HIV-1 DNA SHEDDING IN GENITAL ULCERS AND ITS ASSOCIATED RISK-FACTORS IN PUNE, INDIA

HIV infection status was determined in 302 consecutive patients with g enital ulcer disease (GUD) presenting to two sexually transmitted dise ase (STD) clinics in Pune, India. Of the 71 (24%) individuals with HIV infection, 67 (94%) were HIV antibody-positive, and 4 (6%) were HIV a ntibody-negative but p24 antigenpositive at the time of presentation. HIV-1 DNA was detected in 24 (34%) specimens. The genital ulcers of al l four acutely infected p24-antigenemic subjects were HIV-1 DNA-positi ve by polymerase chain reaction (PCR) assay, compared with 20 of 67 (3 0%) seropositive patients (p = .01). Presence of chancroid, GUD sympto ms for >10 days, and concurrent diagnosis of cervicitis or urethritis were significantly associated risk factors for HIV-1 DNA shedding in u lcers, Early GUD diagnosis and aggressive treatment of HIV-infected pa tients may significantly reduce secondary transmission of HIV to other sex partners.