acyclovir and Chlamydia-Infections

Topics: Acyclovir; Anti-Bacterial Agents; Chlamydia Infections; Female; Gonorrhea; Herpes Genitalis; Humans; Male; Neisseria gonorrhoeae; Penicillinase; Recurrence; Sexually Transmitted Diseases

This study aimed to determine the prevalence of genital ulcer and urethral pathogens, as well as their association with clinical features, in men with genital ulcer disease (GUD) enrolled in a clinical trial.. Clinical data were collected by questionnaire. Ulcer swabs were tested for herpes simplex viruses (HSV-1/2), Treponema pallidum, Haemophilus ducreyi, and Chlamydia trachomatis L1-L3. First-pass urine was tested for urethral pathogens, namely Neisseria gonorrhoeae, C. trachomatis, Trichomonas vaginalis, and Mycoplasma genitalium. Pathogens were detected by real-time molecular assays. Blood was tested for HIV, HSV-2, and syphilis-associated antibodies. Pathogens and clinical associations were investigated using the χ test.. A total of 615 men with GUD were recruited. Herpes simplex virus (HSV-1, 4.2%; HSV-2, 98.2%) and bacterial pathogens were detected in 451 (73.6%) and 48 (7.8%) of genital ulcers, respectively. Human immunodeficiency virus, HSV-2, and treponemal antibodies were detected in 387 (62.9%), 434 (70.6%), and 141 (23.0%) men, respectively, whereas 54 men (8.8%) were rapid plasmin reagin (RPR) seropositive. A total of 223 urethral infections were diagnosed in 188 men (30.6%), including 69 (11.2%) M. genitalium, 64 (10.4%) T. vaginalis, 60 (9.8%) C. trachomatis, and 30 (4.9%) N. gonorrhoeae infections. Dysuria was reported by 170 men (27.6%), and 69 men (11.5%) had urethral discharge on examination. Urethral pathogens were detected in 102/409 (24.9%) men without these clinical features.. Herpes accounted for most GUD cases and urethral pathogen coinfections were common. Erythromycin, dispensed to treat infrequent chancroid and lymphogranuloma venereum cases, provided additional treatment of some asymptomatic urethral pathogens. Additional antibiotics would be required to treat asymptomatic trichomoniasis and gonorrhea.

Topics: Acyclovir; Adult; Chancre; Chlamydia Infections; Chlamydia trachomatis; Gonorrhea; Haemophilus ducreyi; Herpes Genitalis; Herpesvirus 1, Human; Herpesvirus 2, Human; HIV Seropositivity; HIV-1; Humans; Male; Neisseria gonorrhoeae; Prevalence; Primary Health Care; Real-Time Polymerase Chain Reaction; Sentinel Surveillance; South Africa; Surveys and Questionnaires; Syphilis; Treponema pallidum; Ulcer; Urethral Diseases; Urine

C trachomatis infection is the most commonly reported STD in the United States, and the majority of women infected are asymptomatic. Screening is recommended for those at high risk, including women who are between 15 and 21 years of age, live in urban areas, are single, or have new or multiple sexual partners. The "gold standard" for diagnosis is chlamydial culture; however, techniques that use DNA and RNA amplification are nearly 100% sensitive and specific and may prove cost-effective. Doxycycline is a recommended first-line therapy, but certain other antibiotics may also be effective. Herpes simplex virus affects more than one third of the world's population. It is diagnosed by observation of shallow, tender ulcerations around the genitalia and by viral isolation using tissue culture. Initial treatment is with antiviral drugs, which may also be necessary episodically or as a suppressive regimen for recurrences. Patient education about prevention of these and other STDs, as well as the impact of such disease on sexual partners, is critical. Physicians should therefore become comfortable questioning and counseling patients about sexual issues and risks for STDs.

Topics: Acyclovir; Antiviral Agents; Chlamydia Infections; Chlamydia trachomatis; Female; Herpes Genitalis; Humans; Recurrence; Treatment Outcome

Topics: Acyclovir; Anti-Bacterial Agents; Bacterial Infections; Chancroid; Chlamydia Infections; Epididymitis; Escherichia coli Infections; Female; Genital Diseases, Male; Herpes Simplex; Humans; Infertility, Male; Male; Mumps; Orchitis; Prostatitis; Syphilis; Urethritis

Topics: Acute Disease; Acyclovir; Adult; Chlamydia Infections; Diagnosis, Differential; Female; Gonorrhea; Herpes Genitalis; Humans; Male; Meningitis; Sexually Transmitted Diseases; Simplexvirus; Syphilis