Anogenital infection by Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-infected men and women in Salvador, Brazil

Infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae are the most common bacterial sexually transmitted infections throughout the world. These sexually transmitted infections are a growing problem in people living with HIV/AIDS. However, the presence of these agents in extra genital...

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Published in:	The Brazilian journal of infectious diseases Vol. 20; no. 6; pp. 569 - 575
Main Authors:	Travassos, Ana Gabriela, Xavier-Souza, Eveline, Netto, Eduardo, Dantas, Eda Vinhaes, Timbó, Maiara, Nóbrega, Isabella, Haguihara, Tatiana, Neumayer, Júlia, Lisboa, Nathalia, Soidan, Maria Angela, Ferreira, Fábio, Brites, Carlos
Format:	Journal Article
Language:	English
Published:	Brazil Elsevier Editora Ltda 01-11-2016 Contexto Elsevier Brazilian Society of Infectious Diseases
Subjects:	Adult AIDS-Related Opportunistic Infections - diagnosis AIDS-Related Opportunistic Infections - epidemiology AIDS-Related Opportunistic Infections - microbiology Analysis Anogenital infections Antiretroviral agents Brazil - epidemiology Chlamydia Chlamydia infections Chlamydia Infections - diagnosis Chlamydia Infections - epidemiology Chlamydia trachomatis Chlamydia trachomatis - isolation & purification Cross-Sectional Studies Disease transmission Epidemiology Female Genitalia, Female - microbiology Gonorrhea - diagnosis Gonorrhea - epidemiology HIV HIV infections HIV patients Humans INFECTIOUS DISEASES Male Neisseria gonorrhoeae Neisseria gonorrhoeae - isolation & purification Original Pregnancy Prevalence Prevalence studies (Epidemiology) Rectum - microbiology Sexually transmitted infections Socioeconomic Factors Brazil Chlamydia trachomatis Neisseria gonorrhoeae HIV Anogenital infections Sexually transmitted infections
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Summary:	Infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae are the most common bacterial sexually transmitted infections throughout the world. These sexually transmitted infections are a growing problem in people living with HIV/AIDS. However, the presence of these agents in extra genital sites, remains poorly studied in our country. The objective of this study was to estimate the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae anal and genital infection in people living with HIV/AIDS followed in a reference center in Salvador, Brazil. Cross-sectional study, from June 2013 to June 2015. Proven HIV-infected people attending this reference center were invited. Clinical and epidemiological data were obtained through interview with standardized form. Chlamydia trachomatis and Neisseria gonorrhoeae screening was performed using qPCR (COBAS 4800® Roche). The frequency of positive cases of Chlamydia trachomatis and Neisseria gonorrhoeae was 12.3% in total, 9.2% cases amongst women and 17.1% amongst men. We found 14.0% of positive cases in anus and 3.1% in genital region in men, while 5.6% and 3.6%, in women, respectively. Among men, anal infection was associated with age <29 years (p=0.033), report of anal intercourse (p=0.029), pain during anal intercourse (p=0.028). On the other hand, no association between genital infection and other variables were detected in bivariate analysis. Among women, we detected an association between Chlamydia trachomatis genital infection and age <29 years (p<0.001), younger age at first sexual intercourse (p=0.048), pregnancy (p<0.001), viral load >50copies/mL (p=0.020), and no antiretroviral use (p=0.008). Anal infection in women was associated with age <29 years old (p<0.001) and pregnancy (p=0.023), and was not associated with report of anal intercourse (p=0.485). Missed opportunities for diagnosis in extra genital sites could impact on HIV transmission. The extra genital sites need to be considered to break the HIV and bacterial sexually transmitted infections chain-of-transmission.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1413-8670 1678-4391 1678-4391
DOI:	10.1016/j.bjid.2016.09.004