Genital Ulcers in Women with HIV Proposed Revision on Management Algoritm

Moerbono Mochtar; Alamanda Murasmita; M. Eko Irawanto; Endra Yustin Elistasari

doi:doi:10.11648/j.ajls.20170503.13

| Peer-Reviewed

Genital Ulcers in Women with HIV Proposed Revision on Management Algoritm

Moerbono Mochtar, Alamanda Murasmita, M. Eko Irawanto, Endra Yustin Elistasari

Published in American Journal of Life Sciences (Volume 5, Issue 3)

Received: 22 March 2017 Accepted: 13 April 2017 Published: 1 June 2017

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

More than 100,000 people has been infected by HIV (Human Immunodeficiency Virus) in Indonesia. Mucocutaneous disorders occur in most patients with HIV during the course of the disease, it is caused by acquired immunodeficiency or the effects of the HIV therapy. One of the most important clinical manifestations is genital ulcers. A specific attention is needed to identify the clinical manifestations of genital ulcers in HIV patients to find the etiology so that the treatment of the case can be more appropriate. There are 4 cases of genital ulcers in women with AIDS (Acquired Immune Deficiency Syndrome). Both VDRL test (Venereal Disease Reseach Laboratory) and TPHA (Trepenoma pallidum Haemagglutination) test gave negative results. Two cases has successful therapy with acyclovir 400 mg three times for 2 weeks. Test results for herpes simplex antibodies is 2 positive. The incidence of genital ulcers, especially in the chronic form, increases along with the incidence of the growing AIDS epidemic. A prospective study in Paris shows that the most common cause of genital ulcers in patients with AIDS is syphilis. All of these four cases have negative results of VDRL and TPHA, so it is necessary to consider another diagnosis as the cause of genital ulcers in immunocompromised patients that often give atypical clinical symptoms. The accuracy of the diagnosis is necessary to provide adequate treatment, especially in immunocompromised patient.

Published in	American Journal of Life Sciences (Volume 5, Issue 3)
DOI	10.11648/j.ajls.20170503.13
Page(s)	93-96
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Genital Ulcers, HIV, AIDS

