The association between Mycoplasma genitalium and HIV-1 acquisition in African women

Napierala, Sue; Pol, Barbara Van Der; Weiss, Helen A.; Kwok, Cynthia; Mambo, Fidelis; Chipato, Tsungai; Straten, Ariane van der; Salata, Robert; Morrison, Charles

doi:10.1097/qad.0b013e32834ff690

Cited by 76 publications

(35 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Importantly, cervicitis has been associated with increased HIV shedding, and treatment of the condition reduces both viral shedding and the presence of virus-infected cells in cervical secretions (51)(52)(53). Having been shown to enhance susceptibility to HIV infection (54,55), and with cross-sectional associations with HIV infection in more than 20 studies (56), continued investigation of M. genitalium remains important, as antibiotic-resistant strains continue to emerge worldwide.…”

Section: Discussionmentioning

confidence: 99%

Mycoplasma genitalium Infection Is Associated with Microscopic Signs of Cervical Inflammation in Liquid Cytology Specimens

Dehon¹,

McGowin²

2014

J Clin Microbiol

View full text Add to dashboard Cite

Cervicitis is a common clinical finding often attributed to sexually transmitted infections (STIs), but no etiologic agent is identified in the majority of cases. In this study, we comparatively assessed inflammation among the common infectious etiologies of cervicitis and assessed the potential value of liquid cytology specimens for predicting STIs. Among 473 Louisiana women at low risk for acquiring STIs, the prevalences of Mycoplasma genitalium, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in liquid-based cytology specimens were 1.5, 2.1, 0.6, and 4.4%, respectively. N. gonorrhoeae and human papillomavirus 18 (HPV18) infections were significantly more common among subjects infected with M. genitalium. Using direct microscopy, we observed significant increases in leukocyte infiltrates among subjects with monoinfections with M. genitalium or C. trachomatis compared to women with no detectable STIs. Inflammation was highest among subjects with M. genitalium. Using a threshold of >2 leukocytes per epithelial cell per high-powered field, the positive predictive values for M. genitalium, C. trachomatis, N. gonorrhoeae, and T. vaginalis were 100, 70, 67, and 20%, respectively. Several novel M. genitalium genotypes were identified, all of which were predicted to be susceptible to macrolide antibiotics, suggesting that different strains may circulate among low-risk women and that macrolide resistance is substantially lower than in high-risk populations. This study highlights the capacity of M. genitalium to elicit cervical inflammation and, considering the strong epidemiologic associations between M. genitalium and human immunodeficiency virus (HIV), provides a potential mechanism for acquisition and shedding of HIV via chronic leukocyte recruitment to the cervical mucosa.

show abstract

Section: Discussionmentioning

confidence: 99%

Mycoplasma genitalium Infection Is Associated with Microscopic Signs of Cervical Inflammation in Liquid Cytology Specimens

Dehon¹,

McGowin²

2014

J Clin Microbiol

View full text Add to dashboard Cite

show abstract

“…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.…”

mentioning

confidence: 99%

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

et al. 2016

View full text Add to dashboard Cite

Following analysis of primary cervix, vagina, and first-void female urine specimens for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis via commercial transcription-mediated amplification (TMA), residual material was subjected to Mycoplasma genitalium research-use-only TMA. Representation within a 2,478-specimen retrospective study set was established by comparison to a 6-month audit of clinical C. trachomatis TMA (12,999 specimens) on the basis of the C. trachomatis detection rate, specimen source distribution, clinic location, and age. M. genitalium was detected in 282 (11.4%) patients. This rate was higher than those seen with T. vaginalis (9.0%; P ‫؍‬ 0.005), C. trachomatis (6.2%), and N. gonorrhoeae (1.4%). Positive M. genitalium results were confirmed by repeat testing or alternative-target TMA at a rate of 98.7%. The mean age of the M. genitalium-infected females (24.7 years) was lower than that of the T. vaginalis-infected females (mean, 30.1 years; P < 0.0001) and higher than that of the C. trachomatis-infected females (mean, 23.8 years; P ‫؍‬ 0.003). Of 566 patient encounters positive for at least one sexually transmitted infection (STI), 35.9% exhibited sole detection of M. genitalium (P < 0.0004 versus sole detection of other STI agents) and 26.1% were solely positive for T. vaginalis (P < 0.0002 versus C. trachomatis). The M. genitalium and T. vaginalis detection rates among 755 patients at urban emergency departments were 14.6% and 13.0%, respectively (P ‫؍‬ 0.37). A 10.0% M. genitalium detection rate from other facilities exceeded that of T. vaginalis (7.2%; P ‫؍‬ 0.004). Incorporation of M. genitalium TMA into comprehensive testing programs would detect M. genitalium in a significant proportion of females, particularly those in outpatient obstetrics and gynecology (OB/GYN) settings. T he sexually transmitted infection (STI) agentMycoplasma genitalium has historically had a role of pathogenicity in male nongonococcal urethritis (1). Recent evidence has implicated the bacterium in clinically significant disease in females (2, 3). Additional studies suggest that M. genitalium infection promotes HIV acquisition (4-6) 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.Until recently, a lack of reliable testing options has curtailed laboratory diagnosis of M. genitalium infection. Culture and serologic modalities have been limited by sensitivity and/or cross-reactivity with other mycoplasmas (1) and are becoming supplanted by molecular diagnostics, largely on a research basis. PCR-based assays have correlated M. genitalium DNA burden with clinical condition (10, 11) and treatment efficacy (12) in males. Quantitative molecular analysis has sought to study progression of genital disease in females (13). In the realm of laboratory diagnosis, initial studies of target capture-based transcription-mediated amp...

