1/4. Primary syphilis remains a cause of oral ulceration.After many years the incidence of infective syphilis (infection with treponema pallidum) is increasing in the United Kingdom. This may reflect changes in sexual attitudes and behaviour, altering trends in hiv disease, and increased foreign travel. Oral disease as a consequence of primary syphilis is rare. The present report details two patients presenting to an oral medicine clinic in london, within a 6-month period in 1999, with oral ulceration as their only clinical manifestation of undiagnosed primary syphilis. The oral aspects of early syphilis and the need for dentists to be aware of changing epidemiological trends in relevant infectious diseases are highlighted.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/4. Multiple sexually acquired diseases occurring concurrently in an hiv positive man: case report, diagnosis and management.A case of an hiv positive man with multiple sexually acquired disease occurring concurrently is described. Risk behaviours that could have predisposed him to hiv infection are discussed. The factors which might have interacted to make the sexually acquired infections severe and difficult to treat are postulated.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
3/4. Acute hepatitis c in hiv-infected men who have sex with men.BACKGROUND: hepatitis c virus (HCV) is usually transmitted via the parenteral route, but there are widely discrepant findings on its possible sexual transmission. Thus there are no recommendations concerning protected sex for couples in which only one partner is HCV-infected. Whether hiv or other sexually transmitted diseases could favour HCV transmission remains unclear, but recent data suggesting an increasing incidence of acute HCV in hiv-infected men underline the major public health implications of this issue. case reports: Between June 2002 and July 2003, five hiv-infected homosexually active men presented with primary (n=4) and secondary (n=1) syphilis and concomitant abnormal liver function tests revealing acute asymptomatic HCV seroconversion. Other causes of acute viral hepatitis were inquired into and excluded. Highly at-risk sexual behaviour, including unprotected anal intercourse and unsafe oral sex, with concomitant syphilis, was found to be the only identifiable important risk factor for transmission of HCV. CONCLUSIONS: Sexual transmission may be fuelling a significant increase in HCV seroconversions among hiv-infected men who have highly risky sexual behaviours. Given the recent data suggesting the spread of sexually transmitted infections among hiv-infected gay men, specific recommendations concerning safe sex are urgently needed.- - - - - - - - - - ranking = 2keywords = behaviour (Clic here for more details about this article) |
4/4. The syphilis-hiv interdependency.Resurgence in the incidence of hiv and syphilis infections has been reported from all Western European Countries and the USA during the past years, the majority of them in men who have sex with men. The attitude among hiv-positive patients towards the application of preventive measures is changing in comparison to the time immediately after the detection of the hiv. Furthermore, hiv care providers do not always talk in an open manner about safer sex and disclosure, with the result that a large group of patients regards oral sex as harmless with respect to the transmission of sexually transmitted diseases (STDs). We illustrate this context by the case presented. Since both hiv and syphilis represent risk factors for the transmission of further STDs, their interdependency must be interrupted by promotion of early and effective STD-related health-care behaviours.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |