Brankin A E, Tobian A A R, Laeyendecker O, Suntoke T R, Kizza A, Mpoza B, Kigozi G, Nalugoda F, Iga B, Chen M Z, Gray R H, Wawer M J, Quinn T C, Reynolds S J
Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
Int J STD AIDS. 2009 Sep;20(9):650-1. doi: 10.1258/ijsa.2009.009067.
HIV acquisition is associated with herpes simplex virus type 2 (HSV-2) infection and genital ulcer disease (GUD). Three randomized control trials demonstrated that male circumcision significantly decreases HIV, HSV-2, human papillomavirus and self-reported GUD among men. GUD is also decreased among female partners of circumcised men, but it is unknown whether male circumcision status affects GUD pathogens in female partners. For the evaluation of GUD aetiology, two separate multiplex assays were performed to detect Haemophilus ducreyi, Treponema pallidum, HSV-1 and HSV-2. Of all the female GUD swabs evaluated, 67.5% had an aetiology identified, and HSV-2 was the primary pathogen detected (96.3%). However, there was no difference in the proportion of ulcers due to HSV-2 or other pathogens between female partners of circumcised men (11/15, 73.3%) compared with uncircumcised men (15/25, 60.0%, P = 0.39). The seroprevalence of HSV-2 is high in this population and therefore most of the detected HSV-2 infections represent reactivation. Since GUD is associated with HIV acquisition and one-third of GUD in this study did not have an aetiological agent identified, further research is needed to better understand the aetiology of GUD in Africa, and its relationship to circumcision and HIV infection.
感染艾滋病毒与2型单纯疱疹病毒（HSV-2）感染及生殖器溃疡疾病（GUD）有关。三项随机对照试验表明，男性包皮环切术可显著降低男性感染艾滋病毒、HSV-2、人乳头瘤病毒的几率，并减少自我报告的GUD病例。接受包皮环切术男性的女性伴侣中GUD病例数也有所减少，但尚不清楚男性包皮环切术状况是否会影响女性伴侣中GUD病原体情况。为评估GUD的病因，我们进行了两项独立的多重检测，以检测杜克雷嗜血杆菌、梅毒螺旋体、HSV-1和HSV-2。在所有接受评估的女性GUD拭子样本中，67.5%的样本确定了病因，其中检测到的主要病原体为HSV-2（96.3%）。然而，接受包皮环切术男性的女性伴侣中因HSV-2或其他病原体导致溃疡的比例（11/15，73.3%）与未接受包皮环切术男性的女性伴侣（15/25，60.0%，P = 0.39）相比，并无差异。该人群中HSV-2的血清阳性率较高，因此检测到的大多数HSV-2感染代表病毒再激活。由于GUD与感染艾滋病毒有关，且本研究中三分之一的GUD病例未确定病原体，因此需要进一步开展研究，以更好地了解非洲GUD的病因及其与包皮环切术和艾滋病毒感染的关系。
