性病门诊患者人类免疫缺陷病毒和单纯疱疹病毒感染的血清学检测

为了解我同性病患者中人类免疫缺陷病毒（ＨＩＶ）和单纯疱疾病毒（ＨＳＶ）感染的流行情况，我们选择了我所性病门诊的病人进行了淋球菌分离培养以及ＨＩＶ和ＨＳＶ感染的血清学检测。结果表明，８８份临床标本淋球菌分离培养阳性率为２８．４％。ＨＳＶ－１和ＨＳＶ－２抗体检出率分别为５９．１％和２５．０％。统计分析结果表明，淋球菌感染和ＨＳＶ－２抗体阳性之间有一定的相关性（Ｐ＜０．０１）。８８份血清标本ＨＩＶ抗体检出率为０．     

STD门诊患者血清HSV－2 IgG抗体检测报告

采用ＥＬＩＳＡ技术检测了８０例ＳＴＤ门诊患者（其中淋病１４例、非特异性泌尿生殖道感染３８例及尖锐湿疣２８例）血清单纯疱疹病毒２型（ＨＳＶ－２）ＩｇＧ抗体。结果发现ＳＴＤ患者血清ＨＳＶ－２ＩｇＧ抗体阳性率为６０．０％，远比正常人群中的２５．３％为高（Ｐ＜０．００１），说明生殖器疱疹病毒感染在我国与西方国家一样，有上升和流行趋势。     

生殖器疱疹的诊断及感染特征探讨

细胞培养法对８０例临床诊断为典型生殖器疱疹的患者进行了人类单纯疱疹病毒（ＨＳＶ）分离，并结合链霉亲和素过氧化物酶免疫组化法（ＬＳＡＢ）及ＰＣＲ法对其中部分患者进行了ＨＳＶ及其型别检查。三种方法的ＨＳＶ检出率分别为５８．８％、２０％、９０％；培养法作为金标准特异性高，对早期患者检出率达８６．４％；ＰＣＲ法与其他两法比较敏感性高，并利于ＨＳＶ型别的诊断；ＬＳＡＢ法对临床标本的检出率虽很低，却可提高培养法的检出率。ＨＳＶ的感染型别ＨＳＶ２占９１．７％、ＨＳＶ１占８．３％。还讨论了ＰＣＲ引物的优点，并总结了本组患者的临床感染特征。     

免疫缺陷性皮肤病

２００００８５３ 热灭活处理对ＨＩＶ抗体检测影响的实验研究／白立石（黑龙江省卫防站）…／／中国性病艾滋病防治．－１９９９，５（４）．－１７０～１７１ 为了寻找更简便有效的实验室安全防范措施，作者对４份ＨＩＶ抗体阳性标本和４份阴性对照标本，通过５６℃３０ｍｉｎ和６５℃热灭活１ｈ的方法分别处理。然后用ＥＬＩＳＡ法、ＰＡ法和ＷＢ检测ＨＩＶ抗体，其结果与不做任何处理的对照组一致。提示检测样品先做热灭活处理，既可以避免实验室ＨＩＶ感染的发生，也不会影响检测结果。表２（杨亚琴）２００００８５４ 河南省艾滋病病…     

STD门诊患者血清HSV—2IgG抗体检测报告

采用ＥＬＩＳＡ技术检测了８０例ＳＴＤ门诊患者（其中淋病１４例、非特异性泌尿生殖道感染３８例及尖锐湿疣２８例）血清单纯疱疹病毒２型）ＨＳＶ－２）ＩｇＧ抗体。结果发现ＳＴＤ患者血清ＨＳＶ－２ＩｇＧ抗体阳性率为６０．０％，远比正常人群中的２５．３％为高（Ｐ＜０．００１），说明生死器疱疹病毒感染在我国与西方国家一样，有上和流行趋势。     

