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Foreskin inflammation is associated with HIV and herpes simplex virus type-2 infections in Rakai, Uganda

We assessed foreskin inflammation associated with HIV and herpes simplex virus type 2 (HSV-2) in circumcised men. Foreskin tissues were assessed in 97 HIV-infected and 135 HIV-uninfected men enrolled in randomized trials of circumcision in Rakai, Uganda. Inflammation was quantified using an ordinal... Full description

Journal Title: AIDS (London) 2009, Vol.23 (14), p.1807-1815
Main Author: JOHNSON, Kristine E
Other Authors: SHERMAN, Mark E , RABKIN, Charles S , GRAY, Ronald H , SSEMPIIJA, Victor , TOBIAN, Aaron A. R , ZENILMAN, Jonathan M , DUGGAN, Maire A , KIGOZI, Godfrey , SERWADDA, David , WAWER, Maria J , QUINN, Thomas C
Format: Electronic Article Electronic Article
Language: English
Subjects:
HIV
Publisher: Hagerstown, MD: Lippincott Williams & Wilkins
ID: ISSN: 0269-9370
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2752438
title: Foreskin inflammation is associated with HIV and herpes simplex virus type-2 infections in Rakai, Uganda
format: Article
creator:
  • JOHNSON, Kristine E
  • SHERMAN, Mark E
  • RABKIN, Charles S
  • GRAY, Ronald H
  • SSEMPIIJA, Victor
  • TOBIAN, Aaron A. R
  • ZENILMAN, Jonathan M
  • DUGGAN, Maire A
  • KIGOZI, Godfrey
  • SERWADDA, David
  • WAWER, Maria J
  • QUINN, Thomas C
subjects:
  • Adolescent
  • Adult
  • AIDS/HIV
  • Article
  • Balanitis - epidemiology
  • Balanitis - pathology
  • Balanitis - virology
  • Biological and medical sciences
  • circumcision
  • Circumcision, Male
  • Disease transmission
  • Epithelium
  • foreskin
  • Foreskin - pathology
  • Herpes Genitalis - complications
  • Herpes Genitalis - epidemiology
  • Herpes Genitalis - pathology
  • Herpes simplex virus 2
  • herpes simplex virus type 2
  • HIV
  • HIV Infections - complications
  • HIV Infections - epidemiology
  • HIV Infections - pathology
  • HIV Infections - virology
  • HIV-1 - isolation & purification
  • Human immunodeficiency virus
  • Human viral diseases
  • Humans
  • Immunodeficiencies
  • Immunodeficiencies. Immunoglobulinopathies
  • Immunopathology
  • Infection
  • Infectious diseases
  • Inflammation
  • Male
  • Medical sciences
  • Middle Aged
  • Sexual Partners
  • Stroma
  • Uganda
  • Uganda - epidemiology
  • Viral diseases
  • Viral diseases of the lymphoid tissue and the blood. Aids
  • Viral Load
  • Young Adult
ispartof: AIDS (London), 2009, Vol.23 (14), p.1807-1815
description: We assessed foreskin inflammation associated with HIV and herpes simplex virus type 2 (HSV-2) in circumcised men. Foreskin tissues were assessed in 97 HIV-infected and 135 HIV-uninfected men enrolled in randomized trials of circumcision in Rakai, Uganda. Inflammation was quantified using an ordinal score evaluating extent, intensity, and cellular composition of infiltrates in the epithelium and stroma. Prevalence rate ratios of inflammation were estimated by multivariate Poisson regression. Foreskin inflammation was primarily focal. Epithelial inflammation was present in 4.2% of men with neither HIV nor HSV-2 infection; 7.8% of men with only HSV-2; 19.0% with HIV alone (P = 0.04); and 31.6% in HIV/HSV-2 coinfected men [prevalence rate ratio (PRR) 7.5, 95% confidence interval (CI) 2.3-23.8, P < 0.001]. Stromal inflammation was present in 14.1% of HIV/HSV-2 uninfected men, compared with 29.7% in men with HSV-2 alone (P = 0.03), 33.3% in men with HIV alone (P = 0.04), and 61.0% in men with HIV/HSV-2 coinfection (PRR 4.3, 95% CI 2.3-7.9, P < 0.001). In HIV-infected men, epithelial inflammation was associated with higher HIV viral load. Epithelial inflammation was more frequent among men reporting recent genital ulceration. Both epithelial and stromal inflammation were more common among men with smegma on physical examination. Foreskin inflammation is increased with HIV and HSV-2 infections, higher HIV viral load and presence of smegma. Foreskin inflammation may have implications for HIV transmission and acquisition in uncircumcised men.
