Continuing Medical EducationAn overview of sexually transmitted diseases. Part III. Sexually transmitted diseases in HIV-infected patients☆,☆☆
Section snippets
Effect on HIV acquisition and transmission
Each of the major genital ulcer diseases, genital herpes simplex virus (HSV) infections, syphilis, and chancroid, have been associated with an increased risk of acquiring and transmitting HIV. One estimation suggests that STDs increase the overall risk of acquiring HIV about 3 to 5 times.3 Cross-sectional studies performed in Nairobi, Kenya have consistently found that HIV seropositivity was more common in persons with either a history or clinical evidence of genital ulcer disease,4, 5, 6, 7
Lymphogranuloma venereum
Lymphogranuloma venereum, caused by the L1, L2, and L3 immunotypes of Chlamydia trachomatis, may present clinically as primary (papule), secondary (inguinal), and tertiary (rectal) lesions.130, 131 Lymphogranuloma venereum occurs most frequently in tropical countries and is rare in the United States.132 In both HIV-positive and HIV-negative patients, diagnosis is made by a combination of clinical presentation and high chlamydial complement fixation antibody titers (≥1:64). No studies have been
Subclinical genital human papillomavirus infections
Subclinical genital human papillomavirus (HPV) can affect the cervix, vagina, vulva, penis, anus, or any other genital skin.136 The same types can also infect the oral epithelium (Fig 6). The association between certain HPV types (eg, HPV types 16, 18, 31, and 45) and the development of dysplastic lesions in the cervix is well known.137 The dysplastic lesion, termed a cervical squamous intraepithelial lesion (CSIL), occurs in the
Molluscum contagiosum
The association between HIV infection and molluscum contagiosum was first noticed in 1983 through an autopsy study of 10 patients with AIDS.171 Many reports of severe and atypical infections have surfaced, and in AIDS patients, the prevalence of molluscum contagiosum lesions ranges from 5% to 18%.172, 173, 174, 175, 176 Dann and Tabibian177 document molluscum contagiosum as one of the 3 most common reasons nondermatologists referred HIV-infected patients to a university-based immunosuppression
Human herpesvirus 8
Human herpesvirus 8 (HHV-8), formerly known as Kaposi's sarcoma-associated herpesvirus, was originally identified in Kaposi's sarcoma (KS) from AIDS patients.221 It has been linked with all other forms of KS as well.222, 223, 224, 225, 226 HHV-8 is also associated with a rare type of non-Hodgkin's lymphoma, termed primary effusion lymphoma,227, 228 and with the plasma cell variant of Castleman's disease. 229, 230 Furthermore, patients with HIV-associated KS are at a significantly greater risk
Hepatitis B virus and hepatitis C virus
Both hepatitis B virus and hepatitis C virus (HBV and HCV, respectively) commonly coinfect HIV-seropositive persons. Sexual transmission of HBV, however, appears to be more frequent than with HCV. Discussion of the cutaneous manifestations of those viruses as well as their treatment and prophylaxis can be found in part II of this 3-part STD review.161
The relationship between hepatitis C infection and sporadic porphyria cutanea tarda in the immunocompetent host is well documented.257, 258
Scabies
Scabies occurs commonly in young adults who acquire it through sexual contact. In 1848, Danielssen and Boeck first described a particularly contagious and fulminant form of scabies in Norwegian patients immunosuppressed as a consequence of Hansen's disease. These patients' infestations were characterized by thick, friable plaques. This form of scabies, Norwegian or crusted scabies, has emerged as yet another harbinger of HIV infection. Published reports of atypical and crusted scabies
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Cited by (97)
Oral and maxillofacial manifestations of human immunodefficiency virus infection
2022, Journal of Stomatology, Oral and Maxillofacial SurgeryCitation Excerpt :Because there is no functional impairment, OHL is generally not treated. Acyclovir applied topically, sometimes combined with topical podophyllotoxin (5% acyclovir – 25% podophyllin cream) makes it disappear in two weeks, and it can be surgically removed in case of excessive discomfort [25]. Herpes infections are more frequent and often more extensive in HIV-infected patients.
Molluscum contagiosum
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2017, Diagnostic Gynecologic and Obstetric PathologySyndromal Tropical Dermatology
2016, Tropical Dermatology: Second EditionBacterial Sexually Transmitted Disease
2016, Tropical Dermatology: Second EditionCutaneous infectious diseases: Kids are not just little people
2015, Clinics in DermatologyCitation Excerpt :Atypical MC lesions are also seen in patients with HIV infection.117 These lesions have resembled comedones, abscesses, furuncles, condyloma, syringomas, keratoacanthomas, basal cell carcinomas, ecthymas, sebaceous nevi of Jadassohn, and even cutaneous horns.118 Table 8 highlights the different presentations of MC in children and adults. (
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Reprint requests: Stephen K. Tyring, MD, PhD, Department of Dermatology, Route 1070, University of Texas Medical Branch, Galveston, TX 77555-1070. E-mail: [email protected].
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J Am Acad Dermatol 2000;43:409–32.