Sexually transmitted coinfections among at-risk HIV-positive MSM: implications for optimal preemptive treatment
BackgroundConcurrent sexually transmitted infections (STIs) are common in sexually active populations. We aimed to estimate the prevalence and coinfection rates of bacterial STIs among sexually active, HIV-positive men who have sex with men (MSM), and to assess the potential benefits of different co...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2024.1328589/full |
| _version_ | 1797261890924052480 |
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| author | Tzong-Yow Wu Tzong-Yow Wu Kuan-Yin Lin Li-Hsin Su Hsin-Yun Sun Yu-Shan Huang Wang-Da Liu Wang-Da Liu Wen-Chun Liu Lan-Hsin Chang Sui-Yuan Chang Sui-Yuan Chang Chien-Ching Hung Chien-Ching Hung Chien-Ching Hung |
| author_facet | Tzong-Yow Wu Tzong-Yow Wu Kuan-Yin Lin Li-Hsin Su Hsin-Yun Sun Yu-Shan Huang Wang-Da Liu Wang-Da Liu Wen-Chun Liu Lan-Hsin Chang Sui-Yuan Chang Sui-Yuan Chang Chien-Ching Hung Chien-Ching Hung Chien-Ching Hung |
| author_sort | Tzong-Yow Wu |
| collection | DOAJ |
| description | BackgroundConcurrent sexually transmitted infections (STIs) are common in sexually active populations. We aimed to estimate the prevalence and coinfection rates of bacterial STIs among sexually active, HIV-positive men who have sex with men (MSM), and to assess the potential benefits of different combination treatment regimens in managing concurrent bacterial STIs.MethodsFrom September 2021 to September 2023, HIV-positive MSM underwent STI testing when they had symptoms suggestive of STIs or recently acquired hepatitis C virus (HCV) infection or early syphilis. The oral rinse, rectal swab, and urethral swab specimens were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma spp., Ureaplasma spp., and Trichomonas vaginalis with the use of multiplex real-time polymerase-chain-reaction assays. The estimated coinfection rates were used to evaluate the benefits of different combination treatment regimens for managing coinfections.ResultsDuring the study period, 535 participants (median age, 37 years; and CD4 count, 615 cells/mm3) were enrolled. On their first visits, at least one bacterial pathogen was detected in 57.9% and concomitant bacterial infections were found in 32.9% of the participants. The most commonly identified pathogen was U. urealyticum (36.3%), followed by C. trachomatis (22.8%), and N. gonorrhoeae (19.8%). The factors associated with any bacterial STIs included older age (per 1-year increase, adjusted odds ratio [AOR], 0.97; 95% confidence interval [CI], 0.95–1.00), early syphilis (AOR, 1.87; 95% CI, 1.22–2.84), and having more than 5 sex partners in the preceding 3 months (AOR, 2.08, 95% CI, 1.07–4.06). A combination therapy of benzathine penicillin G with a 7-day course of doxycycline could simultaneously treat 27.1% of C. trachomatis coinfections in participants with early syphilis, while a combination therapy of ceftriaxone with doxycycline could simultaneously treat 40.6% of chlamydial coinfections in participants with gonorrhea.ConclusionBacterial STIs were prevalent and concomitant infections were not uncommon among sexually active, HIV-positive MSM, supporting regular screening for bacterial STIs. The effectiveness of preemptive use of doxycycline as combination therapy for concurrent STIs warrants more investigations. |
| first_indexed | 2024-04-24T23:48:25Z |
| format | Article |
| id | doaj.art-2650af20a6e5470f829f7a78dd742803 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-24T23:48:25Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-2650af20a6e5470f829f7a78dd7428032024-03-15T04:33:34ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-03-011110.3389/fmed.2024.13285891328589Sexually transmitted coinfections among at-risk HIV-positive MSM: implications for optimal preemptive treatmentTzong-Yow Wu0Tzong-Yow Wu1Kuan-Yin Lin2Li-Hsin Su3Hsin-Yun Sun4Yu-Shan Huang5Wang-Da Liu6Wang-Da Liu7Wen-Chun Liu8Lan-Hsin Chang9Sui-Yuan Chang10Sui-Yuan Chang11Chien-Ching Hung12Chien-Ching Hung13Chien-Ching Hung14Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Medicine, National