The incidence of sexually acquired reactive arthritis: a systematic literature review

Abstract

Objective-Reactive Arthritis (ReA) is an inflammatory spondyloarthritis occurring after infection at a distant site. Chlamydia trachomatis is proposed to be the most common cause ofReA, yet the incidence of sexually-acquired ReA (SARA) has not been well established. We therefore carried out a systematic literature review to collate and critically evaluate the published evidence regarding the incidence of SARA.Methods-MEDLINE and EMBASE databases were searched using free-text and MeSH terms relating to infection and ReA. The title and abstract of articles returned were screened independently by two reviewers and potentially relevant articles assessed in full. Data was extracted from relevant articles and a risk of bias assessment carried out using a validated tool. Heterogeneity of study methodology and results precluded meta-analysis.Results-The search yielded a total of 11680 articles, and a further 17 were identified from review articles. After screening, 55 papers were assessed in full, from which 3 met the relevant inclusion criteria for the review. The studies reported an incidence of SARA of 3.0% -8.1% and were found to be of low to moderate quality.Conclusions-More studies are required to address the lack of data regarding the incidence of SARA. Specific and sensitive classification criteria must be developed in order for consistent classification and valid conclusions to be drawn. In clinical practice, it is recommended clinicians discuss the possibility of ReA developing at the time of STI diagnosis, and to encourage patients to return if they experience any relevant symptoms.

Reactive Arthritis: Update

“…When it comes to genitourinary infections, we can notice a recent decrease in incidence of sexually acquired reactive arthritis (SARA) due to campaigns to raise awareness about sexually transmitted disease. Denison et al have reported an incidence of SARA between 3.0 and 8.1% [14].…”

“…Regarding the Middle East and Africa region, the scarcity of epidemiological data has prevented researchers from estimating the prevalence of ReA [11,15,16]. Given the fact that sexually transmitted diseases are prevalent in Africa, with a high rate of the human immunodeficiency virus (HIV) [15,17], SARA is increasing in this area [14]. For instance, a study conducted in Zambia has demonstrated that the prevalence of spondyloarthritis (SpA) was higher in patients with HIVpositive rather than those who tested HIV-negative (respectively, 180 per 100,000 and 15 per 100,000) [18].…”

Interferon-γ Possesses Anti-Microbial and Immunomodulatory Activity on a Chlamydia trachomatis Infection Model of Primary Human Synovial Fibroblasts

“…C. trachomatis is still an important public health problem worldwide, because of the impact of asymptomatic genital infections in both women (90%) and men (50%), favoring the onset of severe chronic complications, including reactive arthritis (ReA) in both genders [2][3][4]. It is estimated, indeed, that approximately 4-8% of patients will develop ReA one to six weeks after a urogenital C. trachomatis infection [5]. In 30% of all cases, ReA persists for years, compromising joint function and leading, eventually, to joint deformities and ankylosis [6,7].…”

Barriers to sexually transmitted infection testing in New Zealand: a qualitative study

“…S exually transmitted infections (STIs) are a long-standing global health problem with potential serious sequelae including pelvic inflammatory disease, adverse pregnancy outcomes, infertility, rheumatological complications, cancer, organ damage and death. [1][2][3][4] Although progress towards control of STIs has been made, for example with antiviral therapy for human immunodeficiency virus (HIV) 5 and the introduction of the human papillomavirus (HPV) vaccine, 6 we are still some way from controlling or eradicating these and other pathogens. Of particular concern is increasing rates of antimicrobial resistant gonorrhoea 7 and the re-emergence of syphilis.…”