CONHIV14 - HIV-related Infections, Co-infections and Cancers, etc. – Part three - page 10

Characteris*cs
Median age (years)
37.7 (30.3-­‐46.3)
Time from HIV diagnosis (months)
47.7 (10.5-­‐104.1)
CD4 nadir (cells/mm
3
)
294 (3-­‐1224)
AIDS cases
40 (16.1)
CD4 (cells/mm
3
)
607 (440-­‐824)
AnJretroviral therapy
195 (78.6)
Undetectable HIV viral load*
160 (81.5)
Past history of STI
198 (79.8)
Posi*ve CT/NG
(n=24)
Nega*ve CT/NG
(n=224)
P
Age (years)
32.3 (28.0-­‐38.7)
38.8 (31.1-­‐46.7)
0.03
Caucasian race
19 (79.1)
209 (93.3)
0.03
CD4 nadir (cells/mm
3
)
323 (161-­‐468)
294 (157-­‐418)
0.4
Time from HIV diagnoses
16.1 (2.5-­‐53.7)
50.3 (11.7-­‐112.9)
0.005
AIDS
2 (8.3)
38 (16.9)
0.4
AnJretroviral therapy
15 (62.5)
180 (80.4)
0.06
Time on anJretroviral therapy 20.5 (2.8-­‐60.7)
43.4 (14.5-­‐87.8)
0.8
CD4 (cells/mm
3
)
513 (387-­‐664)
608 (447-­‐834)
0.1
Undetectable HIV viral load
9 (37.5)
150 (66.9)
0.006
RelaJons in their lives
1-­‐30 men
>30 men
7 (29.2)
17 (70.8)
83 (37.1)
129 (57.6)
0.4
InserJve anal intercourse
20 (83.3)
152 (67.8)
0.3
RecepJve anal intercourse
18 (75)
147 (65.6)
0.8
Oral sex
21 (87.5)
169 (75.4)
0.6
Pay for sexual relaJons
1 (4.2)
10 (4.4)
1.0
ProsJtuJon
3 (12.5)
6 (2.7)
0.5
Condom use
Mostly
Rarely
21 (87.5)
3 (12.5)
185 (82.6)
34 (15.2)
1.0
Past history of STI
22 (91.6)
176 (78.6)
0.2
HbsAg +
1 (4.2)
5 (2.2)
0.5
PCR VHC +
0 (0)
8 (3.6)
1.0
PosiJve syphilis serology
16 (66.6)
110 (44.3)
0.1
Tobacco
4 (16.7)
77 (34.4)
0.1
Alcohol
< 3 days/week
> 3 days/week
19 (79.2)
3 (12.5)
168 (75.0)
42 (18.7)
0.6
RecreaJonal drugs
Mostly
Rarely
6 (25.0)
16 (66.7)
34 (15.2)
177 (79.0)
0.2
Comparison between pa*ents with and without posi*ve
samples for
C. trachoma+s
and/or
N. gonorrhoeae
Should Screening for
C. tracoma+s
and
N. gonorrhoae
in
HIV-­‐Men who have Sex with Men be Recommended?
Pérez-­‐Hernández IA
1
, Palacios R
1
, González-­‐Domenech CM
1
, García V
2
,
Márquez M
1
, Clavijo E
2
, Santos J
1
.
1
Hospital Virgen de la Victoria, Infec*ous Diseases, Malaga, Spain;
2
Hospital Virgen de la Victoria, Microbiology, Malaga, Spain.
P-­‐129
Background
Sexually transmiZed infecJons (STI) like
Chlamydia tracoma-s
(CT) and
Neisseria
gonorrhoeae
(NG) have been associated with increased risk of HIV acquisiJon
1
. It
has been also described a high prevalence of asymptomaJc CT and NG infecJons in
men who have sex with men (MSM) so that some clinical guidelines recommend
screening in this populaJon
2,3
. The
aim
of this study was to know the prevalence of
CT and/or NG infecJons in asymptomaJc HIV-­‐MSM and the related factors.
Material and Methods
ProspecJve study of a cohort of asymptomaJc HIV-­‐MSM.
Study period: October/12 and May/13 were evaluated.
Inclusion criteria:
Ø
HIV-­‐MSM paJents sexually acJve in the last three months.
Ø
Regular follow-­‐up in our InfecJous Diseases Unit.
Exclusion criteria:
Ø
PaJents with an opportunisJc event in the previous month.
Ø
PaJents who received acJve anJbioJc therapy for CT and/or NG in the previous
month.
QuesJonnaire about sexual behaviour, barrier methods and recreaJonal drugs use
during sexual acJvity, and STI symptoms.
Demographical, epidemiological, clinical, analyJcal and therapeuJcal data were
collected.
Pharyngeal and rectal swabs, and a urine sample were collected to be tested.
CT and NG nucleic acid amplificaJon test (c4800 CT/NG. Roche DiagnosJcs, Mannheim,
Germany).
StaJsJcs analysis: SPSS 17.0 programme.
Results
n = 248
The quanJtaJve variables are expressed as median and IQR and the qualitaJve variables as n
(%).
STI: Sexually transmiZed infecJons.
*PaJents on anJretroviral therapy
Characteris*cs of the cohort
The quanJtaJve variables are expressed as median and IQR and the qualitaJve variables as n (%).
CT:
C. trachoma-s
. NG:
N.
gonorrhoeae
. STI: Sexually transmiZed infecJons.
Mul*variate analysis
OR IC 95% P
Detectable HIV viral load
3,3
1,4-­‐8,1
0,006
Distribu*on of posi*ve samples
C. trachoma+s
n = 21
N. gonorrhoeae
n = 10
Rectum
15
5
Pharynx
2
5
Urine
4
0
2 pa*ents were co-­‐infected by CT and NG
Conclusions
1.
STI screening had a great acceptance in this populaJon.
2.
There was a high prevalence of asymptomaJc CT and/or NG
infecJons.
3.
Rectum sample was the most effecJve one.
4.
Viral suppression could protect from these STI.
5.
We think that screening should be recommended in HIV-­‐MSM.
References
1.
MaloZ RJ, et al. Neisseria gonorrhoeae-­‐derived heptose elicits an innate immune response and
drives HIV-­‐1 expression. Proc Natl Acad Sci USA. 2013; 110: 10234-­‐10239.
2.
Heiligenberg M, et al.
High prevalence of sexually transmiZed infecJons in HIV-­‐infected men during rouJne outpaJent
visits in the Netherlands. Sex Transm Dis. 2012; 39: 8-­‐15.
3.
Soni S, White JA. Self-­‐screening for
Neisseria gonorrhoeae and Chlamydia trachomaJs in the human immunodeficiency virus clinic-­‐
high yields and high acceptability. Sex Transm Dis. 2011; 12: 1107-­‐1109.
Pa*ents with posi*ve CT/NG 24 (9.7%)
1,2,3,4,5,6,7,8,9 11,12
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