FQ—PCR与细胞培养检测女性HSV感染者宫颈排泌HSV的对照研究

目的：比较FQ—PCR与细胞培养方法检测无症状生殖器疱疹宫颈排泌HSV的阳性率。方法：用型特异性抗体-2型单纯疱疹病毒糖蛋白G—IgG（HSVgG2-IgG）筛选出阳性女性34例,每例连续2月每月在排卵期和月经前取宫颈拭子,共取材136个。每次取材的拭子分别使用细胞培养鉴定和荧光定量多聚酶反应（Fluorescent quantitation—polymerase chain reaction,FQ—PCR）检测宫颈分泌物中HSV。结果：FQ—PCR方法得到38个拭子阳性,均为HSV-2;细胞培养方法得到4个拭子阳性,经直接免疫荧光分型鉴定为HSV-2。即所有宫颈拭子HSV阳性标本均为HSV-2,无HSV-1。采用Mc-Nemer检验细胞培养与FQ—PCR检测结果阳性率的差异有统计学意义（P〈0．05）,FQ—PCR检测的阳性率比细胞培养法高。结论：对于女性无症状生殖器疱疹,FQ—PCR的方法检测宫颈排泌HSV优于细胞培养方法。     

FQ-PCR检查性罪错妇女阴道和宫颈分泌物沙眼衣原体比较

目的：采用荧光定量PCR(Fluorescent Quantitative PCR，VQ—PCR)检测比较深圳市妇教所的性罪错妇女宫颈分泌物和阴道分泌物沙眼衣原体(CT)阳性率的异同。方法：研究对象为深圳市2002年10月～11月因卖淫而收容教育的120例性罪错妇女，用FQ—PCR检测宫颈分泌物和阴道分泌物CT感染。结果：120例性罪错妇女宫颈分泌物FQ—PCR检查CT感染率为30．8％。阴道分泌物的CT感染率为29．2％；阴道分泌物与宫颈分泌物检测CT阳性率的差异无显著性。结论：阴道分泌物与宫颈分泌物检测CT阳性率的差异无显著性。应用荧光定量PCR检测时可用阴道拭子取材。     

沙眼衣原体感染与盆腔炎的相关性研究

采用连接酶链反应法(LCR)对68例盆腔炎和40例健康已婚女性(对照组)进行宫颈分泌物标本的Ct检查,以探讨Ct感染与盆腔炎的关系。盆腔炎组宫颈分泌物中Ct阳性检出率明显高于对照组,证明Ct是盆腔炎的重要致病因素。     

重庆地区妇科门诊沙眼衣原体、解脲支原体的检测及分析

目的：了解重庆地区疑有泌尿生殖道感染的女性患者沙眼衣原体(Ct)、解脲支原体(Uu)的感染情况。方法：运用荧光探针PCR法(FQ—PCR)对妇科门诊453例疑为泌尿生殖道感染患者同时进行Ct和Uu检测。结果：Ct阳性感染者39例，阳性率8．61％；Uu阳性感染者26例，阳性率5．74％，其中仅有2例Ct和Uu同时阳性，各年龄段之间阳性率无显著差异。结论：(1)重庆地区Ct和Uu感染在妇科病人中占有一定比例，值得重视；(2)荧光PCR技术检测Ct和Uu具有操作简单、反应时间短、结果客观准确、敏感性和特异性好的优点，适宜门诊初查。     

STD5种病原体同时检测的意义

应用聚合酶链反应（PCR）技术对66例高危人群进行CT、UU、NG、HPV、HSV检测，结果显示5种病原体的阳性率依次为CT28．79％、UU28．79％、NG16．67％、HPV12．12％、HSV4．54％，其中11例有混合感染。同时显示PCR具有一次性检测多种病原体，且简便、敏感、特异的优点。     

