Increased Risk of Genital Ulcer Disease in Women During the First Month After Initiating Antiretroviral Therapy
INTRODUCTION:Genital ulcer disease (GUD) is common in HIV-1-infected women, and a small number of studies have suggested increased GUD risk after antiretroviral therapy (ART) initiation. To better define this risk, we monitored 134 women at ART initiation and monthly thereafter. METHODS:Women were e...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2009-12, Vol.52 (5), p.600-603 |
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| container_title | Journal of acquired immune deficiency syndromes (1999) |
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| creator | Graham, Susan M Masese, Linnet Gitau, Ruth Mwakangalu, Dickson Jaoko, Walter Ndinya-Achola, Jeckoniah Mandaliya, Kishor Peshu, Norbert Baeten, Jared M McClelland, R Scott |
| description | INTRODUCTION:Genital ulcer disease (GUD) is common in HIV-1-infected women, and a small number of studies have suggested increased GUD risk after antiretroviral therapy (ART) initiation. To better define this risk, we monitored 134 women at ART initiation and monthly thereafter.
METHODS:Women were evaluated monthly for genital ulcers. Syphilis serology was tested quarterly, and chancroid culture was performed on ulcers that were felt to be clinically consistent with a diagnosis of chancroid. A logistic model with generalized estimating equations was used to analyze predictors of GUD from baseline until 6 months after ART initiation.
RESULTS:During the study period, GUD occurred in 54 women (40.3%) at 85 visits (10.0%). GUD prevalence was 9.7% at baseline, increased to 16.7% at month 1 [adjusted odds ratio (aOR) 1.9 (1.0-3.6), P = 0.04], then decreased to 6.4% by month 6. History of GUD [aOR 3.8 (1.9-7.7), P < 0.001) and CD4 count |
| doi_str_mv | 10.1097/QAI.0b013e3181b065cf |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2787852</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1909095371</sourcerecordid><originalsourceid>FETCH-LOGICAL-c545f-d9adf9e9f76c6e89beb33550108175abac1b220bdbd16c2ddad0aac7660adfde3</originalsourceid><addsrcrecordid>eNp9kV9rFDEUxQdRbK1-A5EgiE9bk0z-vghLa-tCRZQWH0Mmc6eTdjbZJpmWfnuzdKnaB5_uhfs7h3M5TfOW4EOCtfz0Y7k6xB0mLbREkQ4L7oZnzT7RjC2kUux53TnlC0Zavte8yvkKYyIY0y-bPaIFU4rS_SaugktgM_Top8_XKA7oFIIvdkIXk4OEjn3enpEP6FdcQ0DHc_LhEpUR0IlPuaBvMZQRLYdS6VWVelu2wDIUn6CkeOtTdTsfIdnN_evmxWCnDG9286C5OPlyfvR1cfb9dHW0PFs4zviw6LXtBw16kMIJULqDrm05xwQrIrntrCMdpbjru54IR_ve9thaJ4XAVdhDe9B8fvDdzN0aegeh1BRmk_zapnsTrTf_XoIfzWW8NVQqqTitBh93BinezJCLWfvsYJpsgDhnI5nASrZUVfL9E_IqzinU7wxtW9FqrFmF2APkUsw5wfAYhWCz7dPUPs3TPqvs3d9v_BHtCqzAhx1gs7PTkGxwPj9ylBIpuJaVUw_cXZxqUfl6mu8gmRHsVMb_Z_gNd62_DQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>233639094</pqid></control><display><type>article</type><title>Increased Risk of Genital Ulcer Disease in Women During the First Month After Initiating Antiretroviral Therapy</title><source>MEDLINE</source><source>Journals@Ovid LWW Legacy Archive</source><source>Journals@Ovid Complete</source><source>Free E- Journals</source><creator>Graham, Susan M ; Masese, Linnet ; Gitau, Ruth ; Mwakangalu, Dickson ; Jaoko, Walter ; Ndinya-Achola, Jeckoniah ; Mandaliya, Kishor ; Peshu, Norbert ; Baeten, Jared M ; McClelland, R Scott</creator><creatorcontrib>Graham, Susan M ; Masese, Linnet ; Gitau, Ruth ; Mwakangalu, Dickson ; Jaoko, Walter ; Ndinya-Achola, Jeckoniah ; Mandaliya, Kishor ; Peshu, Norbert ; Baeten, Jared M ; McClelland, R Scott</creatorcontrib><description>INTRODUCTION:Genital ulcer disease (GUD) is common in HIV-1-infected women, and a small number of studies have suggested increased GUD risk after antiretroviral therapy (ART) initiation. To better define this risk, we monitored 134 women at ART initiation and monthly thereafter.
