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1/13. Classic Kaposi's sarcoma after multiple-partner heterosexual behavior in Central africa.

    We present a case of a possible sexual transmission of classic Kaposi's sarcoma. To our knowledge, this is the first report of such a case. We noted a long delay between the probable contaminant contact and onset of lesions, suggesting that human herpesvirus 8 has longer incubation periods in healthy individuals than in immunocompromised patients. ( info)

2/13. Molecular evidence of male-to-female sexual transmission of hepatitis c virus after vaginal and anal intercourse.

    hepatitis c virus (HCV) was transmitted from a chronic carrier to his female partner during unprotected anal and vaginal intercourse. Based on HVR1 and phylogenetic tree analysis, the couple had closely related isolates. These findings confirm sexual transmission of HCV without other risk factors. ( info)

3/13. Sexual transmission of hepatitis c virus from a patient with chronic disease to his sex partner after removal of an intrauterine device.

    BACKGROUND: Approximately 40% of patients infected with hepatitis c virus (HCV) have no history of blood transfusion or other high-risk practice. Other causes should be considered. GOAL: The goal was to describe sexual transmission of HCV from a chronic carrier to his female partner during unprotected vaginal intercourse after removal of an intrauterine device. STUDY DESIGN: A heterosexual woman who was a regular blood donor acquired acute HCV infection from her sex partner, who was chronically infected. The study included an interview and phylogenetic analysis of sequences of virus obtained from the couple. RESULTS: risk factors other than vaginal sexual relations with her partner were ruled out. Phylogenetic analysis showed that sequences from the couple clustered together in all trees generated, in comparison with local and GenBank controls. CONCLUSION: The temporal relationship between removal of the intrauterine device and the acute hepatitis suggests that vaginal mucosal damage might have favored transmission of HCV. Barrier precautions should be suggested whenever damage of the vaginal tract has occurred. ( info)

4/13. Conjugal transfer vaccinia.

    Two cases of conjugal contact transfer vaccinia are described. Each patient had intimate contact after their respective partners, active-duty military personnel, received the smallpox vaccination. ( info)

5/13. Molecular investigation of interspousal transmission of hepatitis c virus in two Japanese patients who acquired acute hepatitis c after 40 or 42 years of marriage.

    A 65-year-old woman (C1I) and a 65-year-old man (C2I) contracted acute hepatitis C 40 or 42 years after marriage, respectively, in japan. They had no discernible risk factors for acquiring hepatitis c virus (HCV) infection, except that they had monogamous sexual relationships with their spouses (C1S [66-year-old] with hepatocellular carcinoma and C2S [64-year-old] with liver cirrhosis, respectively) who were infected with HCV of the same genotype (1b) and had a high-titer HCV rna in the serum (bDNA probe assay, 17 Meq/ml [C1S] and 15 Meq/ml [C2S]). The HCV isolates from patients C1I and C1S and those from patients C2I and C2S shared identity of 99.9% and 99.1%, respectively, in the 1,087-nucleotide (nt) sequence of the NS5B region, although these four isolates were only 91.7%-96.2% identical to the 94 reported genotype 1b isolates including those from Japanese patients. To confirm the high degree of genetic relatedness among ten HCV clones from each spouse within each pair of spouses, the E1 and E2 junctional region sequence (268 or 271 nt) including hypervariable region 1 (HVR-1) was analyzed. There was a close relationship between clones obtained from each spouse within each couple. Regarding the HVR-1 amino acid sequence, nine of the ten C1I clones were 100% identical with six of the ten C1S clones, and one each of the C2I and C2S clones differed by only one amino acid residue. This study indicates that two Japanese patients with acute hepatitis c had acquired HCV infection most probably by interspousal sexual transmission during a long-lasting marriage. ( info)

6/13. Sexual transmission of hepatitis B infection despite the presence of hepatitis B virus immunity in recipients of allogeneic bone marrow transplantation.