生殖器疱疹患者尿道和宫颈HSV感染的研究

目的：了解生殖器疱疹（GH）患者伴发宫颈和男性尿道单纯疱疹病毒（HSV）感染情况，进一步探讨HSV和非淋菌性尿道炎／官颈炎（NGU）的关系。方法：用HSV聚合酶链反应（PCR）方法检测了56例GH患者的宫颈和男性尿道拭子标本。结果：56例患者中HSV PCR检测阳性共5例，阳性率为8．93％（5／56）。20例女性生殖器疱疹患者宫颈HSV PCR检测阳性率为25．0％（5／20）；36例男性GH患者尿道HSV PCR检测结果均为阴性。结论：生殖器疱疹患者伴发女性宫颈HSV感染更为常见，而伴发男性尿道HSV感染相对少见。HSV感染可能是非淋菌性尿道炎／宫颈炎的一个致病因子，在女性宫颈炎的发病中可能更有意义。     

尿道(阴道)炎1693例病原体分析

1994年10月1日～1996年4月30日，性病门诊应用聚合酶链反应（PCR），对尿道（阴道）炎初诊者1693例（男1002例，女691例）进行沙眼衣原体（CT）、解脲支原体（UU）及淋球菌（NG）检查，部分病树结合临床情况，必要时加检单纯疱疹病毒（HSV）或乳头瘤病毒6／11型（HPV）。PCR试剂盒：CT、UU、NG、HSV系华美生物工程公司产品，HPV系上海复垦生物工程中心产品，严格按各试剂盒说明书操作。结果：（1）1693例中，检出CT540例（检出率31．90％），UU454例（26．82％），NG152例（8．98％）。三种病原体的性别分布：CT男检出率30…     

宫颈癌组织中人乳头瘤病毒以及单纯疱疹病毒感染的检测

目的研究人乳头瘤病毒(HPV)以及单纯疱疹病毒(HSV)以及HPV各型别在宫颈癌变中的作用。方法采用PCR方法对宫颈癌和正常宫颈组织HPV、HSV的DNA进行检测,并应用限制性内切酶片段长度多态性方法对HPVDNA进行分型。结果宫颈癌标本HPV的检出率为58.33%,正常宫颈组织标本HPV检出率10.71%。宫颈癌组织中检测到的HPV型别以HPV16、HPV18为主。宫颈癌组织标本中HSV检出率28.33%,正常宫颈组织标本7.14%。宫颈癌组织标本中,HSV与HPV感染可能有相关性。结论HPV感染与宫颈癌变有密切关系,以HPV16和HPV18为主。HSV可能作为HPV协同因子在宫颈癌变过程中发挥作用。     

927例疑似生殖器疱疹患者单纯疱疹病毒抗原检测结果分析

目的：了解生殖器疱疹疑似患者单纯疱疹病毒(HSV)抗原的检测情况。方法：应用ELISA法，对不同皮损(包括疱液、宫颈糜烂、溃疡及结痂)，以及宫颈拭子、尿道拭子进行HSV抗原检测。结果：生殖器疱液、宫颈糜烂、溃疡及结痂、尿道拭子、宫颈分泌物的阳性率分别为62．1％，45．6％，40．5％，7．2％，4．2％。结论：疱液阳性率最高，对患者出现水疱时应进行检测，可提高检出率，宫颈糜烂面阳性率达45．6％，提示女性宫颈糜烂面取材是检测HSV重要取材部位。     

女性尖锐湿疣患者宫颈人乳头瘤状病毒和沙眼衣原体感染的流行病学调查

目的:总结性病门诊女性尖锐湿疣(CA)患者并发泌尿生殖道沙眼衣原体(Ct)的流行病学资料,了解该组患者宫颈有无人乳头瘤状病毒(HPV)感染及HPV基因分型。方法:收集确诊为尖锐湿疣的女性宫颈脱落细胞样本,检测HPV DNA分型及Ct的DNA。结果:123例女性CA患者宫颈样本中HPV、Ct及共同感染率分别是88.6%(109/123)、22.7%(20/88)及22.7%(20/88)。其中高危型HPV感染者占75.6%(93/123),最常见的亚型为HPV-16、52、18、51、58。65.0%(80/123)表现为混合HPV感染;13.0%(16/123)仅为低危HPV感染;10.6%(13/123)仅为高危HPV感染。结论:该组22.7%的CA女性患者宫颈并发Ct感染,88.6%并发宫颈HPV感染,其中高危型达75.6%。在CA女性患者中开展Ct及宫颈HPV检测很有必要。     

