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M94A2595.TXT
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1994-10-25
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Document 2595
DOCN M94A2595
TI Atypical herpes simplex virus type II (HSV II) perineal mass associated
with HIV-1 infection.
DT 9412
AU Mijch A; Garland S; Wright E; Fairfield Hospital, Melbourne, Australia.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):269 (abstract no. PB0506). Unique
Identifier : AIDSLINE ICA10/94369980
AB OBJECTIVE: To describe clinical and histological features and response
to therapy of chronic, atypical genital HSV II infection in an
HIV-infection woman. METHODS: A retrospective review using case records,
serial photographs and laboratory results. RESULTS: A 41 year old
Ethiopian woman presented in May 1988 with four months of vaginal
discharge. Examination revealed warty perineal lesions and cervical and
vaginal ulcers from which HSV II was cultured. An HIV-1 antibody test
was positive, however syphilis and LGV serology, Neisseria and
mycobacterial cultures were negative. The CD4 lymphocyte count was
243/mm3 and antiretroviral therapy was commenced. The perineal lesions
failed to respond to treatment with oral, topical and intermittent
intravenous acyclovir and spread to involve the perianal area. The
lesions have required surgical excision on 4 occasions and histology
showed an inflammatory infiltrate and changes consistent with HSV
infection. No evidence of human papilloma virus (HPV) has been detected.
HSV II has been isolated frequently from the lesions since the time of
presentation and remains sensitive to acyclovir in vitro. Early PAP
smears showed no abnormality, but HPV atypical developed followed by CIN
II changes 12 months later. Cervical cone biopsy showed mild-moderate
dysplasia and HPV was detected. No other AIDS-defining illness has
occurred. DISCUSSION AND CONCLUSION: This case report of an
HIV-1-infected woman demonstrates an unusual presentation and course of
chronic, genital HSV II infection which has been unresponsive to
acyclovir despite ongoing in vitro sensitivity to acyclovir. The
wart-like, herpetic lesions have required surgical removal and have not
demonstrated HPV infection.
DE Adult Biopsy Case Report Cervix Neoplasms/PATHOLOGY Cervix
Uteri/PATHOLOGY Female Herpes Genitalis/*PATHOLOGY Human HIV
Infections/*PATHOLOGY *HIV-1 Papillomavirus, Human Papovaviridae
Infections/PATHOLOGY Perineum/PATHOLOGY Tumor Virus
Infections/PATHOLOGY MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).