language: eng
source:
identifier: ISSN: 0269-9370
fulltext: no_fulltext
issn:
  • 0269-9370
  • 1473-5571
url: Link


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titleForeskin inflammation is associated with HIV and herpes simplex virus type-2 infections in Rakai, Uganda
creatorJOHNSON, Kristine E ; SHERMAN, Mark E ; RABKIN, Charles S ; GRAY, Ronald H ; SSEMPIIJA, Victor ; TOBIAN, Aaron A. R ; ZENILMAN, Jonathan M ; DUGGAN, Maire A ; KIGOZI, Godfrey ; SERWADDA, David ; WAWER, Maria J ; QUINN, Thomas C
creatorcontribJOHNSON, Kristine E ; SHERMAN, Mark E ; RABKIN, Charles S ; GRAY, Ronald H ; SSEMPIIJA, Victor ; TOBIAN, Aaron A. R ; ZENILMAN, Jonathan M ; DUGGAN, Maire A ; KIGOZI, Godfrey ; SERWADDA, David ; WAWER, Maria J ; QUINN, Thomas C
descriptionWe assessed foreskin inflammation associated with HIV and herpes simplex virus type 2 (HSV-2) in circumcised men. Foreskin tissues were assessed in 97 HIV-infected and 135 HIV-uninfected men enrolled in randomized trials of circumcision in Rakai, Uganda. Inflammation was quantified using an ordinal score evaluating extent, intensity, and cellular composition of infiltrates in the epithelium and stroma. Prevalence rate ratios of inflammation were estimated by multivariate Poisson regression. Foreskin inflammation was primarily focal. Epithelial inflammation was present in 4.2% of men with neither HIV nor HSV-2 infection; 7.8% of men with only HSV-2; 19.0% with HIV alone (P = 0.04); and 31.6% in HIV/HSV-2 coinfected men [prevalence rate ratio (PRR) 7.5, 95% confidence interval (CI) 2.3-23.8, P < 0.001]. Stromal inflammation was present in 14.1% of HIV/HSV-2 uninfected men, compared with 29.7% in men with HSV-2 alone (P = 0.03), 33.3% in men with HIV alone (P = 0.04), and 61.0% in men with HIV/HSV-2 coinfection (PRR 4.3, 95% CI 2.3-7.9, P < 0.001). In HIV-infected men, epithelial inflammation was associated with higher HIV viral load. Epithelial inflammation was more frequent among men reporting recent genital ulceration. Both epithelial and stromal inflammation were more common among men with smegma on physical examination. Foreskin inflammation is increased with HIV and HSV-2 infections, higher HIV viral load and presence of smegma. Foreskin inflammation may have implications for HIV transmission and acquisition in uncircumcised men.
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subjectAdolescent ; Adult ; AIDS/HIV ; Article ; Balanitis - epidemiology ; Balanitis - pathology ; Balanitis - virology ; Biological and medical sciences ; circumcision ; Circumcision, Male ; Disease transmission ; Epithelium ; foreskin ; Foreskin - pathology ; Herpes Genitalis - complications ; Herpes Genitalis - epidemiology ; Herpes Genitalis - pathology ; Herpes simplex virus 2 ; herpes simplex virus type 2 ; HIV ; HIV Infections - complications ; HIV Infections - epidemiology ; HIV Infections - pathology ; HIV Infections - virology ; HIV-1 - isolation & purification ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infection ; Infectious diseases ; Inflammation ; Male ; Medical sciences ; Middle Aged ; Sexual Partners ; Stroma ; Uganda ; Uganda - epidemiology ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Viral Load ; Young Adult
ispartofAIDS (London), 2009, Vol.23 (14), p.1807-1815
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1SHERMAN, Mark E
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5TOBIAN, Aaron A. R
6ZENILMAN, Jonathan M
7DUGGAN, Maire A
8KIGOZI, Godfrey
9SERWADDA, David
10WAWER, Maria J
11QUINN, Thomas C
title
0Foreskin inflammation is associated with HIV and herpes simplex virus type-2 infections in Rakai, Uganda
1AIDS (London)
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descriptionWe assessed foreskin inflammation associated with HIV and herpes simplex virus type 2 (HSV-2) in circumcised men. Foreskin tissues were assessed in 97 HIV-infected and 135 HIV-uninfected men enrolled in randomized trials of circumcision in Rakai, Uganda. Inflammation was quantified using an ordinal score evaluating extent, intensity, and cellular composition of infiltrates in the epithelium and stroma. Prevalence rate ratios of inflammation were estimated by multivariate Poisson regression. Foreskin inflammation was primarily focal. Epithelial inflammation was present in 4.2% of men with neither HIV nor HSV-2 infection; 7.8% of men with only HSV-2; 19.0% with HIV alone (P = 0.04); and 31.6% in HIV/HSV-2 coinfected men [prevalence rate ratio (PRR) 7.5, 95% confidence interval (CI) 2.3-23.8, P < 0.001]. Stromal inflammation was present in 14.1% of HIV/HSV-2 uninfected men, compared with 29.7% in men with HSV-2 alone (P = 0.03), 33.3% in men with HIV alone (P = 0.04), and 61.0% in men with HIV/HSV-2 coinfection (PRR 4.3, 95% CI 2.3-7.9, P < 0.001). In HIV-infected men, epithelial inflammation was associated with higher HIV viral load. Epithelial inflammation was more frequent among men reporting recent genital ulceration. Both epithelial and stromal inflammation were more common among men with smegma on physical examination. Foreskin inflammation is increased with HIV and HSV-2 infections, higher HIV viral load and presence of smegma. Foreskin inflammation may have implications for HIV transmission and acquisition in uncircumcised men.
