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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Increased risk of genital ulcer disease in women during the first month after initiating antiretroviral therapy
Journal of Acquired Immune Deficiency Syndromes, Volume 52, No. 5, Year 2009
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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. © 2009 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Graham, Susan Marie
United States, Seattle
University of Washington
Kenya, Nairobi
University of Nairobi
Kenya, Nairobi
Kenya Medical Research Institute
Canada, Toronto
University of Toronto
Masese, Linnet N.
United States, Seattle
University of Washington
Kenya, Nairobi
University of Nairobi
Gitau, Ruth W.
Kenya, Nairobi
University of Nairobi
Mwakangalu, Dickson
Kenya, Nairobi
University of Nairobi
Jaoko, Walter G.
Kenya, Nairobi
University of Nairobi
Ndinya-Achola, Jeckoniah O.
Kenya, Nairobi
University of Nairobi
Mandaliya, Kishor N.
Canada, Toronto
University of Toronto
Peshu, Norbert M.
Kenya, Nairobi
Kenya Medical Research Institute
Baeten, Jared M.
United States, Seattle
University of Washington
McClelland, Raymond Scott
United States, Seattle
University of Washington
Kenya, Nairobi
University of Nairobi
Kenya, Mombasa
Coast Provincial General Hospital, Kenya
Statistics
Citations: 14
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1097/QAI.0b013e3181b065cf
ISSN:
15254135
Research Areas
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Case-Control Study
Participants Gender
Female