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Antiretroviral therapy suppresses rectal HIV-RNA shedding despite inflammation in MSM with rectal and infections-a cross-sectional, single-center study.
- Source :
- Sexually Transmitted Infections; Mar2019, Vol. 95 Issue 2, p95-98, 4p, 2 Charts
- Publication Year :
- 2019
-
Abstract
- <bold>Objectives: </bold>Rectal infections with Chlamydia trachomatis and/or Neisseria gonorrhoeae (CT/NG) are common in men who have sex with men (MSM) and are linked to HIV transmission. However, rectal CT/NG infections are often asymptomatic and it is not known how they contribute to HIV transmission. We assessed clinical and cytological signs of inflammation as well as rectal HIV-RNA in HIV-infected MSM with and without CT/NG infection.<bold>Methods: </bold>112 HIV-positive MSM with or without rectal symptoms and with or without antiretroviral therapy who underwent high-resolution anoscopy (HRA) at the proctological outpatient centre of the University Hospital Essen, Germany, between November 2013 and February 2014 were included in this cross-sectional study. During the examination, rectal swabs for the assessment of CT/NG, HIV-RNA and inflammatory cells (granulocytes, lymphocytes, histiocytes) were collected. 110 patients were assessed according to the study protocol, and no imputation of missing data was performed.<bold>Results: </bold>Rectal infections with CT or NG were detected in 17 participants, and 4 participants were coinfected. Only symptomatic CT/NG infections (8/17) showed signs of inflammation in HRA. Symptomatic CT/NG infections were also associated with the detection of lymphocytes and histiocytes in rectal cytology (both P<0.001). In contrast, asymptomatic CT/NG infections neither resulted in clinical nor cytological signs of inflammation. Rectal HIV-RNA was undetectable in all participants with rectal CT/NG infections who received combined antiretroviral therapy (ART) when plasma HIV-RNA was below the limit of detection (n=13). Besides rectal CT/NG infections, syphilis (n=4) and HPV-associated lesions (n=37) were frequently detected, and proctological symptoms were associated with simultaneous infection with ≥2 STDs.<bold>Conclusions: </bold>Only symptomatic but not asymptomatic rectal infections with CT and/or NG were associated with clinical and cytological signs of inflammation. Rectal HIV shedding was not promoted by CT/NG infections in patients receiving ART with suppressed plasma HIV-RNA.<bold>Trial Registration Number: </bold>UTN: U1111-1150-4804. German Clinical Trials Register (DRKS): DRKS00005468. [ABSTRACT FROM AUTHOR]
- Subjects :
- CHLAMYDIA infection diagnosis
GONORRHEA diagnosis
HIV infection transmission
ANTIRETROVIRAL agents
COMPARATIVE studies
HIV
HIV infections
HOMOSEXUALITY
INFLAMMATION
RESEARCH methodology
MEDICAL cooperation
RECTUM
RESEARCH
RNA
VIRAL physiology
EVALUATION research
CROSS-sectional method
MIXED infections
Subjects
Details
- Language :
- English
- ISSN :
- 13684973
- Volume :
- 95
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Sexually Transmitted Infections
- Publication Type :
- Academic Journal
- Accession number :
- 134978584
- Full Text :
- https://doi.org/10.1136/sextrans-2017-053409