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2AIDS/HIV
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5Balanitis - pathology
6Balanitis - virology
7Biological and medical sciences
8circumcision
9Circumcision, Male
10Disease transmission
11Epithelium
12foreskin
13Foreskin - pathology
14Herpes Genitalis - complications
15Herpes Genitalis - epidemiology
16Herpes Genitalis - pathology
17Herpes simplex virus 2
18herpes simplex virus type 2
19HIV
20HIV Infections - complications
21HIV Infections - epidemiology
22HIV Infections - pathology
23HIV Infections - virology
24HIV-1 - isolation & purification
25Human immunodeficiency virus
26Human viral diseases
27Humans
28Immunodeficiencies
29Immunodeficiencies. Immunoglobulinopathies
30Immunopathology
31Infection
32Infectious diseases
33Inflammation
34Male
35Medical sciences
36Middle Aged
37Sexual Partners
38Stroma
39Uganda
40Uganda - epidemiology
41Viral diseases
42Viral diseases of the lymphoid tissue and the blood. Aids
43Viral Load
44Young Adult
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titleForeskin inflammation is associated with HIV and herpes simplex virus type-2 infections in Rakai, Uganda
authorJOHNSON, Kristine E ; SHERMAN, Mark E ; RABKIN, Charles S ; GRAY, Ronald H ; SSEMPIIJA, Victor ; TOBIAN, Aaron A. R ; ZENILMAN, Jonathan M ; DUGGAN, Maire A ; KIGOZI, Godfrey ; SERWADDA, David ; WAWER, Maria J ; QUINN, Thomas C
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8circumcision
9Circumcision, Male
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21HIV Infections - epidemiology
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28Immunodeficiencies
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30Immunopathology
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35Medical sciences
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37Sexual Partners
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40Uganda - epidemiology
41Viral diseases
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abstractWe assessed foreskin inflammation associated with HIV and herpes simplex virus type 2 (HSV-2) in circumcised men. Foreskin tissues were assessed in 97 HIV-infected and 135 HIV-uninfected men enrolled in randomized trials of circumcision in Rakai, Uganda. Inflammation was quantified using an ordinal score evaluating extent, intensity, and cellular composition of infiltrates in the epithelium and stroma. Prevalence rate ratios of inflammation were estimated by multivariate Poisson regression. Foreskin inflammation was primarily focal. Epithelial inflammation was present in 4.2% of men with neither HIV nor HSV-2 infection; 7.8% of men with only HSV-2; 19.0% with HIV alone (P = 0.04); and 31.6% in HIV/HSV-2 coinfected men [prevalence rate ratio (PRR) 7.5, 95% confidence interval (CI) 2.3-23.8, P < 0.001]. Stromal inflammation was present in 14.1% of HIV/HSV-2 uninfected men, compared with 29.7% in men with HSV-2 alone (P = 0.03), 33.3% in men with HIV alone (P = 0.04), and 61.0% in men with HIV/HSV-2 coinfection (PRR 4.3, 95% CI 2.3-7.9, P < 0.001). In HIV-infected men, epithelial inflammation was associated with higher HIV viral load. Epithelial inflammation was more frequent among men reporting recent genital ulceration. Both epithelial and stromal inflammation were more common among men with smegma on physical examination. Foreskin inflammation is increased with HIV and HSV-2 infections, higher HIV viral load and presence of smegma. Foreskin inflammation may have implications for HIV transmission and acquisition in uncircumcised men.
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pubLippincott Williams & Wilkins
pmid19584700
doi10.1097/QAD.0b013e32832efdf1
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