淋病合并弓形虫感染的临床观察

用酶联免疫吸附试验（ＥＬＩＳＡ）及间接血凝试验（ＩＨＡ）对可疑淋病１３７６例及健康大学生５００份血清标本进行了弓形虫特异性抗体检测，总检出率为１．４４％（２７／１８７６），其中淋病组弓形虫抗体平均检出率（３．３３％，１９／５７１）高于非淋病组（０．４９％，４／８０５）和健康组（０．２３％，１／４２６）。差异有显著性意义（Ｘ￣２＝１６．２８，Ｐ＜０．０１，Ｘ￣２＝１１．８７，Ｐ＜０．０１）。提示淋病患者存在合并弓形虫感染的可能性。     

原位聚合酶链反应技术检测结节性红斑皮损中Ⅱ型单纯疱疹...

目的 探讨结节性红斑（ＥＮ）的发病与Ⅱ型单纯疱疹病毒（ＨＳＶ－２）的关系。方法 用原位聚合酶链反应法（ＩＳＰＣＲ）,对３５ＮＥ皮损组织及１４例正常皮肤组织切片中的ＨＳＶ－２ＤＮＡ进行扩增,ＳＰ免疫组化染色,ＡＥＣ显色,结果 ＨＳＶ－２ＤＮＡ在ＥＮ及正常皮肤中的检出率分别为５７．１％（２０／３５）、８．３％（２／１４）,Ｐ〈０．０１,阳性信号主要位于皮损部位,以小血管为著,细胞内的分布以核内型为主,     

649例淋球菌的血清学分型

目的 研究德国海德堡地区１９８５年－１９９０年间淋球菌血清学分型的变化,方法 协同凝集试验,结果 ６４９株淋球菌标本血清学分型检测显示,在已知的２４种特异性蛋白Ａ（ＰＩＡ）和３１种特异性蛋白Ｂ（ＰＩＢ）中分别检出８种和２６种血清型,其中最常见的６种血清型分别为ＩＢ－３（１９．０％）,ＩＢ－４（１６．０％ＩＢ－２（１５．７％）ＩＢ－１（１３．１％ＩＡ－１／２（１１．７％）和ＩＡ－６（３．２％）此外,     

人乳头瘤病毒及癌基因在人生殖器癌发生中的作用

我们对生殖器疣与癌中人乳头瘤病毒型别别分布及癌基因表达进行了研究。结果：（１）９８例生殖哭疣中ＨＰＶ６，１１的检出率为９５％，４３例生殖器癌中ＨＰＶ１６检出率为８８．３％；（２）Ｃ－Ｈａ－ｒａｓ及Ｃｍｙｓ癌基因在阴茎癌及宫颈癌中表达较生殖器疣中均显著增强（Ｐ＜０．００１）；（３）ＨＰＶ６感染病例ｒａｓ，ｍｙｃ基因表达率分别为１６．７％、６．７％，ＨＰＶ１１分别为１０％、２０％、ＨＰＶ１６分别为７０     

沙眼衣原体热休克蛋白60抗体的测定

为了了解泌尿生殖道沙眼衣原体感染者对沙眼衣原体热休克蛋白６０（ＨＳＰ６０）的血清学反应，应用细胞培养、免疫印迹试验和微量免疫荧光试验（ＭＩＦ）对１７５例非淋菌性尿道炎（宫颈炎）（ＮＧＵ）、７３例盆腔炎（ＰＩＤ）、５２例不育症及３６例健康对照者进行检查。３组患者的沙眼衣原体感染率有显著差异（Ｐ＜０．０１）。１７．８％的ＰＩＤ、１３．５％的不育症和１．７％的ＮＧＵ患者出现ＨＳＰ６０抗体，而健康对照组则未检出此抗体（Ｐ＜０．０１）。ＭＩＦ高滴度者（≥１∶１６０）出现ＨＳＰ６０抗体的机率（３１．３％）明显高于低滴度者（＜１∶１６０）（２．８％）（Ｐ＜０．０１）。提示在有并发症的患者中ＨＳＰ６０抗体常见。检测ＨＳＰ６０抗体对预测沙眼衣原体感染慢性发展及并发症的发生有一定意义。     

