Document 0476
 DOCN  M9550476
 TI    Genital ulcer disease in women infected with human immunodeficiency
       virus.
 DT    9505
 AU    LaGuardia KD; White MH; Saigo PE; Hoda S; McGuinness K; Ledger WJ;
       Department of Obstetrics and Gynecology, New York; Hospital-Cornell
       Medical Center, NY 10021.
 SO    Am J Obstet Gynecol. 1995 Feb;172(2 Pt 1):553-62. Unique Identifier :
       AIDSLINE MED/95160061
 AB    OBJECTIVE: The purpose of this study was to determine the prevalence and
       microbiologic characteristics of genital ulcer disease in a population
       of human immunodeficiency virus-infected women. STUDY DESIGN: A
       retrospective cohort study was performed in university-affiliated,
       hospital-based women's human immunodeficiency virus clinics. A total of
       307 women with human immunodeficiency virus infection were followed up
       during 20 months. There were no interventions. Age, race, CD4+ cell
       counts, bacteriologic and virologic analyses in cases of ulcers,
       serologic testing for syphilis, and histopathologic examination in
       selected cases (n = 6). RESULTS: Among 307 women followed up over a
       20-month period, 43 ulcers were detected with a prevalence of 14%. Among
       the ulcer cases the average absolute CD4+ lymphocyte number was 210/mm3.
       Diagnostic evaluation yielded no proven etiologic agent in 26 (60%) of
       the cases. Twelve of the 43 cases (28%) were positive for herpes
       simplex-2. Five cases (12%) yielded unusual or mixed bacteriologic
       types. No cases were attributable to primary syphilis infection. One
       case each of an ulcer infected with cytomegalovirus, Chlamydia
       trachomatis, and Gardnerella vaginalis, as well as three unusual
       presentations of herpetic ulcers, is analyzed in detail. CONCLUSION:
       These cases exemplify the often dramatic presentation of human
       immunodeficiency virus-related genital ulcers and the clinical
       complexity of both diagnosis and management. The frequent lack of an
       infectious or neoplastic cause in human immunodeficiency virus-infected
       women with genital ulcer disease suggests that human immunodeficiency
       virus may play a local role in causation or exacerbation. Biopsies of
       atypical genital ulcers should be considered to aid diagnosis. Further
       studies are needed to elucidate the pathogenesis of genital ulcer
       disease in human immunodeficiency virus-infected women.
 DE    Adolescence  Adult  AIDS-Related Opportunistic
       Infections/COMPLICATIONS/IMMUNOLOGY  Cohort Studies  CD4 Lymphocyte
       Count  Female  Herpes Genitalis/COMPLICATIONS/IMMUNOLOGY  Human  HIV
       Infections/*COMPLICATIONS/IMMUNOLOGY  Middle Age  New York City
       Outpatient Clinics, Hospital  Prevalence  Retrospective Studies
       Sexually Transmitted Diseases/COMPLICATIONS/IMMUNOLOGY  Support,
       Non-U.S. Gov't  Support, U.S. Gov't, P.H.S.
       Ulcer/EPIDEMIOLOGY/ETIOLOGY/PATHOLOGY  Vulvar
       Diseases/EPIDEMIOLOGY/*ETIOLOGY/PATHOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).