1/7. Acute self-limiting hepatitis c after possible sexual exposure: sequence analysis of the E-2 region of the infected patient and sexual partner.We describe a case of symptomatic acute infection with HCV in a woman whose sexual partner had chronic hepatitis c. The patient cleared HCV rna 8 weeks after the onset of acute hepatitis and was found to be persistently HCV-rna negative during 90 weeks of follow-up. Part of the E-2 region of HCV was directly sequenced in the patient and her sexual partner. Four local controls with subtype-1a infection and 9 1a isolates obtained from GenBank were analyzed. The average nucleotide divergence between the sequences of the infected patient and her sexual partner was 5.1%, compared with an average nucleotide divergence of 19.4% (range 16.6-21.8%) between the sequences of the patient and those of controls. Comparison of the phylogenetic trees in the partial E-2 region showed that the sequence of the patient was closely related to that of her sexual partner. Our findings suggest that the infection was transmitted to the patient from her sexual partner. The resolution of acute hepatitis c in this case was probably related to the host rather than to intrinsic characteristics of the HCV genome.- - - - - - - - - - ranking = 1keywords = hepatitis (Clic here for more details about this article) |
2/7. A patient in whom only hepatitis b virus (HBV) was thought to have been contracted, by kissing, from a same-sex partner coinfected with HBV and human immunodeficiency virus-1.A 31-year-old homosexual man was admitted to our hospital in August 2001 with liver dysfunction. His diagnosis was acute hepatitis B. He had had a steady partner coinfected with hepatitis b virus (HBV) and human immunodeficiency virus-1 (hiv) from August 2000 to July 2001. Because he knew that the partner was infected with hiv, the sexual relationship had included only deep kissing, with no oral-genital or anal-genital sex. The serum HBV dna level of the partner was relatively high compared with the serum hiv rna level. Direct sequencing of the full HBV dna genome from serum showed that the entire base sequences of the viruses from both patients were of genotype A and identical. HBV infectivity was shown to be stronger than that of hiv in our patient, in whom only HBV was transmitted from a partner coinfected with HBV and hiv. This case highlights the importance of HBV as a sexually transmitted disease.- - - - - - - - - - ranking = 0.85714285714286keywords = hepatitis (Clic here for more details about this article) |
3/7. Fitz-Hugh-Curtis syndrome.The Fitz-Hugh-Curtis syndrome consists of right upper quadrant abdominal pain, perihepatitis and genital tract infection. neisseria gonorrhoeae and chlamydia trachomatis have been identified as causative agents. This syndrome frequently mimics other diseases and typically occurs in sexually active young women. A high index of suspicion is essential for early diagnosis. laparoscopy may be indicated for diagnosis and for lysis of adhesions.- - - - - - - - - - ranking = 0.14285714285714keywords = hepatitis (Clic here for more details about this article) |
4/7. syphilis and other sexually transmitted diseases.As early syphilis becomes more uncommon in the community, it will present frequently to the tertiary hospital as a diagnostic problem. Twenty patients with classic signs and symptoms of primary and secondary syphilis in whom the correct diagnosis was initially missed are presented. The importance of a routine admission Venereal Disease research Laboratory test (VDRL) in making the correct diagnosis is emphasized. The laboratory techniques for diagnosing syphilis and recommended treatment schedules are presented. Clinical manifestations of herpes progenitalis, problems with pregnancy and association with cervical carcinoma are also presented. Enteric diseases (hepatitis, shigellosis, giardiasis and amebiasis) as sexually transmitted diseases in homosexual men are summarized.- - - - - - - - - - ranking = 0.14285714285714keywords = hepatitis (Clic here for more details about this article) |
5/7. Fulminant hepatitis associated with hepatitis b virus e antigen-negative infection: importance of host factors.The precore stop-codon variant of hepatitis b virus (HBV) has been implicated in fulminant hepatitis. The precore/core regions of such variants from two sets of patients with interpartner transmission resulting in fulminant hepatitis in the contact, were sequenced to establish whether further sequence variations in the core region are specifically associated with the fulminant disease. In both sets of patients, there was sequence diversity of the precore/core region from the wild type, leading to numerous amino acid substitutions in the core region. Between the infecting source and the contact, there was only one amino acid change in one set of patients and none in the other. In addition, in the second set of patients, serum samples from four different time points were investigated. Sequence data showed no variation in each patient at the nucleotide level in the core region, even in the case of the source, who was followed for 3 years. In this same pair of subjects, the remainder of the genome was sequenced and was identical at the nucleotide level. Therefore, it appears that, at least in some cases of fulminant hepatitis caused by infection with the precore variant, the nucleotide sequence of the patient with fulminant hepatitis is identical to that observed in the asymptomatic source of infection. These data indicate that the severity and outcome of infection in such cases are unrelated to any additional variation in the entire HBV genome, and that the changed clinical picture is dependent on host factors, possibly the HLA environment.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1.8571428571429keywords = hepatitis (Clic here for more details about this article) |
6/7. The gay bowel syndrome: clinico-pathologic correlation in 260 cases.The clinical and pathological findings in a group of 260 homosexual men comprising 10% of a private proctologic practice are reviewed. A clinical pattern of anorectal and colon diseases encountered with unusual frequency in these homosexual patients is termed the gay bowel syndrome. The clinical diagnoses in decreasing order of frequency include condyloma acuminata, hemorrhoids, nonspecific proctitis, anal fistula, perirectal abscess, anal fissure, amebiasis, benign polyps, viral hepatitis, gonorrhea, syphilis, anorectal trauma and foreign bodies, shigellosis, rectal ulcers and lymphogranuloma venereum. 60 anorectal and sigmoid biopsies from 51 patients failed to disclose evidence of specific infection other than condyloma acuminata. Of 21 patients with biopsy diagnosis of nonspecific proctitis, 8 had a specific infection which was detected by other means,--5 cases of shigellosis and one case each of gonorrheal proctitis, amebiasis and lymphogranuloma venereum. In evaluating proctologic problems in the gay male, all of the known sexually transmitted diseases should be considered. Shigellosis, amebiasis and viral hepatitis should be included. Microbiological evaluation is essential. Concurrent infections with 2 or more pathogens should be anticipated. chlamydia trachomatis, an important cause of nonspecific urethritis in the general population, is high on the list of possible causes of the nonspecific proctitis present in 31 of the 260 patients.- - - - - - - - - - ranking = 0.28571428571429keywords = hepatitis (Clic here for more details about this article) |
7/7. Two patients with acute hepatitis B with suspected sexual transmission of hepatitis G virus.Two patients with acute hepatitis B with suggested sexual transmission of hepatitis G virus (HGV) are reported. A total of 18 patients with community acquired acute hepatitis B were analyzed in this study. Two of the 18 patients (patients 1 and 2) were positive for serum HGV rna at the initial consultation. Both patients had had sexual contact with prostitutes several weeks before the onset of acute hepatitis, and hepatitis b virus (HBV) was suggested to be infected through the sexual contacts. These patients showed no other history of exposure to possible transmission routes for blood-borne hepatitis viruses. Patient 1 was diagnosed as with acute HGV infection because the antibody to HGV envelope-2 protein seroconverted to positive during the course of acute hepatitis. HGV rna was negative in a serum sample collected from patient 2 before the onset of acute hepatitis, also suggesting acute HGV infection. These results indicate that in patients 1 and 2 HGV was infected along with HBV through sexual contact. The clinical manifestations of acute hepatitis in the two patients with HGV co-infection did not differ from those in the 16 patients with HBV infection alone.- - - - - - - - - - ranking = 2.4285714285714keywords = hepatitis (Clic here for more details about this article) |