References

[1]	Maartens G, Celum C, Lewin SR. HIV infection: epidemiology, pathogenesis, treatment, and prevention. The Lancet. 2014; 384(9939): 258-71.
[2]	Situasi dan analisis AIDS. [online]. 2014. [cited on 15 Mei 2015]; Download link on: http://www.depkes.go.id/folder/view/01/structure-publikasi-pusdatin-info-datin.html.
[3]	Oninla OA. Mucocutaneous Manifestations of HIV and the Correlation with WHO Clinical Staging in a Tertiary Hospital in Nigeria. AIDS research and treatment. 2014; 2014: 360970.
[4]	Marfatia YS, Menon DS, Jose S, Patel BJ. Nonhealing genital ulcers in AIDS: A diagnostic dilemma. Indian J Sex Transm Dis. 2016 Jul-Dec; 37 (2): 197–200.
[5]	Gomes Naveca F, Sabido M, Amaral Pires de Almeida T, Araujo Veras E, Contreras Mejia Mdel C, Galban E, dkk. Etiology of genital ulcer disease in a sexually transmitted infection reference center in Manaus, Brazilian Amazon. PloS one. 2013; 8 (5): e63953.
[6]	Hastuti EB, Nugrahini N, Subronto Y, Dzoerban Z, Djauzi S, Hastuti EY, dkk. Situasi Epidemi dan Program Penanggulangan HIV/AIDS di Indonesia. Pedoman Nasional Tatalaksana Klinis Infeksi HIV dan Terapi Antiretroviral pada orang dewasa. Kementerian Kesehatan Republik Indonesia Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan 2011. 2011. p: 1.
[7]	Roett MA, Mayor MT, Uduhiri KA. Diagnosis and management of genital ulcers. American family physician. 2012; 85 (3): 254-61.
[8]	Aditama TY, Subuh M, Daili SF, Indriatmi W, Zubier F, Nilasari H, dkk. Pedoman Nasional Penanganan Infeksi Menular Seksual 2011. Kementerian Kesehatan Republik Indonesia Direktorat Jenderal Pengendalian Penyakit dan Penyehatan Lingkungan 2011. 2011. p: 29.
[9]	Herpes Genital pada Imunokompromais. Lumintang H, Nilasari H, Indriatmi W, Zubier F, Daili SF. Penyunting. Penatalaksanaan Infeksi Herpes Virus Humanus di Indonesia 2011. Airlangga University Press. 2011. p: 23.
[10]	Stephan Lautenschlager AE. the heterogenous clinical spectrum of genital herpes. Dermatology. 2001; 202: 211-9.
[11]	Corey L. Synergistic copathogens-hiv-1 and hsv-2. The New England journal of medicine. 2007; 356(8): 854-5.
[12]	B H B Van Benthem JS, J A R van den hoek, J Merks, R A Coutinho, M Prins. Prevalence and risk factors of hsv-1 and hsv-2 antibodies in european HIV infected women. Sexually transmitted infections. 2001; 77: 120-4.
[13]	Nijhawan AE, Delong AK, Chapman S, Rana A, Kurpewski J, Ingersoll J, dkk. Effect of HSV-2 suppressive therapy on genital tract HIV-1 RNA shedding among women on HAART: a pilot randomized controlled trial. Infectious diseases in obstetrics and gynecology. 2012; 2012: 868526.
[14]	Delany S, Mlaba N, Clayton T, Akpomiemie G, Capovilla A, Legoff J, dkk. Impact of aciclovir on genital and plasma HIV-1 RNA in HSV-2/HIV-1 co-infected women: a randomized placebo-controlled trial in South Africa. Aids. 2009; 23 (4): 461-9.
[15]	Lingappa JR, Baeten JM, Wald A, Hughes JP, Thomas KK, Mujugira A, dkk. Daily acyclovir for HIV-1 disease progression in people dually infected with HIV-1 and herpes simplex virus type 2: a randomized placebo-controlled trial. Lancet. 2010; 375: 824-31.
[16]	Posavad CM WA, Kuntz S, Huang ML, Selke S, Krantz ZE. dkk. Frequent reactivation of HSV among HIV-1 infected treated with highly active antiretroviral therapy. Journal of Investigative Dermatology. 2004; 190: 693-6.
[17]	Reis Machado J, da Silva MV, Cavellani CL, dos Reis MA, Monteiro ML, Teixeira Vde P, dkk. Mucosal immunity in the female genital tract, HIV/AIDS. BioMed research international. 2014; 2014: 350195.
[18]	Disease Characterized by Genital, anal or perianal ulcers [online]. 2015. [Cited 10 Juni 2015]; Download link on: http://www.cdc.gov/std/tg2015/genital-ulcers.html.
[19]	Infeksi HIV & AIDS di Indonesia Tahapan Infeksi, Perawatan, Dukungan dan Prinsip Pengobatan. Dalam HIV & AIDS Pendekatan Biologi Molekular, Klinis dan Sosial. Bab 33. Jusuf Barakbah, Soewandojo E, Suharto, Hadi U, Astuti WD. Penyunting. Airlangga University Press. 2007. p: 266.