性病与HIV感染者中HSV2、HBsAg和HCV的检测

目的 比较性病患者和HIV感染者血清中单纯疱疹病毒(HSV)、乙型肝炎病毒(HBV)及丙型肝炎病毒(HCV)的感染情况,为采取综合性的防治方案提供参考依据。方法 对经蛋白印迹法确证的HIV(+)/AIDS库存血清标本和梅毒、淋病及衣原体感染患者血清标本,用ELISA方法同时检测HSV2-IgG、HSV2-IgM、HBsAg和HCV-IgG4项指标,并对2组标本的检测结果进行比较。结果 在76份性病样品中,检出HSV2-IgG24例占31.58%;HSV2-IgM1例占1.32%;HBsAg8例占10.53%和HCV1例占1.32%。在另外分组的14例HIV阳性标本中,检出HSV2-IgG7例占50.00%;HSV2-IgM5例占35.71%;HBsAg8例占57.14%和HCV3例占21.43%。在总共90份标本中,有6例标本同时检测到HSV和HBV;2例标本同时检出HSV-IgM和HBV;2例同时检出上述4项指标。统计分析发现,HIV(+)/AIDS组中HSV、HBV和HCV的检出率明显高于性病组(P<0.05)。结论 HIV(+)/AIDS患者中合并HSV、HBV及HCV的感染率明显高于其他性病患者。     

Secretory IgA against herpes simplex virus in cervical secretions.

A recently developed method to recover proteins from cervical secretions was combined with methods to detect minute concentrations of herpes simplex virus (HSV) type specific antibodies to measure the concentrations of locally produced antibodies in women with genital infections. Forty nine women attending a sexually transmitted disease (STD) clinic were included. Cervical secretions were obtained by suction into a plastic catheter. Soluble proteins were recovered from the secretions by elution with hyperosmolar sodium chloride. A rabbit antibody to human secretory component, which was conjugated to horseradish peroxidase, was used to measure secretory IgA (S-IgA) that was HSV type specific. For comparison, HSV type specific IgG was measured in serum samples from the patients. Of the 49 women, 16 yielded detectable HSV type 2 (HSV 2) S-IgA in secretions. Twelve of them also reacted to the HSV type common antigen, but only five had HSV 2 IgG detectable in their serum. S-IgA against HSV was found in significantly more women with a clinical diagnosis of acute cervicitis than in others. This could be explained by a general increase in local antibody production and immunity triggered by previous contacts with HSV. It is concluded that local mucosal immunity to HSV 2 can be detected in women who do not have a specific humoral antibody response to the virus. For seroepidemiological studies of infection with HSV 2 this local immunity may be considered to be a factor that gives an underestimation of the true incidence of HSV 2 infection.     

性病门诊患者与献血员单纯疱疹病毒Ⅱ型血清抗体的调查报告

目的:了解特定人群单纯疱疹病毒Ⅱ型(HSV-2)的流行情况。方法:用酶联免疫吸附试验(ELISA)检测同期性病门诊患者297例和义务献血员91例血清HSV-2抗体(IgG),其中85例的检测结果用蛋白印迹法(WB)验证。结果:性病门诊患者血清HSV-2阳性率20.88％(62/297);义务献血员血清HSV-2阳性率8.79％(8/91)。WB法验证显示:ELISA法的敏感性与特异性分别为93.33％、97.14％,阳性与阴性预期值各为87.50％、98.55％。结论:江门市性病门诊患者血清HSV-2抗体阳性率明显高于献血员(P<0.01),接近某些西方国家的感染率。     

