Indian Journal of Sexually Transmitted Diseases and AIDS最新文献

{"title":"Immunovirological discordance among people living with human immunodeficiency virus at a center in Western India: A retrospective study.","authors":"Mayank Kacker,&nbsp;Rohit Vashisht,&nbsp;Anil S Menon","doi":"10.4103/ijstd.ijstd_121_22","DOIUrl":"10.4103/ijstd.ijstd_121_22","url":null,"abstract":"<p><strong>Background and objectives: </strong>Treatment of people living with human immunodeficiency virus (HIV) (PLHIV) is monitored using plasma HIV viral load levels and CD4 counts. Patients with either immunological nonresponse (virological suppression achieved) or virological nonresponse (immune reconstitution achieved) are termed as having a discordant response. These patients are at higher risk for acquired immunodeficiency syndrome (AIDS)-related infections/diseases/neoplasms, non-AIDS-related illnesses (cardiovascular, neurological, renal, hepatic diseases), and all-cause death. This study was conducted to assess the prevalence of immunovirological discordance among PLHIV after completion of at least 1 year of combination antiretroviral therapy (cART) at an antiretroviral therapy (ART) plus center in India and analyze contributory factors.</p><p><strong>Methods: </strong>The study was a retrospective study of PLHIV receiving cART at the ART plus clinic in Western India from January 18 to December 21. Four hundred and ninety-six patients were studied based on sample size calculated and assessed for CD4 and viral load response at 0, 6, and 12 months of ART.</p><p><strong>Results: </strong>Of the 496 patients, 48 patients (9.7%) had immunovirological discordance. Out of them, 36 patients (75%) had a virological response (immunological nonresponse) and 12 (25%) patients had an immunological response (virological nonresponse). The factors contributing to immunological nonresponse were as follows - low baseline CD4 levels (<100 cells) (36.1%), adherence <95% (33.3%), presence of opportunistic infections (16.6%), and failure on first-line therapy (11.1%). Other factors noted included higher baseline viral load (2.7%), chronic kidney disease (5.5%), and chronic hepatitis B virus co-infection (5.5%). Virological nonresponse was associated with poor adherence to therapy <95% (33%) and failure of first-line regimen (33%). Opportunistic infections were noted among 33% of patients and 8.3% of patients were found to have higher baseline viral load.</p><p><strong>Interpretation and conclusion: </strong>Immunovirological discordance is an important factor influencing response to cART and is associated with many complications such as AIDS and non-AIDS-related events and even death. Improved adherence and timely identification and management of opportunistic infections are measures that are beneficial in reducing the incidence of immunovirological discordance.</p>","PeriodicalId":44880,"journal":{"name":"Indian Journal of Sexually Transmitted Diseases and AIDS","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ac/76/IJSTD-44-15.PMC10343130.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circinate mucositis and keratoderma blennorrhagicum of reactive arthritis.","authors":"Neerja Saraswat,&nbsp;Sushil Kumar,&nbsp;Durga Madhab Tripathy,&nbsp;Eeshaan Ranjan,&nbsp;Shobhit Goel","doi":"10.4103/ijstd.ijstd_89_22","DOIUrl":"10.4103/ijstd.ijstd_89_22","url":null,"abstract":"Reactive arthritis (ReA) is a syndrome characterized by a triad of arthritis, conjunctivitis, and urethritis with specific skin manifestations in the form of circinate balanitis and keratoderma blennorrhagicum. The entity has been linked to HLA‐B27 and has either a preceding diarrheal illness or venereal urethritis caused by Chlamydiae trachomatis. We report a case of ReA with circinate balanitis and keratoderma blennorrhagicum, also associated with circinate oral mucositis.","PeriodicalId":44880,"journal":{"name":"Indian Journal of Sexually Transmitted Diseases and AIDS","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/98/IJSTD-44-102.PMC10343109.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective study to estimate the incidence and pattern of adverse drug reactions to first-line antiretroviral therapy (tenofovir, efavirenz, and lamivudine).","authors":"Boby Singh,&nbsp;Ankur Guliani,&nbsp;Vinod Hanumanthu,&nbsp;Tarun Narang,&nbsp;Sunil Dogra,&nbsp;Sanjeev Handa,&nbsp;Aman Sharma","doi":"10.4103/ijstd.ijstd_44_21","DOIUrl":"10.4103/ijstd.ijstd_44_21","url":null,"abstract":"<p><strong>Background: </strong>Antiretroviral drugs are efficacious but are associated with long-term toxicities, drug interactions, and emergence of drug resistance.