METHODS:Women were evaluated monthly for genital ulcers. Syphilis serology was tested quarterly, and chancroid culture was performed on ulcers that were felt to be clinically consistent with a diagnosis of chancroid. A logistic model with generalized estimating equations was used to analyze predictors of GUD from baseline until 6 months after ART initiation.
RESULTS:During the study period, GUD occurred in 54 women (40.3%) at 85 visits (10.0%). GUD prevalence was 9.7% at baseline, increased to 16.7% at month 1 [adjusted odds ratio (aOR) 1.9 (1.0-3.6), P = 0.04], then decreased to 6.4% by month 6. History of GUD [aOR 3.8 (1.9-7.7), P < 0.001) and CD4 count <100 [aOR 1.8 (1.0-3.4), P = 0.06] were associated with increased risk of GUD after ART initiation.
DISCUSSION:Women experience increased risk of GUD in the first month after ART initiation, particularly if they have low CD4 counts or a history of GUD.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0b013e3181b065cf</identifier><identifier>PMID: 19648822</identifier><identifier>CODEN: JDSRET</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Anti-HIV Agents - adverse effects ; Anti-HIV Agents - therapeutic use ; Antiretroviral drugs ; Antiretroviral Therapy, Highly Active ; Biological and medical sciences ; CD4 Lymphocyte Count ; Cohort Studies ; Drug therapy ; Female ; Fundamental and applied biological sciences. Psychology ; Genital Diseases, Female - epidemiology ; Genital Diseases, Female - immunology ; HIV ; HIV Infections - drug therapy ; HIV Infections - immunology ; HIV-1 ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Infectious diseases ; Kenya - epidemiology ; Medical sciences ; Microbiology ; Miscellaneous ; Prevalence ; Risk Factors ; Treponema pallidum ; Ulcer - epidemiology ; Ulcer - immunology ; Ulcers ; Urology ; Viral diseases ; Virology ; Womens health</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2009-12, Vol.52 (5), p.600-603</ispartof><rights>2009 Lippincott Williams & Wilkins, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright Lippincott Williams & Wilkins Dec 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c545f-d9adf9e9f76c6e89beb33550108175abac1b220bdbd16c2ddad0aac7660adfde3</citedby><cites>FETCH-LOGICAL-c545f-d9adf9e9f76c6e89beb33550108175abac1b220bdbd16c2ddad0aac7660adfde3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22176597$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19648822$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Graham, Susan M</creatorcontrib><creatorcontrib>Masese, Linnet</creatorcontrib><creatorcontrib>Gitau, Ruth</creatorcontrib><creatorcontrib>Mwakangalu, Dickson</creatorcontrib><creatorcontrib>Jaoko, Walter</creatorcontrib><creatorcontrib>Ndinya-Achola, Jeckoniah</creatorcontrib><creatorcontrib>Mandaliya, Kishor</creatorcontrib><creatorcontrib>Peshu, Norbert</creatorcontrib><creatorcontrib>Baeten, Jared M</creatorcontrib><creatorcontrib>McClelland, R Scott</creatorcontrib><title>Increased Risk of Genital Ulcer Disease in Women During the First Month After Initiating Antiretroviral Therapy</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>INTRODUCTION:Genital ulcer disease (GUD) is common in HIV-1-infected women, and a small number of studies have suggested increased GUD risk after antiretroviral therapy (ART) initiation. To better define this risk, we monitored 134 women at ART initiation and monthly thereafter.
