RESUMEN
Background According to the Department of Public Health Malaysia, the total number of HIV patients up to December 2006 was 76,389. More than 90% were males with Malays being the majority. IVDU was the main mode of transmission followed by heterosexual contact. Objectives To determine the sociodemography, associated risk factors and clinical presentation of patients with HIV attending the Genitourinary Medicine (GUM) clinic. Method A retrospective study analyzing the data using a standard questionnaire. All HIV patients seen in the GUM clinic between 1/1/2000-31/12/2005 were recruited. Results A total of 191 patients with HIV were seen, with 84% being males and 16% females. This constituted 4.2% of the total number of patients seen in the clinic. 64% were Chinese, 18% Malays, 15% Indians and 2% other races. 90% were between 21-50 years of age. The major risk factors for males were sexual promiscuity (61%) and IVDU (14%). 41% frequented commercial sex workers. 74% were heterosexuals, 18% homosexuals and 8% bisexuals. The major risk factors for females were being sexual partners of HIV infected males (48%), IVDU (16%) and sex workers (6%). Majority reported no usage of condom. The main diagnoses at presentation were herpes genitalis (24%), genital warts (22%), gonorrhoea (10%) and syphilis (10%). Non venereal disease accounted for 23%. Conclusions The major risk factor for HIV transmission in patients attending the GUM clinic was exposure to sex workers, and the predominant race was Chinese. According to the national figure the main mode of HIV transmission was IVDU with Malays being the majority. The main diagnoses at presentation were herpes genitalis, genital warts, gonorrhoes and syphilis.
RESUMEN
Background Herpes genitalis (HG) is the commonest cause of sexually transmitted ulcerative disease in the world, including Malaysia1. Herpes simplex virus (HSV) type 2 is more frequently implicated than HSV type 1. This pattern has seen some changes in many parts of the world, with increasing HSV type 1 rates2. Objective The aim of this study was to determine the type of HSV implicated in patients with herpes genitalis at the Genito-Urinary Medicine Clinic, Department of Dermatology, Hospital Kuala Lumpur. Methods A retrospective study was undertaken on 242 patients with a diagnosis of herpes genitalis at the Genito-Urinary Medicine Clinic from January 2000 to December 2004. The study included all cases of genital herpes in patients aged over 12 years. The typing was done by a immunofluorescent - labeled monoclonal antibody technique specific for HSV antigens. Results Majority (76%) were between the ages of 20-49 years. Males outnumbered females by 1.6:1. Younger women (20-29 years old) tend to be more frequently affected than their male counterpart. One fourth (25.7%) of the patients reported having sex with sex workers and less than 1% (0.4%) were sex workers. A significant percentage (30.5%) of married men reported extramarital relationship with sex workers or had a casual or regular partner. Usage of condoms was low at 12%. Clinical diagnosis at presentation was primary herpes genitalis (56%) and recurrent (44%). 162 (67%) out of a total of 242 patients had the herpes immunofluorescent test done. 110 (68%) of those done were negative. Only 34 (21%) of patients with herpes genitalis had a positive immunofluorescent antibody test. Of the 21%, herpes simplex virus type 2 was found in 19 (12%) of patients with herpes genitalis, HSV type 1 in 10 (6%) and HSV types 1 & 2 coinfection in 5 (3%) patients. Conclusions In our study, HSV-2 was still more common causing 57% of the cases seen, HSV-1 29% and HSV-1 and HSV-2 coinfection in 14%. An increased rate of HSV-1 seen could possibly be due to a change in sexual behavior of the patients especially with regards to oro-genital sexual contact.