Screening should target M. genitalium in patients with HIV

Health care providers should consider including Mycoplasma genitalium, an STD-causing bacteria, among targets of routine screening in patients with HIV, according to researchers.

M. genitalium prevalence was high among a cohort of United States Air Force personnel with HIV, according to the study published in Clinical Infectious Diseases.

“This is the first report in the United States to describe the results of incorporating M. genitalium as part of standard STD screening for HIV-infected patients,” Shilpa Hakre, DrPH, MPH, of the U.S. Military HIV Research Program, and colleagues wrote. “The prevalence of M. genitalium was high and substantially higher than the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis among U.S. Air Force patients with newly diagnosed or chronic HIV infection who were stationed throughout the U.S. and receiving HIV specialty care at a central medical facility.”

The researchers analyzed data from 102 patients with HIV who had made clinical visits between May 16 and Sept. 30, 2016.

Nearly all patients, 99%, were male. The median age was 31 years, and 74% had an undetectable or unquantifiable HIV viral load of less than 20 copies/mL.

Urine and swab samples taken from the patients were tested for M. genitalium and T. vaginalis, in addition to infections screened under existing standards. A total of 298 rectal, oropharyngeal and urine samples were taken. Patient demographics, information on sexual activity and details were collected as well.

In all, 19 patients (18.6%) tested positive for M. genitalium, the researchers said (95% CI, 11.6%-27.6%). Two patients (2%) tested positive for T. vaginalis (95% CI, 0.2%-6.9%). No patient tested positive for both.

Nearly all patients infected with M. genitalium (95%) reported sexual contact in the past year with men. They had much higher risk for infection than those patients with no partners or female partners in the past year (OR = 8.21; 95% CI, 1.04-64.81).

Citing previous studies, the researchers pointed out potential associations between M. genitalium, HIV and other infections.

“Whether there is a significant relationship between M. genitalium infection and factors such as duration of HIV infection and history of C. trachomatis/N. gonorrhoeae remains to be determined with a larger cohort of patients,” they wrote. – by Joe Green

Disclosure: The researchers report no relevant financial disclosures.