</p><p><strong>Objective: </strong>To study the incidence and pattern of adverse drug reactions in human immunodeficiency virus (HIV) patients receiving first-line antiretroviral therapy (ART) (tenofovir, efavirenz, and lamivudine (TEL) which was introduced by NACO in 2013.</p><p><strong>Materials and methods: </strong>A prospective, single-center observational study that included 135 treatment-naive HIV patients who were started on fixed drug once-daily regimen (TEL). At baseline, detailed clinical history, body weight, waist-hip ratio, complete blood count, liver and renal function test, CD4 cell count were performed. Clinical monitoring for cutaneous, neuropsychiatric, and gastrointestinal side effects was done every month along with laboratory monitoring and anthropometric measurement for every 6 months. CD4 counts were measured at baseline and end of the study at 12 months.</p><p><strong>Results: </strong>Out of 135 participants, 89 (65.9%) were males and 46 (34%) were females. The mean age and the mean duration of illness at inclusion were 35.10 ± 8.97 years and 1.2 ± 0.6 years, respectively. The mean increase in weight at baseline and at 12 months (57.55 ± 6.56 to 64.04 ± 8.2) was statistically significant (95% confidence interval [CI]: 4.35-8.62, <i>P</i> < 0.001). The mean CD4 counts at baseline were 309.73 ± 118.44 and increased after 12 months of treatment to 421 ± 129.4 which was statistically significant (95% CI: 81.54-140.99, <i>P</i> < 0.001). The mean difference in platelet count was statistically significant between baseline and 12 months (95% CI: 10.32-46.13, <i>P</i> = 0.002). The mean difference in serum urea levels at baseline and at 6 months (95% CI: 0.60-1.61, <i>P</i> < 0.001) as well as 12 months were statistically significant (95% CI: 0.08-1.03, <i>P</i> = 0.02). The mean increase in serum creatinine at baseline (0.75 ± 0.12) and at 12 months (0.97 ± 0.16) was also significant (95% CI: 0.21-0.28, <i>P</i> < 0.001). There was a significant difference between mean creatinine clearance at baseline and at 12 months (109.9 ± 13.75 to 99.33 ± 12.52, <i>P</i> < 0.0001). One patient discontinued treatment due to adverse effects while two patients were shifted to second-line antiretroviral treatment.</p><p><strong>Limitations: </strong>Small sample size, single-center study and short follow-up period, long-term toxicities were not appreciated.</p><p><strong>Conclusion: </strong>Fixed drug combination with TEL as a first-line ART for HIV is a safe regime as we observed minimal side effects with current regimen.</p>","PeriodicalId":44880,"journal":{"name":"Indian Journal of Sexually Transmitted Diseases and AIDS","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/16/IJSTD-44-6.PMC10343103.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual transmission in monkeypox: A discussion on the possibility.","authors":"Rujittika Mungmunpuntipantip,&nbsp;Viroj Wiwanitkit","doi":"10.4103/ijstd.ijstd_54_22","DOIUrl":"10.4103/ijstd.ijstd_54_22","url":null,"abstract":"This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution‐NonCommercial‐ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‐commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. 5. Poynten IM, Grulich AE, Templeton DJ. Sexually transmitted infections in older populations. Curr Opin Infect Dis 2013;26:80‐5.","PeriodicalId":44880,"journal":{"name":"Indian Journal of Sexually Transmitted Diseases and AIDS","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/14/IJSTD-44-93.PMC10343111.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9816673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexually transmitted infections among geriatric population.","authors":"Hitaishi Mehta,&nbsp;Sunil Dogra,&nbsp;Bhushan Kumar","doi":"10.4103/ijstd.ijstd_12_22","DOIUrl":"10.4103/ijstd.ijstd_12_22","url":null,"abstract":"The inclusion criteria of the study were all patients over 60 years of age referred to STI clinic, regardless whether the final evaluation demonstrated an STI or not. So how do we logically label every genital complaint as an STI? Several of the presenting complaints were rather nonspecific to warrant inclusion in a cohort of STI patients. For example, genital itching was the presenting or associated complaint in 20 patients. Possible etiologies of genital pruritus are numerous. In the absence of associated genital lesions, or presence of a causative sexually transmissible organism, it is most likely that STIs were the etiology in only a small fraction of patients. Similarly, one patient each with fluid‐filled lesions (site not mentioned), burning micturition, rash