Seroprevalence of human immunodeficiency virus among reproductive age group females presenting with genital ulcer: study from a tertiary care centre in India
Keywords:Condom, Genital ulcer, Herpes progenitalis, Human immunodeficiency virus
Background: The co-existence genital ulcers either in the recipient or donor could potentially increase the risk of transmission of human immunodeficiency virus (HIV). Hence the meticulous clinical and serologic evaluation of females presenting with genital ulceration is important to curb the future spread of HIV.
Methods: A total 80 female patients within the age group 15-45 years presenting with genital ulceration were enrolled in the study done at tertiary care centre in Amritsar for a period of one year. Various investigations such as Tzanck smear, VDRL, gram staining, genital mucosal biopsy, HSV serology and HIV testing - ELISA and Tri dot were done on study participants.
Results: Out of 80 females, 8 patients with genital ulceration tested positive for HIV. Most common cause of genital ulceration in HIV positive female patients was herpes progenitalis (50%). Only 25% of HIV seropositive females were married rest were widowed or unmarried. History of condom use was absent in 62.5% of HIV positive females.
Conclusions: Pre-existing genital ulcers due to sexually transmitted diseases (STD) or due to non-STDs, inconsistent condom use, urbanization and pre/extra marital affairs are risk factors for the acquisition of HIV.
Farrill NO. Genital ulcers, stigma, HIV and STI control in Sub-Saharan Africa. Sex Transm Infect 2000;78:143-6.
Paz Bailey G, Sternberg M, Lewis DA, Puren A. Acute HIV infections among men with genital ulcer disease in South Africa. J Infect Dis. 2010;201(12):1811-5.
Phiri S, Zadrozny S, Weiss HA, Martinson F, Nyirenda N, Chen CY, et al. Etiology of genital ulcer disease and association with HIV infection in Malawi. Sex Transm Dis. 2013;40(12):923-8.
Fernandes FR, Mousquer GJ, Castro LS, Puga MA, Tanaka TS, Rezende GR, et al. HIV seroprevalence and high-risk sexual behavior among female sex workers in Central Brazil. AIDS Care. 2014;26(9):1095-9.
Annual report 2016-17. Department of AIDS Control. National AIDS Control Organization. Ministry of Health and Family Welfare. Government of India. Available at: http://www.naco.gov.in/sites/default/files/NACO%20ANNUAL%20REPORT%202016-17.pdf. Accessed on 14th May 2020.
Kim HN, Wald A, Harris J, Almekinder J, Heitman C, Corey L. Does frequency of genital herpes recurrences predict risk of transmission? Further analysis of the valacyclovir transmission study. Sex Transm Dis. 2008;35(2):124-8.
Wand H, Ramjee G. Biological impact of recurrent sexually transmitted infections on HIV seroconversion among women in South Africa: results from frailty models. J Inter AIDS Society. 2015;18(1):19866.
Kotagiri S, Damarla S, Netha G.N. Clinical profile of sexually transmitted infections in people living with HIV/AIDS. Int J Biomed Res. 2019;10(8):e5253.
Fawole OI, Okesola AO, Fawole AO. Genital ulcer disease among sexually transmitted disease clinic attendees in Ibadan Nigeria. Afr J Med Sci. 2000;29(1):17-22.
Devi SA, Vetrichevvel TP, Pise GA, Thappa DM. Pattern of sexually transmitted infections in a tertiary care centre at Puducherry. Indian J Dermatol. 2009;54(4):347.
Krishnamurthy VR, Ramachandran V. STD trends in Chengolpattu Hospital. Indian J Dermatol Venereol Leprol. 1996;62:3-12.
Chen CY, Ballard RC, Beck-Sagire CM, Dangor Y, Radebe F, Schmid S et al. Human immunodeficiency virus infection and genital ulcer disease in South Africa. The herpetic connection. Sex Transm Dis. 2000;27(1):30-1.
Kumar SA, Kumar N, Kumarasamy N. Genital lesions: an indication for changing ART regimen. Indian J Sex Transm Dis AIDS. 2011;32(1):37-9.
Shewamene Z, Legesse B, Tsega B, Bhagavathula AS, Endale A. Consistent condom use in HIV/AIDS patients receiving antiretroviral therapy in northwestern Ethiopia: implication to reduce transmission and multiple infections. HIV AIDS (Auckl). 2015;7:119-24.