昆明地区1766例STD门诊就诊者HIV感染状况

目的　了解近年来STD门诊就诊者HIV感染状况。方法　对 1998年～ 2 0 0 2年在本科STD门诊就诊的 1766例患者血液标本进行了抗HIV 2抗体的检测 ,用明胶颗粒凝集试验作初筛试验 ,蛋白印迹检测法作确证试验。结果　检出HIV阳性 16例 ,阳性率 0 .91% ;男女之比为 3∶1;年龄分布在 17～ 56岁之间 ;其中静脉吸毒 9例 ,性传播 5例 ,输血传播 1例 ,可能因使用消毒不合格注射器传播 1例 ;个体经营者及工人感染人数最多 ;文化程度以初中为主 ;HIV阳性者中合并梅毒 1例。结论　HIV感染正从静脉吸毒人群向一般人群传播     

HIV and other sexually transmitted diseases at a rural hospital in Zimbabwe.

OBJECTIVE--To define the epidemiological characteristics of STD patients attending an outpatient clinic in rural Zimbabwe, to examine the aetiologic agents causing infection and to determine their relationship with HIV infection. SUBJECTS--319 men and 146 women, making a sample of about 7% all patients attending an STD clinic during the 3 month study period. Microbiological data were collected from 104 men and 72 women selected randomly from these. Pregnant women were excluded and patients who had received antibiotics within the previous 14 days were excluded from the microbiology sub-sample. SETTING--An outpatient STD clinic at a District Hospital on a major truck route about 300 km north of the capital, Harare. METHODS--All new patients attending the clinic during a 3 month period were enrolled for clinical and epidemiological investigations using a standard procedure. Specimens for microbiological investigation were taken from every second patient seen on the first three days of each week. RESULTS--The typical patient was male (m:f ratio 2.2) aged 20-29 years (68% patients), not married (56% men) and in paid employment (66% men vs. 27% for the district). In men the most common presenting feature was genital ulceration, while in women, discharges were more common. Genital warts were noted frequently in both sexes. In the sub-sample examined microbiologically, H ducreyi was isolated from 46% ulcers clinically diagnosed as chancroid, and motile spirochaetes were detected in 25% painless ulcers. Neither of these were detected in ulcers in women, but HSV antigen was found as frequently in ulcers from men (19%) as from women (17%). In patients with genital discharges, gonococcal infection occurred in 64% men and 17% women, while T vaginalis was isolated from 39% women and only 8% men. Over 60% gonococcal isolates were PPNG, and 18% showed in vitro resistance to tetracycline. Yeasts, mainly C albicans were isolated from 42% women with a discharge and 25% women with ulcers. In men the presence of yeasts was associated with superficial ulceration and itchiness of the glans. Positive HIV-1 serology was found in 64% patients. There was no statistical association with current genital ulcers, though there was an association with previous STD episodes and particularly with serological evidence of syphilis. Apart from yeasts, there was no association between positive HIV-1 serology and the presence of pathogens in the genital tract. CONCLUSIONS--The high prevalence of HIV-1 antibodies in STD patients in Karoi suggests integration of STD and AIDS control programmes to be a necessity. Since paid employment was a common feature of both STD clinic attendance and HIV-1 seropositivity, these programmes may be effectively directed through the work place.     

Clinical profile of STD clinic patients seropositive for HIV antibodies

This article provides clinical profiles for HIV seropositive patients discovered at an STD clinic in Tirupati, India. Considering that sexual contact is the most common mode of transmission of HIV, researchers from the SV Medical College at Tirupati conducted a surveillance for HIV infection among patients attending an STD clinic. From January 1988 to April 1989, the researchers collected serum samples from 2320 patients. 11 people were found to be infected with HIV, 1 of whom exhibited the AIDS Related Complex (ARC). 9 out the HIV-infected patients were 20-30 year-old males categorized as heterosexually promiscuous; the remaining 2 seropositive patients were female prostitutes. The seropositivity rate among heterosexually promiscuous males was 0.58%, and 6.7% among female prostitutes (the total seropositivity rate was 0.47%). Among the HIV-infected patients, the most commonly associated STD was syphilis. 5 of the patients had syphilis alone, and 2 others had syphilis and another STD. One of the HIV-infected patients, a 50 year-old heterosexual male with a history of multiple partners, suffered from a nonhealing genital ulcer and inguinal buboes of 1 month duration. A biopsy of the genital ulcer revealed a pattern consistent with that of granuloma venereum. He also developed angular stomatitis which did not respond to B complex therapy. Furthermore, suffering from persistent lymphadenopathy, weight loss, slight thrombo-cytopenia, an opportunistic infection in the form of oral candidosis and persistent seropositivity for HIV antibodies, the patient was deemed to have the AIDS Related Complex. Tirupati's seropositivity rate of .47% was higher that noticed in other parts of the country, leading the authors call for a plan to investigate the problems of HIV-infected people.     