深圳市性滥妇女性传播感染调查分析

目的：了解深圳市公安局收容教育所性滥妇女性传播感染(STI)情况。方法：收集整理1998～2002年10月深圳市某监测点性滥妇女体检资料及实验室检测资料，并作流行病学分析。结果：在6673例性滥妇女中，共检出性病1396例，检出率为20．92％。其中梅毒检出例数最多，尖锐湿疣、NGU、淋病等次之。结论：性滥妇女性病检出率高，是性病传播的主要传染源，也是性病防治的重点人群，梅毒是当前该地区应重点监控的病种。     

New sexually transmitted infections among adolescent girls infected with HIV

OBJECTIVES: Although the prevalence of sexually transmitted infections (STIs) among girls infected with HIV has been reported, the incidence of STI diagnoses has not been well documented. The objectives of this study were to examine (1) incident STI diagnoses and (2) the association between viral load (VL) and incident STI diagnosis among HIV-infected adolescent girls in care. METHODS: This was a prospective longitudinal 18-month study of girls enrolled in the Adolescent HIV trials network. Cox proportional hazard modelling was performed to evaluate the incidence of STI by baseline viral load. RESULTS: The mean (SD) age of participants was 20.6 (2.0) years, viral load of participants was 66,917 (165,942) copies/ml and median viral load was 7,096 copies/ml. The incidence of STIs for the entire cohort was 1.4 per 100 person-months. During the 18-month follow-up period, there were no significant differences in the STI incidence between the high and low viral load groups (hazard ratio (HR) = 0.86, 95% CI 0.37 to 1.95) There was also no significant association between STI incidence and log-transformed viral load (HR = 1.10, 95% CI 0.92 to 1.3). CONCLUSIONS: Adolescent girls with HIV infection continue to acquire sexually transmitted infections after diagnosis. This analysis does not suggest that VL is a critical factor in STI acquisition over time. Additional work exploring the role of other contextual factors on STI acquisition among HIV-infected adolescent girls is warranted.     

Sex partner concurrency, geographic context, and adolescent sexually transmitted infections

BACKGROUND: Geographic areas characterized by a high prevalence of sexually transmitted infections (STIs) are critical to the maintenance and persistence of STIs within populations. Sex partner concurrency has been shown to be associated with increased risk for individual-level STIs. OBJECTIVES: The objectives of this study were to determine whether gonorrhea rate per census block group and sex partner concurrency independently and interactively are associated with a current bacterial STI among adolescents. STUDY: Face-to-face interviews and urine testing for Chlamydia trachomatis and Neisseria gonorrhoeae were conducted among female, sexually active, 14- to 19-year-olds presenting for reproductive clinic care between August 2000 and June 2002. RESULTS: Gonorrhea rate per census block group and sex partner concurrency were not independently but were interactively associated with a current bacterial STI. Among participants with a main sex partner who practiced concurrency, living in high-prevalence geographic areas was significantly associated with a current bacterial STI. CONCLUSIONS: The results suggest that geographic context may moderate an adolescent sex partner's behaviors. The research adds to the basic understanding of sexually transmitted disease transmission and acquisition in a high-prevalence inner-city setting.     

Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men

BACKGROUND: Since 1996, there has been a resurgence in sexually transmitted infections (STIs) among men who have sex with men (MSM) in Western Europe. This has coincided with a significant decrease in HIV-associated mortality following the introduction of highly active antiretroviral therapies (HAART) and a corresponding increase in the number of MSM living with HIV. Levels of unprotected anal intercourse have also increased. In this article, we use STI surveillance data from a number of Western European countries to better understand the contribution of HIV-positive MSM to the recent increase in STIs. METHODS: Published literature, surveillance reports, and ad hoc publications relating to HIV prevalence trends and STIs among HIV-positive MSM in Western Europe were reviewed. RESULTS: Post-HAART, HIV prevalence among community samples of MSM ranged from 5% to 18%. HIV prevalence among MSM diagnosed with an STI was substantially higher. On average, HIV prevalence among MSM diagnosed with syphilis in 11 countries was 42% (range 14%-59%). Most HIV-positive MSM with syphilis were aware of their HIV status. In England and Wales, 32% of MSM with gonorrhea were HIV-positive in 2004. Outbreaks of lymphogranuloma venereum have been documented in 9 countries; HIV-positive MSM accounted for 75% of cases on average (range 0%-92%). Cases of sexually transmitted hepatitis C have been predominantly identified among HIV-positive MSM in Rotterdam, Paris, Amsterdam, and the United Kingdom. CONCLUSIONS: In Western Europe, STIs have been disproportionately diagnosed among HIV-positive MSM post-HAART. Improved survival coupled with serosorting among HIV-positive MSM appears to explain the high prevalence of HIV among MSM with STIs. STI transmission among HIV-positive men will have contributed substantially to increasing STI trends seen among MSM in Western Europe, since 1996. These findings highlight the need for routine STI testing among HIV-positive MSM as well as safer sex messages highlighting the implications of STI coinfection.     

