Co-infections and sero-prevalence of HIV, syphilis, hepatitis B and c infections in sexually transmitted infections clinic attendees of tertiary care hospital in north India

Background: HIV, syphilis, hepatitis B and C [HBV and HCV] infections modify the epidemiology and presentation of each other. This study aimed to estimate the seroprevalence of these infections and their co-infections in sexually transmitted infections ]STI] clinic attendees in New Delhi, India

Methods: A retrospective study including 220 patients was conducted during May 2014 through December 2014. Serodiagnosis of HIV was performed as per Strategy III of NACO guidelines; syphilis by VDRL followed by TPHA; HBV and HCV by rapid immuno-chromatographic test followed by ELISA

Results: Male subjects were slightly more in number as compared to females [56.36% vs. 43.63%]. Twelve [5.45%], 14 [6.36%], three [1.36 %] and one [0.45%] were reactive for HIV, VDRL, HBV and HCV, respectively. Three were both HIV and syphilis positive and one was both HIV and HBV positive; no co-infections of HBV/HCV, HIV/HBV/HCV and HIV/HBV/HCV/syphilis coexisted

Conclusions: High prevalence of HIV, HBV, HCV and syphilis in STI clinic attendees mandate routine screening to detect co-infections and follow prompt therapy in order to minimize their sequelae

True prevalence of shigellosis in Indian children with acute gastroenteritis: have we been missing the diagnosis?

Background: shigella is responsible for high morbidity and mortality among children, yet its true prevalence remains inconclusive. The aim of this study was to determine the actual prevalence of Shigella infection in childhood diarrhea and dysentery cases and assess the applicability of ipaH gene PCR in Indian settings

Methods: this study was conducted at Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India during 2011-12. A total of 385 children [207 with diarrhea, 118 with dysentery, and 60 matched controls] were enrolled. Stool samples were cultured, and the suspected colonies were analyzed using biochemical reactions and serotyping. Antimicrobial susceptibility testing was done using disc diffusion method. ipaH-gene PCR was performed directly on stool samples collected from 180 randomly selected patients [60 from each group]

Results: shigella was isolated using conventional culture methods in 8.2% [95% CI: 5.1%, 12.8%], 33.1% [95% CI: 25.2%, 42.0%], and 0% in the diarrhea, dysentery and control cases, respectively. High resistance was seen towards co-trimoxazole, nalidixic acid, fluoroquinolones, doxycycline and several beta-lactams drugs. Actual prevalence of shigellosis was determined using ipaH gene PCR to be 18.3% [95% CI: 10.4% - 30.1%] diarrhea cases and 56.7% [95% CI: 44.1, 68.4%] dysentery cases. One [1.7%, 95% CI: 0.01%, 9.7%] control specimen also yielded positive result in PCR

Conclusions: correct diagnosis of shigellosis is essential to start antimicrobial therapy in selected cases. The prevalence of Shigella / EIEC infection in children is much higher than previously estimated. Despite its high costs and other limitations, we recommend the use of ipaH-gene PCR as a routine tool in the management of childhood acute gastroenteritis cases

Sexually transmitted infections and HIV in self reporting men who have sex with men: a two-year study from India

Homosexuality is not legally and socially accepted in India. Thus, this area of research has largely been ignored by Indian authors, resulting in dearth of knowledge, particularly with respect to sexually transmitted infections [STIs] in this high-risk group. Over a period of two years [2013-2014], 738 males sought care at skin and venereal diseases clinics, 52 [7.05%, 95% CI = 5.4-9.14%] of who identified themselves as MSM and were enrolled in the study. Diagnosis was made on the basis of clinical presentation and laboratory testing, wherever indicated. Thirty six percent of MSM had only homosexual preferences, while 64% were bisexual. The most common sexually transmitted infection was genital warts [23.08%, 95% CI = 13.58-36.28%]. Fourteen patients [26.92%, 95% CI = 16.67-40.35%] were VDRL and TPHA positive [two, five and four with primary syphilis, secondary syphilis and latent syphilis, respectively]. These were followed by genital herpes [11.54%, 95% CI = 5.03-23.34%], genital molluscum contagiosum [9.62% 95% CI = 3.75-21.04%], and gonorrhea [5.77%, 95% CI = 1.38-16.25%]. Of those tested, 23.08% [95% CI = 13.58-36.28%] of patients were reactive for HIV serology. Thus, MSM is a high-risk group with high prevalence of HIV and other STIs in this group, mandating greater focus, education and counseling