The association between Mycoplasma genitalium and HIV-1 acquisition in African women


Mavedzenge, SN; van der Pol, B; Weiss, HA; Kwok, C; Mambo, F; Chipato, T; van der Straten, A; Salata, R; Morrison, C; (2012) The association between Mycoplasma genitalium and HIV-1 acquisition in African women. AIDS (London, England), 26 (5). pp. 617-624. ISSN 0269-9370 DOI: https://doi.org/10.1097/QAD.0b013e32834ff690

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Abstract

Objective: Mycoplasma genitalium is an emerging sexually transmitted infection (STI) and has been associated with reproductive tract infections and HIV in cross-sectional studies. In this longitudinal study, we assess whether M. genitalium is associated with risk of acquiring HIV-1 infection. Design: Nested case-control study within a large prospective study in Zimbabwe and Uganda Methods: A total of 190 women who seroconverted to HIV-1 during follow-up (cases) were matched with up to two HIV-negative controls. Mycoplasma genitalium testing was performed by PCR-ELISA, using archived cervical samples from the HIV-1 detection visit and the last HIV-negative visit for cases, and equivalent visits in follow-up time for controls. Risk factors for HIV-1 acquisition were analyzed using conditional logistic regression, with M. genitalium as the primary exposure. Results: Mycoplasma genitalium was a common infection in these populations (14.8 and 6.5% prevalence among cases and controls, respectively, at the visit prior to HIV-1 detection), and more prevalent than other nonviral STIs. We found a greater than two-fold independent increased risk of HIV-1 acquisition among women infected with M. genitalium at the visit prior to HIV-1 acquisition [ adjusted odds ratio (AOR) = 2.42; 95% confidence interval (CI) 1.01-5.80), and at time of HIV-1 acquisition (AOR 2.18; 95% CI 0.98-4.85). An estimated 8.7% (95% CI 0.1-12.2%) of incident HIV-1 infections were attributable to M. genitalium. Conclusion: This is the first longitudinal study to assess the relationship between M. genitalium and HIV-1 acquisition. If findings from this research are confirmed, M. genitalium screening and treatment among women at high risk for HIV-1 infection may be warranted as part of an HIV-1 prevention strategy. (C) 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Item Type: Article
Keywords: Africa, epidemiology, HIV, Mycoplasma genitalium, sexually transmitted, infection, pelvic-inflammatory-disease, cervical epithelial-cells, risk-factors, sex workers, infection, azithromycin, replication, lymphocytes, chimpanzees, urethritis, Adolescent, Adult, Case-Control Studies, Enzyme-Linked Immunosorbent Assay, Female, Follow-Up Studies, HIV Infections, complications, epidemiology, HIV-1, isolation & purification, Humans, Longitudinal Studies, Mycoplasma Infections, complications, epidemiology, Mycoplasma genitalium, isolation & purification, Prevalence, Real-Time Polymerase Chain Reaction, Risk Factors, Uganda, epidemiology, Young Adult, Zimbabwe, epidemiology
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
PubMed ID: 22210630
Web of Science ID: 301333000011
URI: http://researchonline.lshtm.ac.uk/id/eprint/28230

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