O'Farrell N, Tovey S J
Lloyd Clinic, Guy's Hospital, London, UK.
Int J STD AIDS. 1994 Nov-Dec;5(6):415-8. doi: 10.1177/095646249400500607.
The cumulative incidence of sexually transmitted diseases (STD) in a cohort of 51 (35 female, 16 male) HIV-1 seropositive STD clinic attenders who had acquired HIV-1 infection via heterosexual transmission was investigated through a retrospective review of the case notes. The women were followed up for a mean 11.6 months and the men for 18 months. Thirty-one (88%) of the women and 13 (81%) of the men were of sub-Saharan African origin. Approximately half of the subjects were first diagnosed as HIV-1 positive with CD4 counts < 200 x 10(6)/1 and a quarter with CD4 counts < 50 x 10(6)/1. STDs detected in women were: genital herpes 15 (43%), candida 12 (34%), bacterial vaginosis 9 (25%), and in men: genital herpes 6 (38%), non-gonococcal urethritis 4 (25%). No cases of gonorrhoea were detected. At the time of first diagnosis of genital herpes at the clinic, the mean CD4 count in women was 275 x 10(6)/1 and in men 285 x 10(6)/1. Genital herpes was the AIDS defining diagnosis in 3 of the women. The recognized risk of HIV transmission via genital lesions should be stressed in HIV-1 positive subjects with genital herpes. The incidence of other STD was low--both knowledge of HIV status and safer sex counselling may limit unsafe sexual behaviour and should be evaluated further as a strategy for limiting the spread of HIV-1 infection.
通过对病历进行回顾性研究，调查了一组51名（35名女性，16名男性）通过异性传播感染HIV-1的性病门诊就诊者中性传播疾病（STD）的累积发病率。女性随访时间平均为11.6个月，男性为18个月。31名（88%）女性和13名（81%）男性来自撒哈拉以南非洲。大约一半的研究对象首次被诊断为HIV-1阳性时CD4细胞计数<200×10⁶/L，四分之一的研究对象CD4细胞计数<50×10⁶/L。女性检测到的性传播疾病有：生殖器疱疹15例（43%）、念珠菌感染12例（34%）、细菌性阴道病9例（25%）；男性检测到的性传播疾病有：生殖器疱疹6例（38%）、非淋菌性尿道炎4例（25%）。未检测到淋病病例。在诊所首次诊断出生殖器疱疹时，女性的平均CD4细胞计数为275×10⁶/L，男性为285×10⁶/L。3名女性的生殖器疱疹被确定为艾滋病确诊诊断。对于患有生殖器疱疹的HIV-1阳性患者，应强调通过生殖器病变传播HIV的已知风险。其他性传播疾病的发病率较低——了解HIV感染状况和进行安全性行为咨询可能会限制不安全的性行为，应进一步评估其作为限制HIV-1感染传播策略的作用。
