The Natural History of Rectal Gonococcal and Chlamydial Infections: The ExGen Study
Autor: | Lindley A. Barbee, Winnie Yeung, James P. Hughes, Olusegun O. Soge, Matthew R. Golden, Micaela Haglund, Christine M Khosropour |
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Rok vydání: | 2021 |
Předmět: |
Male
Microbiology (medical) medicine.medical_specialty Gonorrhea Chlamydia trachomatis HIV Infections urologic and male genital diseases Men who have sex with men Sexual and Gender Minorities Internal medicine CHLAMYDIAL INFECTIONS Humans Medicine Prospective Studies Homosexuality Male Chlamydia Coinfection business.industry Transmission (medicine) Chlamydia Infections medicine.disease Neisseria gonorrhoeae Natural history Major Articles and Commentaries Rectal Diseases Infectious Diseases Female Observational study business Cohort study |
Zdroj: | Clin Infect Dis |
ISSN: | 1537-6591 1058-4838 |
DOI: | 10.1093/cid/ciab680 |
Popis: | Background The duration of rectal gonococcal and chlamydial infection remains unknown. This basic epidemiologic parameter is needed to understand transmission dynamics. Methods We conducted a prospective, longitudinal, observational cohort study of 140 men who have sex with men (MSM) at risk of gonorrhea and chlamydia acquisition. For 48 weeks, enrolled men collected rectal swabs (Aptima multi-test kit) at home and responded to an electronic survey about sexual behavior and health conditions weekly. Swabs remained untested until participants completed the study. We used Kaplan-Meier estimates to determine the median duration of infection, censoring infections for treatment, loss to follow-up, and end-of-study. We used log-rank test to compare duration of infection by human immunodeficiency virus (HIV) status, history of infection with gonorrhea or chlamydia, and coinfection with the other pathogen. Results 140 enrolled MSM contributed 70.5 person-years of follow-up. Eighteen men had 20 incident rectal gonococcal infections, which persisted for 2–23 weeks; 30% were censored for treatment. The estimated median duration of rectal gonorrhea was 9 weeks (95% confidence interval [CI]: 3–12 weeks). Twenty-four men experienced 32 rectal chlamydial infections, persisting between 2 and 42 weeks; 60% were censored. The estimated duration of rectal chlamydia was 13 weeks (95% CI: 6 weeks–undefined). There were no differences in the duration of rectal gonorrhea or chlamydia by HIV status, history of chlamydia/gonorrhea, or coinfection. Conclusions On average, rectal gonorrhea and chlamydial infections last 2–3 months, although some infections persisted for 6–11 months. Further understanding into predictors of persistence is needed. |
Databáze: | OpenAIRE |
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