Incidence of sexually transmitted infections is lower among kidney transplant recipients compared to the general population—A nationwide cohort study

Abstract

Aim:The burden of sexually transmitted infections (STI) among solid-organ transplant recipients is currently unknown. We studied the risk of STIs among kidney transplant recipients compared with the general population in a nationwide cohort. Methods: Between 2002 and 2019, all microbiological findings of Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum (syphilis), and human immunodeficiency virus among kidney transplant recipients <65 years and transplanted between 1995 and 2017 in our country were captured from statutory national registries. Data from the general population of Finland, population 5.5 million, were used for comparisons.Incidence of STIs and age and sex-adjusted standardized incidence ratios (SIR) were calculated.Results: Altogether 3612 transplantations, with a total follow-up of 27 069 personyears were included. A total of 30 STIs microbiological findings of STI were confirmed in 25 patients: C. trachomatis (N = 27), N. gonorrhoeae (N = 2), and syphilis (N = 1). No hospitalizations associated with STIs were detected. The risk of STI after kidney transplantation was significantly lower compared to the general population (SIR, 0.57, 95% CI 0.39-0.80). The lower risk of STIs was more pronounced in female patients (SIR 0.40, 95% CI 0.20-0.74), whereas in male patients the difference was statistically not significant (SIR 0.69, 95% CI 0.44-1.04). Of the confirmed STI cases, 30% were detected in patients who received their transplants during adolescence.

Risk for Donor-Derived Syphilis after Kidney Transplantation, China, 2007–2022

“…By chance, 1 recipient was infected after receiving a kidney from his spouse with active syphilis infection even when prophylactic measures were implemented. In the nationwide cohort study evaluating the burden of sexually transmitted infections after transplantation, 25 of 3,612 recipients were confirmed to have acquired infections, including 1 case of syphilis ( 14 ). Those findings underscore the imperative for recipients and their spouses to undergo treatment.…”

Sexual and reproductive health screening and counseling in adolescent and young adult transplant recipients

“…38,39 A small cross-sectional review of 49 adolescent renal transplant recipients found a 30% STI prevalence in targeted screening of symptomatic patients compared to 15% prevalence in the general adolescent clinic population offering universal screening. 40 In the review of a large database of SOT recipients, the highest frequency of STI was seen among patients transplanted during adolescence, 41 suggesting that screening and counseling efforts should be focused on AYA. STIs can be severe and difficult to eradicate in immune-suppressed patients.…”