    BACKGROUND: After hematopoietic cell transplantation (HCT), hepatitis due to hepatitis b virus (HBV) rarely occurred beyond the initial 12 months after transplantation. OBJECTIVES: We investigated the cause of "late" hepatitis due to HBV infection in two recipients after allogeneic HCT. STUDY DESIGN: Two male patients with acute myeloid leukemia and light chain myeloma, respectively, developed HBV-related hepatitis more than 2 years after HCT. All serum samples collected from the recipients, donors and their respective spouses were tested for HBV dna by nested PCR, and if positive further quantified by Digene Hybrid Capture assay II. The HBV genotype was determined by PCR and sequencing. RESULTS: Genotypic analysis suggested that the cause of "late" hepatitis was due to acute HBV infection transmitted from their respective spouse. CONCLUSION: Our findings suggested that sexual precautions should be taken in these patients after HCT. Alternatively, or even additionally, active vaccination should be delivered to these patients once they have lost their HBV immunity. ( info)

7/13. Bilateral ureteral obstruction secondary to condylomata acuminata of the urinary bladder.

    Condyloma acuminatum is a viral infection of near epidemic proportions. Both men and women are affected equally. Most lesions are on the external genitalia and the mucous membranes of the urethra or the vagina. A rare occurrence of condyloma acuminata is involvement of the urinary bladder. To date, only 11 cases have been reported. We describe two additional cases, both with bilateral ureteral obstruction. Current urologic management and review of the literature are presented. ( info)

8/13. Acute hepatitis c infection after sexual exposure.

    A case is described of a woman with acute hepatitis c infection whose partner had chronic hepatitis c infection and where heterosexual contact was the only major risk factor. Infection of both partners was confirmed serologically and by the finding of virus rna by reverse transcription and polymerase chain reaction amplification. Nucleotide sequence analysis of the NS5 region (rna polymerase) was used to show that both partners were infected with virus of the same genotype (1a). The nucleotide sequence of virus rna found in the female patient is closest to variants cocirculating in the male contact, consistent with transmission having occurred between the two. ( info)

9/13. Kaposi's sarcoma during immunosuppressive therapy for atopic dermatitis.

    We describe an hiv-negative homosexual man who developed Kaposi's sarcoma (KS). He had CD4 lymphocytopenia during azathioprine and topical corticosteroid therapy for atopic dermatitits (AD). KS was observed after only 2 months of immunosuppressive therapy. No regression was observed despite discontinuation of immunosuppressive therapy and normalization of the CD4 cell count. This patient appears to be the first case of KS associated with AD. Moreover, as our patient had been sexually inactive for 15 years, this case raises the questions about the latency and about the sexual transmission of a novel herpes-like virus (KHSHV) recently detected in all forms of KS. ( info)

10/13. Sexual transmission of hepatitis c virus to a repeat blood donor.

    BACKGROUND: Sexual transmission of hepatitis c virus (HCV) can occur, albeit inefficiently, and this represents a possible cause of community-acquired infections. This study describes a case of asymptomatic HCV infection acquired by a repeat blood donor from her sexual partner. CASE REPORT: A female repeat blood donor showed anti-HCV seroconversion and a slight elevation in alanine aminotransferase. She had a normal physical examination and no clinical symptoms. She admitted a sexual partnership with a man with chronic HCV infection. Genotyping showed subtype 3a infection in both. Nucleotide sequence analysis of the hypervariable region of the viral envelope was performed on five clones obtained from the donor and the partner. Five blood donors with subtype 3a infection were analyzed as controls. The mean homology among clones was 99.3 percent (95% CI, 98.9-99.7) in the donor and 96.8 percent (95% CI, 94.4-99.2) in the partner, which suggests a more recent infection in the woman. The mean homology between donor and partner was 93.4 percent (95% CI, 93.1-93.8), which is different from that between donor and controls (76.2%; 95% CI, 73.3-79.1; difference between means, 17.2%; 95% CI, 16.0-18.4). This suggests that the infection was transmitted to the donor from her sexual partner. Sexual intercourse is the most probable route of transmission, because parenteral risk factors were absent. CONCLUSION: Heterosexual transmission of HCV can occur in the absence of a long-lasting contact, and the infection can be asymptomatic. It remains to be determined whether the sexual partners of HCV-infected subjects should be deferred from blood donation. ( info)
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