The Impact of Genital Ulcers on HIV Transmission Has Been Underestimated—A Critical Review

Detalhes bibliográficos
Autor(a) principal: Sousa, João Dinis
Data de Publicação: 2022
Outros Autores: Müller, Viktor, Vandamme, Anne Mieke
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/148886
Resumo: Funding Information: Funding: V.M.’s work in this study has been completed as part of the ELTE Thematic Excellence Programme 2020 supported by the National Research, Development and Innovation Office (TKP2020-IKA-05). Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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spelling The Impact of Genital Ulcers on HIV Transmission Has Been Underestimated—A Critical ReviewCo-factor of HIV transmissionGenital ulcer diseaseHIVHIV transmissionHIV-1Per-act transmission probabilitySexually transmitted infectionRG Gynecology and obstetricsQR355 VirologyInfectious DiseasesVirologyObstetrics and GynaecologySDG 3 - Good Health and Well-beingFunding Information: Funding: V.M.’s work in this study has been completed as part of the ELTE Thematic Excellence Programme 2020 supported by the National Research, Development and Innovation Office (TKP2020-IKA-05). Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.In the early 1990s, several observational studies determined that genital ulcer disease (GUD), in either the index or the exposed person, facilitates HIV transmission. Several meta-analyses have since presented associated risk ratios (RR) over the baseline per-act transmission probability (PATP) usually in the range of 2–5. Here we review all relevant observational studies and meta-analyses, and show that the estimation of RRs was, in most cases, biased by assuming the presence of GUD at any time during long follow-up periods, while active genital ulcers were present in a small proportion of the time. Only two studies measured the GUD co-factor effect in PATPs focusing on acts in which ulcers were present, and both found much higher RRs (in the range 11–112). We demonstrate that these high RRs can be reconciled with the studies on which currently accepted low RRs were based, if the calculations are restricted to the actual GUD episodes. Our results indicate that the effect of genital ulcers on the PATP of HIV might be much greater than currently accepted. We conclude that the medical community should work on the assumption that HIV risk is very high during active genital ulcers.Instituto de Higiene e Medicina Tropical (IHMT)Global Health and Tropical Medicine (GHTM)TB, HIV and opportunistic diseases and pathogens (THOP)RUNSousa, João DinisMüller, ViktorVandamme, Anne Mieke2023-02-08T22:22:27Z2022-032022-03-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/148886eng1999-4915PURE: 50922780https://doi.org/10.3390/v14030538info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:30:37Zoai:run.unl.pt:10362/148886Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:53:31.803446Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv The Impact of Genital Ulcers on HIV Transmission Has Been Underestimated—A Critical Review
title The Impact of Genital Ulcers on HIV Transmission Has Been Underestimated—A Critical Review
spellingShingle The Impact of Genital Ulcers on HIV Transmission Has Been Underestimated—A Critical Review
Sousa, João Dinis
Co-factor of HIV transmission
Genital ulcer disease
HIV
HIV transmission
HIV-1
Per-act transmission probability
Sexually transmitted infection
RG Gynecology and obstetrics
QR355 Virology
Infectious Diseases
Virology
Obstetrics and Gynaecology
SDG 3 - Good Health and Well-being
title_short The Impact of Genital Ulcers on HIV Transmission Has Been Underestimated—A Critical Review
title_full The Impact of Genital Ulcers on HIV Transmission Has Been Underestimated—A Critical Review
title_fullStr The Impact of Genital Ulcers on HIV Transmission Has Been Underestimated—A Critical Review
title_full_unstemmed The Impact of Genital Ulcers on HIV Transmission Has Been Underestimated—A Critical Review
title_sort The Impact of Genital Ulcers on HIV Transmission Has Been Underestimated—A Critical Review
author Sousa, João Dinis
author_facet Sousa, João Dinis
Müller, Viktor
Vandamme, Anne Mieke
author_role author
author2 Müller, Viktor
Vandamme, Anne Mieke
author2_role author
author
dc.contributor.none.fl_str_mv Instituto de Higiene e Medicina Tropical (IHMT)
Global Health and Tropical Medicine (GHTM)
TB, HIV and opportunistic diseases and pathogens (THOP)
RUN
dc.contributor.author.fl_str_mv Sousa, João Dinis
Müller, Viktor
Vandamme, Anne Mieke
dc.subject.por.fl_str_mv Co-factor of HIV transmission
Genital ulcer disease
HIV
HIV transmission
HIV-1
Per-act transmission probability
Sexually transmitted infection
RG Gynecology and obstetrics
QR355 Virology
Infectious Diseases
Virology
Obstetrics and Gynaecology
SDG 3 - Good Health and Well-being
topic Co-factor of HIV transmission
Genital ulcer disease
HIV
HIV transmission
HIV-1
Per-act transmission probability
Sexually transmitted infection
RG Gynecology and obstetrics
QR355 Virology
Infectious Diseases
Virology
Obstetrics and Gynaecology
SDG 3 - Good Health and Well-being
description Funding Information: Funding: V.M.’s work in this study has been completed as part of the ELTE Thematic Excellence Programme 2020 supported by the National Research, Development and Innovation Office (TKP2020-IKA-05). Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
publishDate 2022
dc.date.none.fl_str_mv 2022-03
2022-03-01T00:00:00Z
2023-02-08T22:22:27Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/148886
url http://hdl.handle.net/10362/148886
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1999-4915
PURE: 50922780
https://doi.org/10.3390/v14030538
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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