable, sustainable, acceptable, and eVective in developing countries. In countries where genital herpes is a significant problem, local adaptation of WHO treatment algorithms should be made. STI service providers should be trained about issues around the transmission of herpes and how best to advise clients about dealing with, and recognising, recurrences. The eVectiveness of antiviral treatment for genital herpes should be investigated in core groups at high risk of HIV. (Sex Transm Inf 1999;75:377-384)

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“…Using polymerase chain reaction (PCR), GUD was caused by syphilis in 14% of affected people in Dar es Salaam, Tanzania, 26 10% in Peru, 5% in the Dominican Republic, 27 4.2% in HIV positive men and 10.6% in HIV negative men in South Africa, 28 and 10% in Pune, India. 29 In the latter, coinfection with chancroid, herpes, or both occurs in 4%. Serological screening for syphilis in antenatal patients and different population groups showed a variable prevalence.…”

Section: Epidemiologymentioning

confidence: 99%

Syphilis in adults

Goh¹

2005

Sexually Transmitted Infections

126

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The Etiology of Genital Ulcer Disease by Multiplex Polymerase Chain Reaction and Relationship to HIV Infection Among Patients Attending Sexually Transmitted Disease Clinics in Pune, India

Cited by 105 publications

References 18 publications

Diagnosing Genital Ulcer Disease in a Clinic for Sexually Transmitted Diseases in Amsterdam, The Netherlands

Diagnosing Genital Ulcer Disease in a Clinic for Sexually Transmitted Diseases in Amsterdam, The Netherlands

Increasing prevalence of genital herpes in developing countries: implications for heterosexual HIV transmission and STI control programmes

Syphilis in adults

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