Prevalence of sexually transmitted infections and high-risk sexual behaviors in heterosexual couples attending sexually transmitted disease clinics in Peru

OBJECTIVES: The objectives of this study were to determine the prevalence of sexually transmitted infection (STIs) in heterosexual couples and the sexual behaviors associated with their acquisition. GOAL: The goal of this study was to better direct educational efforts to decrease STI among heterosexual couples in Lima, Peru. STUDY DESIGN: We conducted a case-control study in 195 heterosexual couples without HIV infection who attended 2 sexually transmitted disease clinics in Lima, Peru. A case was defined as an individual with one or more newly diagnosed STIs such as gonorrhea, chlamydia, trichomoniasis, herpes simplex, syphilis, mycoplasma, or ureaplasma. RESULTS: Thirty-three percent of individuals (41 men and 89 women) had at least one STI and 26 couples (13%) had the same STI detected. Men who have sex with men (MSM) accounted for 13% of all men, had higher rate of STIs and higher risk behaviors than non-MSM. Ureaplasma infection was the most prevalent STI found in both men and women and was associated with oral sexual contact. In heterosexual pairs, condom use during anal sex occurred less than 10% of the time. CONCLUSIONS: The heterosexual couples in sexually transmitted disease clinics have high-risk behaviors and STIs are frequent. The educational effort concerning prevention of STIs requires higher effort.     

Sexually transmitted infections and risk factors among truck stand workers in Dhaka, Bangladesh

OBJECTIVE: This study was conducted to determine the prevalence of selected sexually transmitted infections (STIs) and their risk factors among workers in and near a truck stand in Dhaka, Bangladesh. STUDY DESIGN: A random sample of 696 men and 206 women were recruited into a cross-sectional study using a census that enumerated transport agents, motor mechanics, laborers, and vendors in Tejgaon truck stand. RESULTS: The prevalence rates of syphilis (rapid plasma reagin and Treponema pallidum hemagglutination), gonorrhea (polymerase chain reaction [PCR]), and chlamydial infections (PCR) among men were 4.1%, 7.7%, and 2.3%, respectively, and among women were 2.9%, 8.3%, and 5.2%. Multivariable analysis revealed that having >or=2 sex partners in the last month, never using a condom with sex workers, and ever injecting narcotics were significant predictors of STI among men. Being never married, working as a laborer, older age, and living within the truck stand were significant predictors of practicing high-risk behaviors among men, but none predicted infection with STIs. CONCLUSIONS: Both behavioral and STI data suggest that truck stand workers should be included in the STI/HIV intervention programs.     

High prevalence of HIV and sexually transmitted infections among indirect sex workers in Cambodia

OBJECTIVES: The goal of this study was to assess the baseline prevalence of and risk factors for HIV and other sexually transmitted infections (STIs) among beer girls enrolled in a behavioral intervention in Battambang, Cambodia. METHODS: Ninety-two of 114 women participated in baseline interviewing, HIV/STI testing, and STI treatment. Blood specimens were tested for syphilis and HIV infection. Self-administered vaginal swabs were tested for trichomonas, bacterial vaginosis (BV), gonorrhea, and chlamydia infections. RESULTS: HIV prevalence was 26%. STI prevalences were: 14% chlamydia, 12% trichomonas, 3% gonorrhea, and 0% syphilis. The prevalence of BV was 43%. A history of sex work was reported by 82%. Consistent condom use with clients was reported by 39%. Increased number of partners and symptoms of STI were significantly associated with HIV infection. DISCUSSION: These data suggest high sexual risk among beer girls in Cambodia. Targeted and frequent HIV and STI interventions are urgently needed in this population.     

