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Title: Should screening for Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-men who have sex with men be recommended?
Authors: Pérez-Hernández, Isabel
Palacios, Rosario
González-Doménech, Carmen
García, Victoria
Márquez, Manuel
Clavijo, Encarnación
Santos, Jesús
metadata.dc.contributor.authoraffiliation: [Pérez-Hernández, I; Palacios, R; González-Doménech, C; Márquez, M; Santos, J] Infectious Diseases Unit, Hospital Virgen de la Victoria, Málaga, Spain. [García, V; Clavijo, E] Microbiology, Hospital Virgen de la Victoria, Málaga, Spain.
Keywords: Infecciones por Chlamydia;Chlamydia trachomatis;Gonorrea;Neisseria gonorrhoeae;Seropositividad para VIH;Homosexualidad masculina;Enfermedades del recto;Tamizaje masivo
metadata.dc.subject.mesh: Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Chlamydiaceae Infections::Chlamydia Infections
Medical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Chlamydiales::Chlamydiaceae::Chlamydia::Chlamydia trachomatis
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Neisseriaceae Infections::Gonorrhea
Medical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Aerobic Bacteria::Gram-Negative Aerobic Rods and Cocci::Neisseriaceae::Neisseria::Neisseria gonorrhoeae
Medical Subject Headings::Diseases::Virus Diseases::RNA Virus Infections::Retroviridae Infections::Lentivirus Infections::HIV Infections::HIV Seropositivity
Medical Subject Headings::Phenomena and Processes::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Sexuality::Homosexuality::Homosexuality, Male
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Diseases::Digestive System Diseases::Gastrointestinal Diseases::Intestinal Diseases::Rectal Diseases
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Community Health Services::Preventive Health Services::Diagnostic Services::Mass Screening
Issue Date: Nov-2014
Publisher: International AIDS Society
Citation: Pérez-Hernández I, Palacios R, González-Doménech C, García V, Márquez M, Clavijo E, et al. Should screening for Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-men who have sex with men be recommended? J Int AIDS Soc. 2014; 17(4 Suppl 3):19661
Abstract: INTRODUCTION Sexually transmitted infections (STI) like Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) have been associated with increased risk of HIV acquisition (1). It has been also described as a high prevalence of asymptomatic CT and NG infections in men who have sex with men (MSM) (2). The aim of this study was to know the prevalence of CT and/or NG infections in asymptomatic HIV-MSM and the related factors. MATERIALS AND METHODS Prospective study of a cohort of asymptomatic HIV-MSM with follow-up in Malaga (southern Spain) during October 2012-May 2014. Patients with an opportunistic event or who received active antibiotic therapy for CT and/or NG in the previous month were excluded. All of them completed a questionnaire about sexual behaviour, barrier methods and recreational drugs use. Demographical, epidemiological, clinical, analytical and therapeutic data were also collected. Pharyngeal and rectal swabs, and urine samples were collected to be tested for CT and NG by nucleic acid amplification test (c4800 CT/NG. Roche Diagnostics, Mannheim, Germany) (3). STATISTICS ANALYSIS SPSS 17.0. RESULTS 255 patients were asked to participate and 248 of them accepted. Median age was 37.7 (30.6-46.3) years, median time since HIV diagnosis was 47.7 (10.5-104.1) months, and median CD4 cells count was 607 (440-824) cell/µL. There were 195 (78.6%) patients on antiretroviral therapy; 81.5% of them had undetectable viral load. 80.5% of the patients had a past history of STI. Infection by CT and/or NG was diagnosed in 24 (9.7%) patients. Overall four urine samples, two pharyngeal, and 15 rectal ones were positive for CT, and five pharyngeal and five rectal swabs were positive for NG. Two patients were co-infected by CT and NG: one with CT in urine and both in rectum, another with CT in urine and rectum and NG in pharynx. One patient presented CT in pharynx and rectum, and two patients NG in pharynx and rectum. Positive CT and/or NG tests were only related with detectable HIV viral load (OR 3.08, 95% CI 1.2-7.4; p=0.01). It was not related with sexual behaviour, nor with alcohol or recreational drugs use. CONCLUSIONS STI screening had a great acceptance in this population. There was a high prevalence of asymptomatic CT and/or NG infections. Rectum sample was the most effective one. Viral suppression could protect from these STI. Screening should be recommended in HIV-MSM.
Description: Journal Article;
ISSN: 1758-2652 (Online)
Appears in Collections:01- Artículos - Hospital Virgen de la Victoria

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