Association betweenMycoplasma genitaliuminfection and HIV acquisition among female sex workers in Uganda: evidence from a nested case–control study

Abstract

ObjectivesCross-sectional studies have shown a strong association between Mycoplasma genitalium and HIV infections. We previously reported that in a cohort of female sex workers in Uganda, M genitalium infection at baseline was associated with HIV seroconversion. Here we examine the temporal association between the M genitalium infection status shortly before HIV seroconversion and HIV acquisition.MethodsA nested case-control study was conducted within a cohort of women at high risk for HIV in Kampala. Cases were those of women acquiring HIV within 2 years of enrolment. For each of the 42 cases, 3 controls were selected from women HIV negative at the visit when the corresponding case first tested HIV seropositive. The association between HIV acquisition and M genitalium infection immediately prior to HIV testing was analysed using conditional logistic regression.ResultsThere was weak evidence of an association between M genitalium infection and HIV acquisition overall (crude OR=1.57; 95% CI 0.67 to 3.72, aOR=2.28: 95% CI 0.81 to 6.47). However, time of M genitalium testing affected the association (p value for effect-modification=0.004). For 29 case-control sets with endocervical samples tested 3 months prior to the first HIV-positive result, M genitalium infection increased the risk of HIV acquisition (crude OR=3.09; 95% CI 1.06 to 9.05, aOR=7.19; 95% CI 1.68 to 30.77), whereas there was little evidence of an association among the 13 case-control sets with samples tested at an earlier visit (crude OR=0.30: 95% CI 0.04 to 2.51; aOR=0.34; 95% CI 0.02 to 5.94).ConclusionsOur study showed evidence of a temporal relationship between M genitalium infection and HIV acquisition that suggests that M genitalium infection may be a co-factor in the acquisition of HIV infection.

Mycoplasma genitalium Prevalence, Coinfection, and Macrolide Antibiotic Resistance Frequency in a Multicenter Clinical Study Cohort in the United States

“…genitalium infections reported here are similar to those reported previously in smaller studies of high-risk populations in the United States (6, 9, 10, 14, 15, 20) and in the European community (21, 22), Australia and New Zealand (23–25), Asia (26, 27), and Africa (28, 29). Age-related trends for M.…”

Clinical Laboratory Assessment of Mycoplasma genitalium Transcription-Mediated Amplification Using Primary Female Urogenital Specimens

“…Recent evidence has implicated the bacterium in clinically significant disease in females (2,3). Additional studies suggest that M. genitalium infection promotes HIV acquisition (4)(5)(6) and virus shedding (7,8). Moreover, in a recent meta-analysis, Lis et al (9) reported significant associations between M. genitalium infection and cervicitis, pelvic inflammatory disease, preterm birth, and spontaneous abortion.…”

Epidemiology of sexually transmitted infections in rural Haitian men

“…[15][16][17][18] M. genitalium infection in women may also be a co-factor in acquisition of HIV infection. 19 T. vaginalis is an important cause of NGU in Africa. In one study, it was the most common pathogen identified in urethral samples and found in 14% of symptomatic and 9% of asymptomatic men.…”