show abstract

“…In women, it has been associated with cervicitis, pelvic inflammatory disease, and infertility (1,(3)(4)(5)(6)(7) and studies have also suggested that it plays an important role in HIV acquisition and transmission (8,9). The exact rates of M. genitalium prevalence have been reported in a limited number of studies, with prevalences of 0.8% to 2.3% among young women and 1.1% to 6.9% among young men (10)(11)(12)(13)(14).…”

mentioning

confidence: 99%

Evaluation of the Hologic Panther Transcription-Mediated Amplification Assay for Detection of Mycoplasma genitalium

Tabrizi

Costa

et al. 2016

J Clin Microbiol

View full text Add to dashboard Cite

fThe detection of Mycoplasma genitalium was evaluated on 1,080 urine samples by the use of a Panther instrument. Overall sensitivity, specificity, positive predictive values, and negative predictive values were 100%, 99.4%, 93.6%, and 100%, respectively. Detection of M. genitalium by the use of the Panther transcription-mediated amplification assay offers a simple, accurate, and sensitive platform for diagnostic laboratories. Mycoplasma genitalium is a common cause of nongonococcal urethritis (NGU) in men and currently accounts for 10% to 35% of NGU cases globally (1, 2). In women, it has been associated with cervicitis, pelvic inflammatory disease, and infertility (1,(3)(4)(5)(6)(7) and studies have also suggested that it plays an important role in HIV acquisition and transmission (8, 9). The exact rates of M. genitalium prevalence have been reported in a limited number of studies, with prevalences of 0.8% to 2.3% among young women and 1.1% to 6.9% among young men (10)(11)(12)(13)(14).As this organism is highly fastidious and slow growing, culture is not feasible for diagnosis and is performed in only a small number of laboratories worldwide for research purposes. Diagnosis relies on nucleic acid amplification tests (NAAT); however, as there have been limited commercial assays available, most laboratories have utilized in-house NAATs, utilizing quantitative PCR (qPCR) assays with various targets (15-21). For some time, a research-use-only transcription-mediated amplification assay for detection of M. genitalium (MG-TMA) has been available from Hologic (Bedford, MA, USA) for use on either the manual or automated TIGRIS DTS system; however, this has recently been introduced onto the Panther platform utilizing the open-channel software feature, with the manufacturer package insert indicating a sensitivity of 0.01 CFU/ml (equivalent to 0.004 copies per reaction). The assay has received the CE mark for in vitro diagnosis (CE-IVD) in Europe and is becoming accredited through other regulatory bodies for utilization in diagnostic laboratories. In this study, we evaluated the performance of the MG-TMA on the Panther platform for the detection of M. genitalium 16S rRNA by comparison to three assays: an alternative 16S rRNA target assay (Alt-TMA) available on Panther and two previously described PCR assays, one targeting a 78-bp region of the M. genitalium adhesion (MgPa) gene with sensitivity of five copies per reaction (18) and the other targeting a 517-bp region of the 16S rRNA gene with sensitivity of 10 copies per reaction (21). To our knowledge, this is the first clinical evaluation of the Panther assay for detection of M. genitalium.From February to May 2015, consecutive urine samples received for M. genitalium testing were utilized for this evaluation. Ethical approval for this study was granted by the Royal Women's Hospital Research and Ethics Committees. The patient population included 664 men and women attending Melbourne Sexual Health Centre for management of NGU or sexual contacts of infected partners, 309 co...

show abstract

The association between Mycoplasma genitalium and HIV-1 acquisition in African women

Cited by 76 publications

References 30 publications

Mycoplasma genitalium Infection Is Associated with Microscopic Signs of Cervical Inflammation in Liquid Cytology Specimens

Mycoplasma genitalium Infection Is Associated with Microscopic Signs of Cervical Inflammation in Liquid Cytology Specimens

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

Evaluation of the Hologic Panther Transcription-Mediated Amplification Assay for Detection of Mycoplasma genitalium

Contact Info

Product

Resources

About