Taiwan University Cancer Center, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, TaiwanDepartment of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, TaiwanBackgroundConcurrent sexually transmitted infections (STIs) are common in sexually active populations. We aimed to estimate the prevalence and coinfection rates of bacterial STIs among sexually active, HIV-positive men who have sex with men (MSM), and to assess the potential benefits of different combination treatment regimens in managing concurrent bacterial STIs.MethodsFrom September 2021 to September 2023, HIV-positive MSM underwent STI testing when they had symptoms suggestive of STIs or recently acquired hepatitis C virus (HCV) infection or early syphilis. The oral rinse, rectal swab, and urethral swab specimens were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma spp., Ureaplasma spp., and Trichomonas vaginalis with the use of multiplex real-time polymerase-chain-reaction assays. The estimated coinfection rates were used to evaluate the benefits of different combination treatment regimens for managing coinfections.ResultsDuring the study period, 535 participants (median age, 37 years; and CD4 count, 615 cells/mm3) were enrolled. On their first visits, at least one bacterial pathogen was detected in 57.9% and concomitant bacterial infections were found in 32.9% of the participants. The most commonly identified pathogen was U. urealyticum (36.3%), followed by C. trachomatis (22.8%), and N. gonorrhoeae (19.8%). The factors associated with any bacterial STIs included older age (per 1-year increase, adjusted odds ratio [AOR], 0.97; 95% confidence interval [CI], 0.95–1.00), early syphilis (AOR, 1.87; 95% CI, 1.22–2.84), and having more than 5 sex partners in the preceding 3 months (AOR, 2.08, 95% CI, 1.07–4.06). A combination therapy of benzathine penicillin G with a 7-day course of doxycycline could simultaneously treat 27.1% of C. trachomatis coinfections in participants with early syphilis, while a combination therapy of ceftriaxone with doxycycline could simultaneously treat 40.6% of chlamydial coinfections in participants with gonorrhea.ConclusionBacterial STIs were prevalent and concomitant infections were not uncommon among sexually active, HIV-positive MSM, supporting regular screening for bacterial STIs. The effectiveness of preemptive use of doxycycline as combination therapy for concurrent STIs warrants more investigations.https://www.frontiersin.org/articles/10.3389/fmed.2024.1328589/fullsexually transmitted coinfectionsyphilisChlamydia trachomatisNeisseria gonorrhoeaeMycoplasmaUreaplasma |
| spellingShingle | Tzong-Yow Wu Tzong-Yow Wu Kuan-Yin Lin Li-Hsin Su Hsin-Yun Sun Yu-Shan Huang Wang-Da Liu Wang-Da Liu Wen-Chun Liu Lan-Hsin Chang Sui-Yuan Chang Sui-Yuan Chang Chien-Ching Hung Chien-Ching Hung Chien-Ching Hung Sexually transmitted coinfections among at-risk HIV-positive MSM: implications for optimal preemptive treatment Frontiers in Medicine sexually transmitted coinfection syphilis Chlamydia trachomatis Neisseria gonorrhoeae Mycoplasma Ureaplasma |
| title | Sexually transmitted coinfections among at-risk HIV-positive MSM: implications for optimal preemptive treatment |
| title_full | Sexually transmitted coinfections among at-risk HIV-positive MSM: implications for optimal preemptive treatment |
| title_fullStr | Sexually transmitted coinfections among at-risk HIV-positive MSM: implications for optimal preemptive treatment |
| title_full_unstemmed | Sexually transmitted coinfections among at-risk HIV-positive MSM: implications for optimal preemptive treatment |
| title_short | Sexually transmitted coinfections among at-risk HIV-positive MSM: implications for optimal preemptive treatment |
| title_sort | sexually transmitted coinfections among at risk hiv positive msm implications for optimal preemptive treatment |
| topic | sexually transmitted coinfection syphilis Chlamydia trachomatis Neisseria gonorrhoeae Mycoplasma Ureaplasma |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2024.1328589/full |
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