over palms and soles, inguinal swelling had VDRL positivity (dilution not given), final diagnosis has not been mentioned, although none of the patients were eventually diagnosed as secondary syphilis. Cervical and urethral discharge contributing to vaginal discharge and without finding any pathogen is unusual. Cervical discharge in a woman aged 60 years or more in the absence of an infectious cause is a matter of concern and cannot be left at that. Similarly, the basis for confirmation of diagnosis of late latent syphilis and pelvic inflammatory diseases has not been elucidated.","PeriodicalId":44880,"journal":{"name":"Indian Journal of Sexually Transmitted Diseases and AIDS","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ee/87/IJSTD-44-92.PMC10343127.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9816674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study of pattern and assessment of life quality index in patients of nonvenereal dermatoses of external genitalia at a tertiary care center.","authors":"Seethalakshmi Ganga Vellaisamy,&nbsp;Vivek Muthukumarasamy,&nbsp;Kannan Gopalan","doi":"10.4103/ijstd.ijstd_25_23","DOIUrl":"10.4103/ijstd.ijstd_25_23","url":null,"abstract":"<p><strong>Background: </strong>Nonvenereal dermatoses (NVD) are the spectrum of disorders involving the genitalia with varied etiology and having a considerable influence on the health-related quality of life (QOL), but it remains under evaluated.</p><p><strong>Objective: </strong>To study the prevalence, pattern, and the effect of nonvenereal genital dermatoses on the QOL of patients with the help of dermatological life quality index (DLQI) questionnaire.</p><p><strong>Materials and methods: </strong>This was a cross-sectional study conducted for a period of 1 year. A total of 132 patients were included in the study. QOL was assessed by using the DLQI questionnaire.</p><p><strong>Results: </strong>The prevalence was found to be 10.2/1000 cases in our study. Genital scabies (34.8%) was the common dermatoses followed by vitiligo (18.9%) and lichen simplex chronicus (8.3%). These dermatoses were having moderate effect on the DLQI of majority (52.3%) of the patients and its having very large effect on DLQI in 20.5% of patients. Mean DLQI scores were high among the age group of 41-70 years, male sex and in patients who had <1 month duration of the dermatoses. Regarding individual dermatoses, infestation (scabies) was having higher mean DLQI scores and it was statistically significant.</p><p><strong>Conclusion: </strong>This study depicts that NVD are having impact on the QOL and its mainly attributed to the site of dermatoses and also due to the symptoms. Proper counseling about the nature of these disorders and prompt treatment were important, thereby improving the QOL of such patients.</p>","PeriodicalId":44880,"journal":{"name":"Indian Journal of Sexually Transmitted Diseases and AIDS","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/73/IJSTD-44-49.PMC10343132.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9826159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of serum level of kisspeptin and interferon-beta in genital wart patients.","authors":"Heba Allah Saad Eldeen Bazid,&nbsp;Alaa H Marae,&nbsp;Nermin Tayel,&nbsp;Shereen G Zaid,&nbsp;Mohammed I Mostafa,&nbsp;Eman Masoud Abd El Gayed","doi":"10.4103/ijstd.ijstd_93_22","DOIUrl":"10.4103/ijstd.ijstd_93_22","url":null,"abstract":"<p><strong>Background: </strong>Researchers are interested in genital wart (GW) studies due to their increased incidence. In a single experimental research, virally infected mouse models showed elevated kisspeptin levels and low interferon levels.</p><p><strong>Objective: </strong>The objective of the study was to evaluate the serum levels of kisspeptin and interferon (INF)-beta in GW patients.</p><p><strong>Patients and methods: </strong>Forty patients with GWs and forty healthy participants of comparable age and sex as a control group were included in this case-control study. Serum levels of kisspeptin and IFN-beta were measured using ELISA during the period from December 2021 to April 2022.</p><p><strong>Results: </strong>Kisspeptin was significantly higher among cases than controls, whereas IFN-beta level was lower among cases than controls (<i>P</i> < 0.001). There were no significant relations between kisspeptin and IFN-beta levels and the clinical data for the studied participants, and there was no significant correlation between both (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>The reported increased kisspeptin level which was associated with decreased interferon-beta level in patients with GWs might indicate a new insight into viral infection pathogenesis. Further research including all steps in kisspeptin/G protein-coupled receptor 54 pathway is required. Targeted therapy for this pathway may be of value for those patients.