METHODS:Women were evaluated monthly for genital ulcers. Syphilis serology was tested quarterly, and chancroid culture was performed on ulcers that were felt to be clinically consistent with a diagnosis of chancroid. A logistic model with generalized estimating equations was used to analyze predictors of GUD from baseline until 6 months after ART initiation.
RESULTS:During the study period, GUD occurred in 54 women (40.3%) at 85 visits (10.0%). GUD prevalence was 9.7% at baseline, increased to 16.7% at month 1 [adjusted odds ratio (aOR) 1.9 (1.0-3.6), P = 0.04], then decreased to 6.4% by month 6. History of GUD [aOR 3.8 (1.9-7.7), P < 0.001) and CD4 count <100 [aOR 1.8 (1.0-3.4), P = 0.06] were associated with increased risk of GUD after ART initiation.
DISCUSSION:Women experience increased risk of GUD in the first month after ART initiation, particularly if they have low CD4 counts or a history of GUD.</description><subject>Anti-HIV Agents - adverse effects</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Biological and medical sciences</subject><subject>CD4 Lymphocyte Count</subject><subject>Cohort Studies</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Genital Diseases, Female - epidemiology</subject><subject>Genital Diseases, Female - immunology</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - immunology</subject><subject>HIV-1</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Kenya - epidemiology</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Miscellaneous</subject><subject>Prevalence</subject><subject>Risk Factors</subject><subject>Treponema pallidum</subject><subject>Ulcer - epidemiology</subject><subject>Ulcer - immunology</subject><subject>Ulcers</subject><subject>Urology</subject><subject>Viral diseases</subject><subject>Virology</subject><subject>Womens health</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kV9rFDEUxQdRbK1-A5EgiE9bk0z-vghLa-tCRZQWH0Mmc6eTdjbZJpmWfnuzdKnaB5_uhfs7h3M5TfOW4EOCtfz0Y7k6xB0mLbREkQ4L7oZnzT7RjC2kUux53TnlC0Zavte8yvkKYyIY0y-bPaIFU4rS_SaugktgM_Top8_XKA7oFIIvdkIXk4OEjn3enpEP6FdcQ0DHc_LhEpUR0IlPuaBvMZQRLYdS6VWVelu2wDIUn6CkeOtTdTsfIdnN_evmxWCnDG9286C5OPlyfvR1cfb9dHW0PFs4zviw6LXtBw16kMIJULqDrm05xwQrIrntrCMdpbjru54IR_ve9thaJ4XAVdhDe9B8fvDdzN0aegeh1BRmk_zapnsTrTf_XoIfzWW8NVQqqTitBh93BinezJCLWfvsYJpsgDhnI5nASrZUVfL9E_IqzinU7wxtW9FqrFmF2APkUsw5wfAYhWCz7dPUPs3TPqvs3d9v_BHtCqzAhx1gs7PTkGxwPj9ylBIpuJaVUw_cXZxqUfl6mu8gmRHsVMb_Z_gNd62_DQ</recordid><startdate>200912</startdate><enddate>200912</enddate><creator>Graham, Susan M</creator><creator>Masese, Linnet</creator><creator>Gitau, Ruth</creator><creator>Mwakangalu, Dickson</creator><creator>Jaoko, Walter</creator><creator>Ndinya-Achola, Jeckoniah</creator><creator>Mandaliya, Kishor</creator><creator>Peshu, Norbert</creator><creator>Baeten, Jared M</creator><creator>McClelland, R Scott</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7QL</scope><scope>7U1</scope><scope>7U2</scope><scope>5PM</scope></search><sort><creationdate>200912</creationdate><title>Increased Risk of Genital Ulcer Disease in Women During the First Month After Initiating Antiretroviral Therapy</title><author>Graham, Susan M ; Masese, Linnet ; Gitau, Ruth ; Mwakangalu, Dickson ; Jaoko, Walter ; Ndinya-Achola, Jeckoniah ; Mandaliya, Kishor ; Peshu, Norbert ; Baeten, Jared M ; McClelland, R Scott</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c545f-d9adf9e9f76c6e89beb33550108175abac1b220bdbd16c2ddad0aac7660adfde3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Anti-HIV Agents - adverse effects</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Biological and medical sciences</topic><topic>CD4 Lymphocyte Count</topic><topic>Cohort Studies</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Genital Diseases, Female - epidemiology</topic><topic>Genital Diseases, Female - immunology</topic><topic>HIV</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - immunology</topic><topic>HIV-1</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Kenya - epidemiology</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Miscellaneous</topic><topic>Prevalence</topic><topic>Risk Factors</topic><topic>Treponema pallidum</topic><topic>Ulcer - epidemiology</topic><topic>Ulcer - immunology</topic><topic>Ulcers</topic><topic>Urology</topic><topic>Viral diseases</topic><topic>Virology</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Graham, Susan M</creatorcontrib><creatorcontrib>Masese, Linnet</creatorcontrib><creatorcontrib>Gitau, Ruth</creatorcontrib><creatorcontrib>Mwakangalu, Dickson</creatorcontrib><creatorcontrib>Jaoko, Walter</creatorcontrib><creatorcontrib>Ndinya-Achola, Jeckoniah</creatorcontrib><creatorcontrib>Mandaliya, Kishor</creatorcontrib><creatorcontrib>Peshu, Norbert</creatorcontrib><creatorcontrib>Baeten, Jared M</creatorcontrib><creatorcontrib>McClelland, R Scott</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Graham, Susan M</au><au>Masese, Linnet</au><au>Gitau, Ruth</au><au>Mwakangalu, Dickson</au><au>Jaoko, Walter</au><au>Ndinya-Achola, Jeckoniah</au><au>Mandaliya, Kishor</au><au>Peshu, Norbert</au><au>Baeten, Jared M</au><au>McClelland, R Scott</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased Risk of Genital Ulcer Disease in Women During the First Month After Initiating Antiretroviral Therapy</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2009-12</date><risdate>2009</risdate><volume>52</volume><issue>5</issue><spage>600</spage><epage>603</epage><pages>600-603</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><coden>JDSRET</coden><abstract>INTRODUCTION:Genital ulcer disease (GUD) is common in HIV-1-infected women, and a small number of studies have suggested increased GUD risk after antiretroviral therapy (ART) initiation. To better define this risk, we monitored 134 women at ART initiation and monthly thereafter.
METHODS:Women were evaluated monthly for genital ulcers. Syphilis serology was tested quarterly, and chancroid culture was performed on ulcers that were felt to be clinically consistent with a diagnosis of chancroid. A logistic model with generalized estimating equations was used to analyze predictors of GUD from baseline until 6 months after ART initiation.
RESULTS:During the study period, GUD occurred in 54 women (40.3%) at 85 visits (10.0%). GUD prevalence was 9.7% at baseline, increased to 16.7% at month 1 [adjusted odds ratio (aOR) 1.9 (1.0-3.6), P = 0.04], then decreased to 6.4% by month 6. History of GUD [aOR 3.8 (1.9-7.7), P < 0.001) and CD4 count <100 [aOR 1.8 (1.0-3.4), P = 0.06] were associated with increased risk of GUD after ART initiation.
DISCUSSION:Women experience increased risk of GUD in the first month after ART initiation, particularly if they have low CD4 counts or a history of GUD.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>19648822</pmid><doi>10.1097/QAI.0b013e3181b065cf</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Anti-HIV Agents - adverse effects Anti-HIV Agents - therapeutic use Antiretroviral drugs Antiretroviral Therapy, Highly Active Biological and medical sciences CD4 Lymphocyte Count Cohort Studies Drug therapy Female Fundamental and applied biological sciences. Psychology Genital Diseases, Female - epidemiology Genital Diseases, Female - immunology HIV HIV Infections - drug therapy HIV Infections - immunology HIV-1 Human immunodeficiency virus Human viral diseases Humans Infectious diseases Kenya - epidemiology Medical sciences Microbiology Miscellaneous Prevalence Risk Factors Treponema pallidum Ulcer - epidemiology Ulcer - immunology Ulcers Urology Viral diseases Virology Womens health |
| title | Increased Risk of Genital Ulcer Disease in Women During the First Month After Initiating Antiretroviral Therapy |
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