Augenbraun M H, McCormack W M
State University of New York Health Science Center at Brooklyn.
Infect Dis Clin North Am. 1994 Jun;8(2):439-48.
It appears incontestable that there is a link between genital ulcer disease and HIV infection. On the one hand the natural history and response to therapy of syphilis, HSV-2, and chancroid are all modified by the immunosuppressive effects of HIV infection. On the other hand, HIV transmission is probably facilitated by the disruption of the normal epithelial barriers of the genital organs caused by these ulcerative infections. Information is somewhat less convincing that a similar association exists between the nonulcerative STDs (trichomonas, gonorrhea, chlamydial infections) and HIV. Conceptually, the mucosal inflammation associated with these infections might serve as a focus for HIV transmission. The available data, though suggestive, do not strongly support this contention. Theoretically though, even a small risk might potentially result in significant HIV transmission given the prevalence of nonulcerative STDs. These infectious processes do not appear to be markedly altered by HIV induced immunosuppression. The ability of HPV to cause dysplastic changes in cervical and anal tissue did not require the AIDS epidemic to come to light. In HIV infection, disruptions of immunoregulatory processes, which might ordinarily control the progression of potentially malignant cell lines, have created fertile ground for an increasing incidence of premalignant and malignant cytologic changes. The mutual impact these processes have or may have on one another requires that clinicians who care for patients with either HIV infection or with STDs should be thoroughly familiar with both and not consider them somehow exclusive of one another. Efforts toward the prevention and control of STDs should be considered important in the control and prevention of HIV transmission.
生殖器溃疡疾病与HIV感染之间存在联系，这一点似乎无可争议。一方面，梅毒、单纯疱疹病毒2型（HSV - 2）和软下疳的自然病史及对治疗的反应都会因HIV感染的免疫抑制作用而改变。另一方面，这些溃疡性感染导致生殖器官正常上皮屏障遭到破坏，可能会促进HIV传播。关于非溃疡性性传播疾病（滴虫病、淋病、衣原体感染）与HIV之间是否存在类似关联，相关信息的说服力稍显不足。从概念上讲，与这些感染相关的黏膜炎症可能成为HIV传播的一个病灶。现有数据虽有暗示性，但并未有力支持这一观点。不过从理论上讲，鉴于非溃疡性性传播疾病的流行情况，即使是很小的风险也可能导致大量HIV传播。这些感染过程似乎并未因HIV诱导的免疫抑制而发生显著改变。人乳头瘤病毒（HPV）导致宫颈和肛门组织发育异常变化的能力在艾滋病流行之前就已为人所知。在HIV感染中，免疫调节过程的破坏（而免疫调节过程通常可控制潜在恶性细胞系的进展）为癌前和恶性细胞学变化发病率的上升创造了温床。这些过程相互之间已经或可能产生的影响要求，治疗HIV感染患者或性传播疾病患者的临床医生应全面熟悉这两类疾病，而不应将它们视为相互排斥的。在控制和预防HIV传播方面，应将预防和控制性传播疾病的努力视为重要举措。
