Study finds circumcision safe in both HIV-infected and HIV–uninfected men

Adult circumcision is safe in HIV-infected men without advanced HIV disease, according to research published in PLoS Medicine.

Analyzing results of two clinical trials of circumcision in the rural Rakai district of Uganda, Ron Gray of the Bloomberg School of Public Health, Johns Hopkins University and colleagues found approximately a 3% rate of moderate or severe surgical complications – primarily infections – in both HIV-positive and HIV-negative men, when circumcision was performed under optimal conditions. Healing was slower in the HIV-infected men, however, and men who resumed sexual intercourse before complete wound healing were at higher risk of complications. Men with symptoms of HIV infection or low CD4 T-cell counts were not included in the study.

A separately reported analysis from one of these trials found that women partners are more likely to become HIV infected by HIV-positive men who resume sex prior to complete wound healing. Therefore, for protection of both men and their women partners, refraining from intercourse after circumcision is essential until the wound has completely healed, which may take 6 weeks or longer.

Three clinical trials have already shown that circumcision reduces the risk of becoming HIV infected by about 60% in HIV-negative African men, with infrequent side effects. However, the side effects in HIV-positive men have not been previously reported. Because this study found no increased risk of surgical complications in HIV-positive men who undergo circumcision, it should not be necessary to screen men who have no symptoms of HIV in future circumcision programs. Not requiring screening should reduce the complexity of implementing such programs and also reduce any stigma resulting from exclusion, making it likely that more men will be willing to be circumcised.

CITATION: Kigozi G, Gray RH, Wawer MJ, Serwadda D, Makumbi F, et al. (2008) The safety of adult male circumcision in HIV-infected and uninfected men in Rakai, Uganda. PLoS Med 5(6): e116.

IN YOUR COVERAGE PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi-10,1371/journal.pmed.0050116

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-05-06-gray.pdf

CONTACT: Ron Gray Johns Hopkins University, Bloomberg School of Public Health Baltimore, MD 21205 United States of America +1 410 955 7818 +1 410 614 7386 (fax) rgray@jhsph.edu

New classification of malignant melanoma that integrates genetic and morphologic features

Boris Bastian and colleagues from the University of California San Francisco present a refined morphological classification of primary melanomas that can be used to improve existing melanoma classifications by defining genetically homogeneous subgroups.

In a related Research in Translation paper, Jonathan Rees of the University of Edinburgh – uninvolved with the research - outlines a number of puzzling gaps that remain in our knowledge of the etiology of non-acral melanomas.

CITATION: Viros A, Fridlyand J, Bauer J, Lasithiotakis K, Garbe C, et al. (2008) Improving melanoma classification by integrating genetic and morphologic features. PLoS Med 5(6): e120.

IN YOUR COVERAGE PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050120

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-05-06-bastian.pdf

CONTACT: Boris Bastian University of California, San Francisco Dermatology & Pathology San Francisco, CA 94115 United States of America +1 415 476-5132 +1 415 476-8218 (fax) bastian@cc.ucsf.edu

Related PLoS Medicine Research in Translation:

Citation: Rees JL (2008) Melanoma: What are the gaps in our knowledge? PLoS Med 5(6): e122.

IN YOUR COVERAGE PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050122

PRESS-ONLY PREVIEW OF THE ARTICLE: http://www.plos.org/press/plme-05-06-rees.pdf

CONTACT: Jonathan Rees University of Edinburgh Grant Chair of Dermatology Lauriston Place Edinburgh, EH3 9HA United Kingdom +44-131-536-2041 jonathan.rees@ed.ac.uk