Vaginal douching, condom use, and sexually transmitted infections among Chinese female sex workers

BACKGROUND AND OBJECTIVE: Vaginal douching has been hypothesized to increase a woman's risk for human immunodeficiency virus (HIV) infection. However, data on the prevalence of this practice and its association with condom use and sexually transmitted infections (STIs) are limited. STUDY: A cross-sectional survey among 454 female sex workers (FSWs) in a Chinese county. RESULTS: Vaginal douching was reported by 64.7% of the women. The prevalence of self-reported history of STI and that of current STI was 19.4% and 41.5%, respectively. Fifteen percent of the women reported consistent use of condoms with their clients and 8.4% with their regular partners. Vaginal douching was significantly associated with decreased use of condoms (with clients: OR = 0.31; with regular partner(s): OR = 0.22) and increased rate of self-reported STI history (OR = 1.95). However, there was no direct relation between douching and current STI. Over one third of the women believed that douching can prevent STI/HIV. CONCLUSION: Vaginal douching exposes FSWs to a high risk of STI/HIV. Medical professional and public health workers should correct women's misconception about the effectiveness of douching and discourage women from douching through educational activities.     

性病门诊男性就诊者性病感染现状及艾滋病知晓率影响因素分析

目的:了解性病门诊男性就诊者性病感染的现状,分析影响其艾滋病知识的因素,为下一步开展针对性的干预提供科学依据。方法:采用方便抽样的方式,利用问卷调查来进行数据收集,问卷内容包括病人的一般人口学特征、艾滋病知识、性病感染状态等。结果:研究共纳入456名就诊者,平均年龄为(34.06±11.40)岁;HIV感染率为3.29%,尖锐湿疣感染率为16.23%,生殖器疱疹为6.80%,生殖道沙眼衣原体为5.48%,淋病为4.17%,梅毒为3.95%;26.75%的就诊者仅感染1种性病,2.41%的就诊者同时感染2种,0.44%就诊者同时感染4种,0.66%同时感染5种,无就诊者同时感染3种性病。艾滋病知识知晓率仅为37.94%,教育程度低、年龄较大、已婚、月收入低和未接受过健康教育的就诊者艾滋病知识知晓率低。结论:应加强性病门诊男性就诊者各种性病的筛查,为其提供一整套规范化的诊疗服务,同时加强重点人群健康宣教,做好重点人群性病艾滋病的一级预防。     

The burden and determinants of reproductive tract infections in India: a population based study of women in Goa, India

BACKGROUND/ OBJECTIVE: Reproductive tract infections (RTI) present major health, social, and economic problems in developing countries. Our objective was to describe the prevalence and risk factors of RTIs in a population based sample of women aged 18-45 years. METHOD: 2494 women of 3000 randomly selected from the population defined by a primary health centre catchment area consented to participate. Participants were interviewed regarding complaints and risk factors. Laboratory specimens were collected for the diagnosis of RTIs. Analyses of risk factors were carried out separately for the outcomes of sexually transmitted infections: chlamydia, gonorrhoea, trichomoniasis; and endogenous infections: bacterial vaginosis (BV) and candida. RESULTS: Endogenous infections were relatively common (BV 17.8%; candida 8.5%), and sexually transmitted infections (STI) were infrequent (4.2%). Factors indicative of poverty and marginalisation were associated with STIs and BV. Gender disadvantage, particularly spousal violence, was associated with BV, while concern about a husband's extramarital relationships, an indicator of sexual risk, was associated with STI. Husband's discharge was strongly associated with STI, and a non-white vaginal discharge was associated with both STI and BV. Condom use and oral contraceptive use were associated with a reduced risk of BV. CONCLUSIONS: Most of the population burden of RTIs is attributed to endogenous infections. Socioeconomic deprivation and gender disadvantage are associated with raised risk for BV, while the risk factors for STIs indicated that disadvantaged women were likely to be infected by their husbands.