Increasing relative prevalence of HSV-2 infection among men with genital ulcers from a mining community in South Africa

OBJECTIVES: To determine the aetiology of genital ulcer disease (GUD) and its association with HIV infection in the mining community of Carletonville, South Africa, from two cross sectional surveys of consecutive men presenting with genital lesions during October 1993 to January 1994 and July to November 1998. METHODS: A multiplex polymerase chain reaction (M-PCR) assay combined with amplicon detection was used to identify DNA specific sequences of Treponema pallidum, herpes simplex virus (HSV), and Haemophilus ducreyi. A real time PCR assay was used to differentiate between HSV-1 and HSV-2. RESULTS: M-PCR detected T pallidum, HSV, and H ducreyi in 10.3%, 17.2%, and 69.4% of 232 GUD patients during 1993-4 and in 12.4%, 36.0%, and 50.5% of 186 GUD patients in 1998. The proportion of patients with more than one agent increased significantly from 7.3% (17/232) in 1993-4 to 16.7% (31/186) in 1998 (p <0.01). HSV-2 was detected in a higher proportion of ulcer specimens from HIV infected patients than in specimens from HIV uninfected patients during both time periods (1993-4: 26.2% v 6.7%, p <0.001; 1998: 42.1% v 29.6%, p >0.09). CONCLUSIONS: Based on two cross sectional surveys, 4 years apart, chancroid remained the leading cause of GUD in men who presented at the STD clinic with genital ulcers in the mining community of Carletonville, South Africa. The relative prevalence of primary syphilis has remained low. However, HSV-2 has emerged as a more significant cause of GUD and the proportion of GUD patients infected with more than one agent also increased significantly. HSV-2 DNA was detected in a significantly higher proportion of ulcer specimens from HIV positive patients than from HIV negative patients. No association was found between HIV infection status and the relative prevalence of chancroid or syphilis.     

Prevalence and risk factors for herpes simplex infection among patients at high risk for HIV infection in Brazil

Background Herpes simplex infection is responsible for substantial morbidity in patients with HIV infection. Data from less‐developed countries analyzing risk factors within this population are largely unavailable. Aims Investigate the incidence and seroprevalence of HSV‐1 and HSV‐2 infection in populations at high and low risk for HIV infection. Materials and methods A prospective cohort study was performed in a population at high risk for STDs composed of 170 HIV seronegative male homosexuals and bisexuals (group A). The population at low risk for STDs was composed of 155 volunteer male blood donors (group B). All blood samples were screened using a type specific ELISA to HSV‐1 and HSV‐2 glycoprotein G (gG). Results The prevalence of HSV‐1 and HSV‐2 infection among all the 325 patients was 83.5% and 63.4%, respectively. Annual incidence of HSV‐1 and 2 among group A were 0.053% and 0.08%, respectively. Among group B, the incidence for HSV‐1 was 0.04% and for HSV‐2 was 0.02%. Educational parameters (P<0.001), irregular use of condoms (P<0.001), and percentage of previous receptive anal intercourse (P<0,012) were significantly associated with seropositivity to HSV‐2. About 8.4% of the HSV‐1 seronegative subjects presented recurrence episodes of herpes labialis as well as 7.6% of the HSV‐2 seronegative patients had genital herpes in the past. Discussion The high seroprevalence detected suggests that routine screening for HSV should be performed in populations at high risk for STDs, especially in HIV‐infected patients. Conclusion Educational campaigns, with particular focus on the transmission of HSV, and the regular use of condoms are important measures to reduce the HSV dissemination among patients with less advanced educations and at high risk for STDs.     