</p>","PeriodicalId":44880,"journal":{"name":"Indian Journal of Sexually Transmitted Diseases and AIDS","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/33/IJSTD-44-30.PMC10343131.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penile ulcerative pyoderma gangrenosum: A rare entity.","authors":"Jalpa Kailashbhai Patel,&nbsp;Devna Subramonia Pillai,&nbsp;Priyanka Bodar,&nbsp;Pragya Ashok Nair","doi":"10.4103/ijstd.ijstd_115_22","DOIUrl":"10.4103/ijstd.ijstd_115_22","url":null,"abstract":"<p><p>Pyoderma gangrenosum (PG) is a rare, chronic, ulcerative, neutrophilic, and inflammatory skin disease. It most commonly affects the lower limb, may affect peristomal skin, and rarely involves mucosal and internal sites. Genital involvement has been rarely reported. Hereby, we report a case of penile PG in a 70-year-old male treated with oral steroids.</p>","PeriodicalId":44880,"journal":{"name":"Indian Journal of Sexually Transmitted Diseases and AIDS","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/90/IJSTD-44-77.PMC10343122.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9881477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syphilis resurgence: Exploring the impact of COVID-19 pandemic.","authors":"Tejinder Kaur,&nbsp;Mohita Mahajan,&nbsp;B B Mahajan","doi":"10.4103/ijstd.ijstd_19_22","DOIUrl":"10.4103/ijstd.ijstd_19_22","url":null,"abstract":"Indian Journal of Sexually Transmitted Diseases and AIDS Volume 44, Issue 1, January-June 2023 95 stated that PKMB evolves into four stages: (i) the initial plaque stage, (ii) late tumor stage, (iii) verrucous tumor on the plaque, and (iv) transformation to SCC and invasion. Thickness of the plaque can be sometimes quite huge that the lesion appears as a penile horn. Hyperkeratotic plaques involving perimeatal skin can cause multiple urinary streams on micturition giving an appearance of a “watering‐can penis.” Histopathological examination demonstrates hyperkeratosis, parakeratosis, acanthosis, elongated rete ridges, and mild lower epidermal dysplasia with a nonspecific dermal inflammatory infiltrate composed of eosinophils and lymphocytes.[1] Differential diagnoses include penile horn, penile psoriasis (early plaque stage), giant condyloma, verrucous carcinoma, erythroplasia of Queyrat, SCC, and keratoacanthoma. Chaux et al.[4] studied 74 penile intraepithelial lesions using a triple immunohistochemical panel (p16/p53/Ki‐67) and found a distinctive immunohistochemical profile for associated and precursor penile epithelial lesions. All patients with squamous hyperplasia were p16 and p53 negative, and patients with high‐grade penile intraepithelial neoplasia (basaloid and warty patterns) were consistently p16 and p53positive and variably Ki‐67 positive. Treatment options include topical measures such as 5‐fluorouracil, podophyllin resin, and steroids and physical measures such as cryotherapy, radiotherapy, and wide local excision.[5]","PeriodicalId":44880,"journal":{"name":"Indian Journal of Sexually Transmitted Diseases and AIDS","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/af/IJSTD-44-95.PMC10343124.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Granuloma inguinale diagnosed on the bedside.","authors":"D Senkadhir Vendhan,&nbsp;Biju Vasudevan,&nbsp;Vinay Gera,&nbsp;Shekhar Neema","doi":"10.4103/ijstd.ijstd_68_22","DOIUrl":"10.4103/ijstd.ijstd_68_22","url":null,"abstract":"<p><p>Donovanosis is a chronic bacterial infection caused by gram-negative bacterium Klebsiella granulomatosis and is characterized by painless beefy red granulomatous ulcer which bleeds on touch and is mostly confined to the endemic regions of the world. It is rarest among the sexually transmitted genital ulcer diseases. We hereby report a case of donovanosis in a non-endemic area who initially presented with a solitary genital ulcer. Initial tests did not reveal any aetiology. However after four days of admission, since no aetiology was coming forth, a repeat tissue smear from the lesion revealed Donovan bodies which helped in the bedside diagnosis and management of the case.</p>","PeriodicalId":44880,"journal":{"name":"Indian Journal of Sexually Transmitted Diseases and AIDS","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/49/IJSTD-44-87.PMC10343105.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9816670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}