Cite This Article

Plain Text BibTeX RIS

APA Style

Moerbono Mochtar, Alamanda Murasmita, M. Eko Irawanto, Endra Yustin Elistasari. (2017). Genital Ulcers in Women with HIV Proposed Revision on Management Algoritm. American Journal of Life Sciences, 5(3), 93-96. https://doi.org/10.11648/j.ajls.20170503.13

Copy | Download

ACS Style

Moerbono Mochtar; Alamanda Murasmita; M. Eko Irawanto; Endra Yustin Elistasari. Genital Ulcers in Women with HIV Proposed Revision on Management Algoritm. Am. J. Life Sci. 2017, 5(3), 93-96. doi: 10.11648/j.ajls.20170503.13

Copy | Download

AMA Style

Moerbono Mochtar, Alamanda Murasmita, M. Eko Irawanto, Endra Yustin Elistasari. Genital Ulcers in Women with HIV Proposed Revision on Management Algoritm. Am J Life Sci. 2017;5(3):93-96. doi: 10.11648/j.ajls.20170503.13

Copy | Download

@article{10.11648/j.ajls.20170503.13,
  author = {Moerbono Mochtar and Alamanda Murasmita and M. Eko Irawanto and Endra Yustin Elistasari},
  title = {Genital Ulcers in Women with HIV Proposed Revision on Management Algoritm},
  journal = {American Journal of Life Sciences},
  volume = {5},
  number = {3},
  pages = {93-96},
  doi = {10.11648/j.ajls.20170503.13},
  url = {https://doi.org/10.11648/j.ajls.20170503.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajls.20170503.13},
  abstract = {More than 100,000 people has been infected by HIV (Human Immunodeficiency Virus) in Indonesia. Mucocutaneous disorders occur in most patients with HIV during the course of the disease, it is caused by acquired immunodeficiency or the effects of the HIV therapy. One of the most important clinical manifestations is genital ulcers. A specific attention is needed to identify the clinical manifestations of genital ulcers in HIV patients to find the etiology so that the treatment of the case can be more appropriate. There are 4 cases of genital ulcers in women with AIDS (Acquired Immune Deficiency Syndrome). Both VDRL test (Venereal Disease Reseach Laboratory) and TPHA (Trepenoma pallidum Haemagglutination) test gave negative results. Two cases has successful therapy with acyclovir 400 mg three times for 2 weeks. Test results for herpes simplex antibodies is 2 positive. The incidence of genital ulcers, especially in the chronic form, increases along with the incidence of the growing AIDS epidemic. A prospective study in Paris shows that the most common cause of genital ulcers in patients with AIDS is syphilis. All of these four cases have negative results of VDRL and TPHA, so it is necessary to consider another diagnosis as the cause of genital ulcers in immunocompromised patients that often give atypical clinical symptoms. The accuracy of the diagnosis is necessary to provide adequate treatment, especially in immunocompromised patient.},
 year = {2017}
}

Copy | Download

TY - JOUR
T1 - Genital Ulcers in Women with HIV Proposed Revision on Management Algoritm
AU - Moerbono Mochtar
AU - Alamanda Murasmita
AU - M. Eko Irawanto
AU - Endra Yustin Elistasari
Y1 - 2017/06/01
PY - 2017
N1 - https://doi.org/10.11648/j.ajls.20170503.13
DO - 10.11648/j.ajls.20170503.13
T2 - American Journal of Life Sciences
JF - American Journal of Life Sciences
JO - American Journal of Life Sciences
SP - 93
EP - 96
PB - Science Publishing Group
SN - 2328-5737
UR - https://doi.org/10.11648/j.ajls.20170503.13
AB - More than 100,000 people has been infected by HIV (Human Immunodeficiency Virus) in Indonesia. Mucocutaneous disorders occur in most patients with HIV during the course of the disease, it is caused by acquired immunodeficiency or the effects of the HIV therapy. One of the most important clinical manifestations is genital ulcers. A specific attention is needed to identify the clinical manifestations of genital ulcers in HIV patients to find the etiology so that the treatment of the case can be more appropriate. There are 4 cases of genital ulcers in women with AIDS (Acquired Immune Deficiency Syndrome). Both VDRL test (Venereal Disease Reseach Laboratory) and TPHA (Trepenoma pallidum Haemagglutination) test gave negative results. Two cases has successful therapy with acyclovir 400 mg three times for 2 weeks. Test results for herpes simplex antibodies is 2 positive. The incidence of genital ulcers, especially in the chronic form, increases along with the incidence of the growing AIDS epidemic. A prospective study in Paris shows that the most common cause of genital ulcers in patients with AIDS is syphilis. All of these four cases have negative results of VDRL and TPHA, so it is necessary to consider another diagnosis as the cause of genital ulcers in immunocompromised patients that often give atypical clinical symptoms. The accuracy of the diagnosis is necessary to provide adequate treatment, especially in immunocompromised patient.
VL - 5
IS - 3
ER -

