Prevalence and factors associated with asymptomatic gonococcal and chlamydial infection among US Navy and Marine Corps men infected with the HIV: a cohort study.
Prevalence and factors associated with asymptomatic gonococcal and chlamydial infection among US Navy and Marine Corps men infected with the HIV: a cohort study.
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DOI：
10.1136/bmjopen-2013-002775
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发表时间：
2013-05-28
期刊：
影响因子：
2.9
通讯作者：
Crum-Cianflone NF
中科院分区：
文献类型：
--
作者：
Carpenter RJ;Refugio ON;Adams N;O'Brien KP;Johnson MD;Groff HL;Maves RC;Bavaro MF;Crum-Cianflone NF
淋病奈瑟菌（GC）和沙眼衣原体（CT）可促进艾滋病毒的传播。男男性行为者（MSM）可能在生殖器和生殖器外部位感染病毒。军事人群中关于生殖器外GC和CT感染的数据缺乏。我们检查了这类hiv感染军人中无症状GC和CT感染的患病率和相关因素。横断面队列研究（试点）。加利福尼亚圣地亚哥某军事治疗设施的传染病诊所对99名hiv阳性男性进行了评估，其中79%的男性与男性发生过性行为，平均年龄31岁，36%为黑人，33%为已婚。纳入标准：男性，艾滋病毒感染者，国防部受益人。排除标准：任何与尿道、咽部或直肠有关的症状。GC和CT筛查结果。24%的人感染了GC或CT。直肠拭子CT阳性率为18%，GC阳性率为3%；咽拭子GC阳性率为8%，CT阳性率为2%。尿中仅检出1例感染（GC）。肛交（p=0.04）、男性伴侣（OR 7.02, p=0.04）和每周至少一次性行为（OR 3.28, p=0.04）与感染相关。相关人口统计包括年龄<35岁（OR 6.27, p=0.02）、非白种人（p=0.03）、自HIV诊断以来<3年（OR 2.75, p=0.04）和既往性传播感染（OR 5.10, p=0.001）。我们发现hiv感染的军人中生殖器外GC/CT感染的发生率很高。在尿液中只检测到一种感染，这表明需要对MSM进行积极的三点筛查。临床医生应该意识到高患病率，以便通过全面的性传播感染筛查实践来提高健康水平。
Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) can facilitate transmission of HIV. Men who have sex with men (MSM) may harbour infections at genital and extragenital sites. Data regarding extragenital GC and CT infections in military populations are lacking. We examined the prevalence and factors associated with asymptomatic GC and CT infection among this category of HIV-infected military personnel. Cross-sectional cohort study (pilot). Infectious diseases clinic at a single military treatment facility in San Diego, CA. Ninety-nine HIV-positive men were evaluated—79% men who had sex with men, mean age 31 years, 36% black and 33% married. Inclusion criteria: male, HIV-infected, Department of Defense beneficiary. Exclusion criteria: any symptom related to the urethra, pharynx or rectum. GC and CT screening results. Twenty-four per cent were infected with either GC or CT. Rectal swabs were positive in 18% for CT and 3% for GC; pharynx swabs were positive in 8% for GC and 2% for CT. Only one infection was detected in the urine (GC). Anal sex (p=0.04), male partner (OR 7.02, p=0.04) and sex at least once weekly (OR 3.28, p=0.04) were associated with infection. Associated demographics included age <35 years (OR 6.27, p=0.02), non-Caucasian ethnicity (p=0.03), <3 years since HIV diagnosis (OR 2.75, p=0.04) and previous sexually transmitted infection (STI) (OR 5.10, p=0.001). We found a high prevalence of extragenital GC/CT infection among HIV-infected military men. Only one infection was detected in the urine, signalling the need for aggressive three-site screening of MSM. Clinicians should be aware of the high prevalence in order to enhance health through comprehensive STI screening practices.
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