Risk of Human Immunodeficiency Virus Acquisition Among High-Risk Heterosexuals With Nonviral Sexually Transmitted Infections: A Systematic Review and Meta-Analysis.

Autor:	Barker EK; From the Philip R. Lee Institute for Health Policy Studies., Malekinejad M, Merai R; Institute for Global Health Sciences., Lyles CM; Division of HIV/AIDS Prevention., Sipe TA; Division of HIV/AIDS Prevention., DeLuca JB; Division of HIV/AIDS Prevention., Ridpath AD; Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Gift TL; Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Tailor A; Division of HIV/AIDS Prevention., Kahn JG
Jazyk:	angličtina
Zdroj:	Sexually transmitted diseases [Sex Transm Dis] 2022 Jun 01; Vol. 49 (6), pp. 383-397. Date of Electronic Publication: 2022 Jan 13.
DOI:	10.1097/OLQ.0000000000001601
Abstrakt:	Background: Nonviral sexually transmitted infections (STIs) increase risk of sexually acquired human immunodeficiency virus (HIV) infection. Updated risk estimates carefully scrutinizing temporality bias of studies are needed. Methods: We conducted a systematic review (PROSPERO CRD42018084299) of peer-reviewed studies evaluating variation in risk of HIV infection among high-risk heterosexuals diagnosed with any of: Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoeae, Treponema pallidum, and/or Trichomonas vaginalis. We searched PubMed, Web of Science, and Embase databases through December 2017 and included studies where STIs and HIV were assessed using laboratory tests or medical examinations and where STI was diagnosed before HIV. After dual screening, data extraction, and risk of bias assessment, we meta-analytically pooled risk ratios (RRs). Results: We found 32 eligible studies reporting k = 97 effect size estimates of HIV acquisition risk due to infection with one of the abovementioned STIs. Most data were based on women engaged in sex work or other high-risk occupations in developing countries. Many studies did not measure or adjust for known confounders, including drug injection and condom use, and most were at medium or high risk of bias because of the potential for undetected HIV infection to have occurred before STI infection. Human immunodeficiency virus acquisition risk increased among women infected with any pathogen; the effect was greatest for women infected with Mycoplasma genitalium (RR, 3.10; 95% confidence interval [CI], 1.63-5.92; k = 2) and gonorrhea (RR, 2.81; 95% CI, 2.25-3.50; k = 16) but also statistically significant for women infected with syphilis (RR, 1.67; 95% CI, 1.23-2.27; k = 17), trichomonas (RR, 1.54; 95% CI, 1.31-1.82; k = 17), and chlamydia (RR, 1.49; 95% CI, 1.08-2.04; k = 14). For men, data were space except for syphilis (RR, 1.77; 95% CI, 1.22-2.58; k = 5). Conclusion: Nonviral STI increases risk of heterosexual HIV acquisition, although uncertainty remains because of risk of bias in primary studies. Competing Interests: Conflict of Interest: None declared. (Copyright © 2022 American Sexually Transmitted Diseases Association. All rights reserved.)
Databáze:	MEDLINE
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