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Contracept Technol Update. 2000 Jan;21(1):4-5.
STDs: flushing out the "hidden epidemic".

[No authors listed]

PIP: The rapid explosion of HIV infection ranks as the most significant event in the arena of sexually transmitted diseases (STDs). In making efforts against HIV/AIDS, public health officials are now preparing to confront what is called "the hidden epidemic" of STDs. Important progress has been made in research in diagnosing and treating STDs including urine-based screening for gonorrhea, single-dose treatments for curable STDs, as well as improved chlamydia screening and treatment. While herpes simplex virus-2 (HSV-2) remains incurable, the arrival of antiviral drugs such as acyclovir, famciclovir, and valacyclovir offer suppressive treatment to keep HSV-2 outbreak to a minimum level. Efforts to eliminate syphilis have been undertaken. As progress was made on bacterial STDs, viral STDs have become more important. Health providers will need to be ready to face such STDs in the coming years. It is hoped that vaccines and microbicides will be developed to combat the epidemic.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12295506&dopt=Abstract

AIDS Action. 1990 Apr;(10):2-3.
Skin conditions common to people with HIV infection or AIDS.

Kalibala S.

PIP: The World Health Organization clinical criteria for AIDS diagnosis in Africa include Kaposi's sarcoma, Herpes zoster, Herpes simplex, and pruritic maculopapular rash, which have a predictive value for HIV seropositivity of 71-98%. Skin conditions may be classified as: 1) generalized dermatitis, 2) bacterial, fungal, viral, and parasitic infections, and 3) skin tumors. Pruritic maculopapular rash (prurigo) is often the first outward sign of HIV infection. Soothing preparations such as calamine lotion or E45 emollient cream can be applied. Occasionally antihistamine may be necessary, e.g., 10 mg of chlorpheniramine 8 hourly. Skin lesions may become secondarily infected with bacteria; usually Staphylococcus aureus and Streptococcus species. Persistent folliculitis or carbuncles should be treated with flucloxacillin 250 mg QDS for 7 days. In HIV/AIDS fungal infections often develop secondary infection. Candidiasis (thrush) is caused by yeasts, mainly Candida albicans and a small percentage by Tolurosis glabrata. Many HIV-infected patients suffer from seborrheic dermatitis. Fungal diseases more typically present as ringworms of the scalp (Tinea capitis). Whitfield's ointment is effective for ringworm. Antifungal creams such as miconazol or clotrimazole and systemic antifungal tablets such as ketoconazole, fluconazole, and itraconazole are also effective. Gentian violet lotion twice daily and Acyclovir tablets, 200 mg 5 times daily for 5 days, may help to reduce secondary Herpes simplex infection. HIV has been associated with an increased incidence of Herpes zoster (shingles). It is often necessary to give analgesics like aspirin or paracetamol to control the pain. Gentian violet paint may help to prevent secondary infection. When shingles affects the eye, Acyclovir tablets (800 mg 5 times daily) should be given. Kaposi's sarcoma affects wider age groups, and it is disseminated and more aggressive than the endemic type. Treatment options include radiotherapy and systemic cytotoxics such as vincristine. Intralesional injections of the drug interferon have also given successful results with some patients.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12342834&dopt=Abstract

Afr Health. 1994 Nov;17(1):19-20.
HIV and STDS: how are they linked?

Dallabetta G.

PIP: The 153-327 million new cases of treatable sexually transmitted diseases (STDs) each year are a critical health problem and are increasingly associated with transmission of HIV infections. There is strong epidemiological evidence that STDs (especially HIV-1 and genital ulcer diseases such as syphilis, herpes, and chancroid) increase a person's ability to transmit or acquire an HIV infection. In addition, HIV may alter the clinical presentation, natural history, diagnosis, and responsiveness to therapy of STDs; and STDs may alter the natural history of HIV infection by inducing immunosuppression, by chronic immune stimulation, or by direct viral interactions. Most reports on HIV infection and syphilis document neurological manifestation of syphilis in HIV-1 infected individuals. HIV-1 may modify an individual's response to syphilis infection, producing more persistent and higher RPR titres, increasing the likelihood of losing reactivity to treponemal tests correlating with advanced HIV disease, and increasing biological false-positive reactions. HIV also appears to reduce the responsiveness of chancroid to standard therapy, especially single-dose therapy, thus requiring multiple-dose therapy over 5-7 days. Herpes simplex viral infections are more frequent and severe in HIV-infected individuals, but dosage adjusted acyclovir therapy is effective in most patients. Gonorrhea does not appear to be affected by the presence of HIV infection, except that HIV-infected women may be more susceptible to cervical gonococcal infection and pelvic inflammatory disease. The clinical presentation of human papilloma virus, however, is altered by HIV infection as is the rate of recurrence and the responsiveness to standard therapy. Because of the recognition of the interaction of HIV and STDs, STD control is now recognized as an essential component of HIV prevention programs. Parallel prevention campaigns, such as condom promotion, could reduce both.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12345749&dopt=Abstract

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