Copy | Download

Author Information

Moerbono Mochtar

Department of Dermatovenereology, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia
Alamanda Murasmita

Department of Dermatovenereology, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia
M. Eko Irawanto

Department of Dermatovenereology, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia
Endra Yustin Elistasari

Department of Dermatovenereology, Faculty of Medicine, Dr. Moewardi’s General Hospital, Surakarta, Indonesia

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Moerbono Mochtar, Alamanda Murasmita, M. Eko Irawanto, Endra Yustin Elistasari. (2017). Genital Ulcers in Women with HIV Proposed Revision on Management Algoritm. American Journal of Life Sciences, 5(3), 93-96. https://doi.org/10.11648/j.ajls.20170503.13

Copy | Download

ACS Style

Moerbono Mochtar; Alamanda Murasmita; M. Eko Irawanto; Endra Yustin Elistasari. Genital Ulcers in Women with HIV Proposed Revision on Management Algoritm. Am. J. Life Sci. 2017, 5(3), 93-96. doi: 10.11648/j.ajls.20170503.13

Copy | Download

AMA Style

Moerbono Mochtar, Alamanda Murasmita, M. Eko Irawanto, Endra Yustin Elistasari. Genital Ulcers in Women with HIV Proposed Revision on Management Algoritm. Am J Life Sci. 2017;5(3):93-96. doi: 10.11648/j.ajls.20170503.13

Copy | Download

@article{10.11648/j.ajls.20170503.13,
  author = {Moerbono Mochtar and Alamanda Murasmita and M. Eko Irawanto and Endra Yustin Elistasari},
  title = {Genital Ulcers in Women with HIV Proposed Revision on Management Algoritm},
  journal = {American Journal of Life Sciences},
  volume = {5},
  number = {3},
  pages = {93-96},
  doi = {10.11648/j.ajls.20170503.13},
  url = {https://doi.org/10.11648/j.ajls.20170503.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajls.20170503.13},
  abstract = {More than 100,000 people has been infected by HIV (Human Immunodeficiency Virus) in Indonesia. Mucocutaneous disorders occur in most patients with HIV during the course of the disease, it is caused by acquired immunodeficiency or the effects of the HIV therapy. One of the most important clinical manifestations is genital ulcers. A specific attention is needed to identify the clinical manifestations of genital ulcers in HIV patients to find the etiology so that the treatment of the case can be more appropriate. There are 4 cases of genital ulcers in women with AIDS (Acquired Immune Deficiency Syndrome). Both VDRL test (Venereal Disease Reseach Laboratory) and TPHA (Trepenoma pallidum Haemagglutination) test gave negative results. Two cases has successful therapy with acyclovir 400 mg three times for 2 weeks. Test results for herpes simplex antibodies is 2 positive. The incidence of genital ulcers, especially in the chronic form, increases along with the incidence of the growing AIDS epidemic. A prospective study in Paris shows that the most common cause of genital ulcers in patients with AIDS is syphilis. All of these four cases have negative results of VDRL and TPHA, so it is necessary to consider another diagnosis as the cause of genital ulcers in immunocompromised patients that often give atypical clinical symptoms. The accuracy of the diagnosis is necessary to provide adequate treatment, especially in immunocompromised patient.},
 year = {2017}
}

Copy | Download