Chancroid and Human Immuno-deficiency Virus

Individuals who were seropositive for human immunodeficiency virus were found to have increased numbers of ulcers caused by Haemophilus ducreyi. Also it has been noted that in countries with high cases of HIV infection, chancroid is the most frequent infection leading to genital ulcer diseases unlike in areas with low HIV prevalence.

Effects of chancroid on HIV susceptibility and transmission

Chancroid increases chances of HIV viral infection and their infectiousness by the presence of the genital ulcers associated with chancroid. HIV viral shedding and infectiousness increases when these ulcers bleed during coitus.

This was so real and evident among the prostitutes who had ulcers when the cervicovaginal exudates were examined for this virus than those without the genital ulcers.

For men with chancroid, it was found that an increased HIV viral load was highly concentrated in the seminal fluid, especially in those who had non-gonococcal urethritis. There was an increased HIV viral load in the blood tested to be also infected with Haemophilus ducreyi.

Due to chanchroid infection, there is induction of the cellular immuno response which lead to increased activation and presence of the T-helper cells, macrophages and other HIV –susceptible cells in chancroid lesions and at the edges of the ulcers and thus increasing the HIV infections rate. This also increases due to the stimulation of the specific HIV receptors-CCR-5.

Another cause of the increased HIV infections could result with the invasive diagnostic and therapeutic techniques used for treatment of chancroid, especially in aspiration and drainage of bubos with unsterilized blades and other equipment used for multiple subjects.

Effects of HIV on chancroid

HIV too alters the pattern of chancroid by increasing the incubation period of the Haemophilus ducreyi and also increasing the sites with the genital ulcers, e.g. the anus, hands, mouths and the thighs. These ulcers have been found to sheal deficiently and very slowly and thus increased chancroid invasion.

For patients with concomitant HIV infection can affect the success of the chancroid chemotherapy that may lead to massive bleeding and penile amputation. It is more likely that HIV infected patients with Haemophilus ducreyi to present with giant genital ulcers and lesions. These patients should be then closely monitored as single doses of fleroxacin or ceftriaxone are not very effective. The serologic tests of HIV should be followed up routinely even after a window period of three months.

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