珠海市皮肤性病专科门诊就诊人群7种性传播疾病感染分析

目的了解珠海市皮肤性病专科门诊就诊人群性传播疾病(STD)的感染情况,为临床性病的防治提供实验室依据。方法选取珠海市慢性病防治中心2015年至2017年皮肤科、性病科和妇科诊治患者,对沙眼衣原体(CT)、解脲支原体(UU)、人型支原体(MH)、梅毒(TP)、念珠菌(CA)、淋病奈瑟菌(NG)和人类免疫缺陷病毒(HIV)7种病原体(抗体)阳性率情况进行分析,统计分析剔除阳性复诊患者,同时统计分析混合感染和反复感染情况。结果3年共有6862人进行STD不同项目检查,7种病原体检测共有14828项,阳性1963项(13.2%),CT、NG、TP、HIV、UU、MH和CA病原体阳性率分别为14.2%、23.6%、11.1%、2.9%、31.9%、4.8%和17.3%,3年间STD病原体阳性率差异无统计学意义(P>0.05)。不同科室中,妇科送检病原体阳性率最高,为19.2%;不同性别中,女性患者的病原体总阳性率为19.3%,男性为9.8%,两者差异具有统计学意义(P<0.05),但男性CT、NG和HIV阳性率高于女性。患者混合感染率为2.5%,男性混合感染比女性高,但女性反复感染率高于男性。结论专科门诊就诊者7种病原体阳性率较高,女性病原体总阳性率高于男性,女性支原体、念珠菌反复感染现象较普遍,男性泌尿生殖道支原体和念珠菌感染应受到重视。加强对该类人群的性传播疾病的健康教育,引导就诊者进行STD联合筛查,对性传播疾病的防控具有重要意义。     

生殖器部位皮损的单纯疱疹病毒检测及分型

目的 探讨生殖器疱疹部位皮损的不典型表现及其与单纯疱疹病毒型别的关系。方法 对外生殖器部位及其周围有硬结或疖肿、裂隙、毛囊炎等非水疱性皮肤黏膜损害的患者进行临床资料采集和分析,并对皮损标本进行单纯疱疹病毒的分离培养、PCR检测和病毒分型。结果 105例有外生殖器部位非水疱性皮损的患者入选本研究,在硬结(或疖肿)、裂隙、毛囊炎、类似擦破、单个溃疡、非特异性红斑和红肿渗液性包皮龟头炎皮损中,PCR检测HSV的阳性率分别33.3%(6/18)、20%(3/15)、37.5%(6/16)、28.6%(2/7)、33.3%(4/12)、20%(5/25)和50%(6/12),总的检出阳性率为30.5%(32/105)。分离培养法检测HSV的阳性率分别为22.2%(4/18)、13.3%(2/15)、25%(4/16)、14.3%(1/7)、33.3%(4/12)、8%(2/25)和41.7%(5/12),总的检出阳性率为21%(22/105)。两种方法检测HSV的总检出率差异无统计学意义(κ=0.095,P=0.114)。HSV-PCR分型结果与荧光单克隆抗体分型结果相符。在所有HSV阳性者中,HSV-1感染占9.4%(3/32),HSV-2感染占90.6%(29/32)。结论 生殖器HSV感染的皮肤黏膜损害多样,可为外生殖器部位的硬结(疖肿)、裂隙、毛囊炎、类似擦破、单个溃疡、非特异性红斑和红肿渗液性包皮龟头炎等不典型表现,而且主要由HSV-2感染引起。