scholarly journals Recurring infection with ecologically distinct HPV types can explain high prevalence and diversity

2017 ◽  
Vol 114 (51) ◽  
pp. 13573-13578 ◽  
Author(s):  
Sylvia L. Ranjeva ◽  
Edward B. Baskerville ◽  
Vanja Dukic ◽  
Luisa L. Villa ◽  
Eduardo Lazcano-Ponce ◽  
...  
Keyword(s):  
Mechanistic Models ◽  
Sexually Active ◽  
Risk Of Infection ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hpv Prevalence ◽  
Increased Risk ◽  
High Prevalence ◽  
Hpv Types ◽  
The Impact

The high prevalence of human papillomavirus (HPV), the most common sexually transmitted infection, arises from the coexistence of over 200 genetically distinct types. Accurately predicting the impact of vaccines that target multiple types requires understanding the factors that determine HPV diversity. The diversity of many pathogens is driven by type-specific or “homologous” immunity, which promotes the spread of variants to which hosts have little immunity. To test for homologous immunity and to identify mechanisms determining HPV transmission, we fitted nonlinear mechanistic models to longitudinal data on genital infections in unvaccinated men. Our results provide no evidence for homologous immunity, instead showing that infection with one HPV type strongly increases the risk of infection with that type for years afterward. For HPV16, the type responsible for most HPV-related cancers, an initial infection increases the 1-year probability of reinfection by 20-fold, and the probability of reinfection remains 14-fold higher 2 years later. This increased risk occurs in both sexually active and celibate men, suggesting that it arises from autoinoculation, episodic reactivation of latent virus, or both. Overall, our results suggest that high HPV prevalence and diversity can be explained by a combination of a lack of homologous immunity, frequent reinfections, weak competition between types, and variation in type fitness between host subpopulations. Because of the high risk of reinfection, vaccinating boys who have not yet been exposed may be crucial to reduce prevalence, but our results suggest that there may also be large benefits to vaccinating previously infected individuals.

scholarly journals Recurring infection with ecologically distinct human papillomavirus (HPV) types explains high prevalence and diversity

2017 ◽  
Author(s):  
Sylvia Ranjeva ◽  
Edward B. Baskerville ◽  
Vanja Dukic ◽  
Luisa Villa ◽  
Eduardo Lazcano-Ponce ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hpv Prevalence ◽  
Increased Risk ◽  
High Prevalence ◽  
Hpv Types ◽  
One Year ◽  
The One ◽  
The Impact

AbstractThe high prevalence of human papillomavirus (HPV), the most common sexually transmitted infection, arises from the coexistence of over 200 genetically distinct types. Accurately predicting the impact of vaccines that target multiple types requires understanding the factors that determine HPV diversity. The diversity of many pathogens is driven by type-specific or “homologous” immunity, which promotes the spread of variants to which hosts have little immunity. To test for homologous immunity and to identify mechanisms determining HPV transmission, we fitted nonlinear mechanistic models to longitudinal data on genital infections in unvaccinated men. Our results provide no evidence for homologous immunity, instead showing that infection with one HPV type strongly increases the risk of infection with that type for years afterwards. For HPV16, the type responsible for most HPV-related cancers, an initial infection increases the one-year probability of reinfection by 20-fold, and the probability of reinfection remains 14-fold higher two years later. This increased risk occurs in both sexually active and celibate men, suggesting that it arises from auto-inoculation, episodic reactivation of latent virus, or both. Overall our results show that high HPV prevalence and diversity can be explained by a combination of a lack of homologous immunity, frequent reinfections, weak competition between types, and variation in type fitness between host subpopulations. Due to the high risk of reinfection, vaccinating boys that have not yet been exposed may be crucial to reduce prevalence, but our results suggest that there may also be large benefits from vaccinating previously infected individuals.

scholarly journals 433. Implementation of an Emergency Department Syphilis Screening Program

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S216-S216
Author(s):  
Tasleem Chechi ◽  
Allyson C Sage ◽  
Nam Tran ◽  
Sarah Waldman ◽  
Larissa S May
Keyword(s):  
Best Practice ◽  
Congenital Syphilis ◽  
Screening Program ◽  
Turnaround Time ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Increased Risk ◽  
High Prevalence ◽  
Syphilis Screening

Abstract Background Syphilis incidence across all regions of California increased by 22% compared with 2016 cases; with the largest number of chlamydia, gonorrhea, syphilis, and congenital syphilis cases among all states (CDC 2017). The USPSTF recommends targeted syphilis screening in patients at increased risk. However, in emergency departments (EDs) targeted syphilis screening is not routinely performed even when patients present for concerns of a sexually transmitted infection (STI). The purpose of this program was to implement routine syphilis screening among ED patients being tested for chlamydia and gonorrhea (CT/GC) through the use of an EHR enhancement to maximize the number of new syphilis diagnoses. Methods From November 27, 2018 to March 31, 2019, EHR-based syphilis screening was implemented in a quaternary care ED in Northern California serving urban and rural populations. EMR best practice alerts (BPA) were developed and populated on patients receiving STI testing. Syphilis testing employed a reverse sequence algorithm, which is suggested for high prevalence settings and provides rapid turnaround time. Patients were excluded if they opted out from testing. We determined the proportion of all CT/GC tested patients who underwent syphilis screening and the prevalence of syphilis among this group. Results During a four-month period, 649 ED patients with suspected STI received a BPA to screen for syphilis. Of those, 425 patients (65.5%) were screened for syphilis, 22 had a reactive IgG/IgM and RPR, while 5 patients had a reactive IgG/IgM and a nonreactive RPR which required a TPPA test to detect their infection. Fourteen of the 22 patients with a reactive RPR had titers of 1:32 or higher. Nine (32%) of those with a positive CT/GC test tested positive for syphilis. Conclusion Implementation of a syphilis screening program in patients undergoing testing for other STIs yielded 28 new diagnoses compared with those tested prior to the screening in 2018. Introducing an automated EMR-based syphilis screening program is an effective method to maximize syphilis screening in all ED patients seeking treatment for STIs. The screening data suggest that the majority of patients undergoing STI testing in our ED are not screened for syphilis, yet the prevalence of infection in those screened is substantial. Disclosures All authors: No reported disclosures.

scholarly journals Reducing the Health Burden of HPV Infection Through Vaccination

2006 ◽  
Vol 2006 ◽  
pp. 1-5 ◽  
Author(s):  
David Soper
Keyword(s):  
Disease Burden ◽  
Cervical Screening ◽  
Hpv Infection ◽  
Quadrivalent Vaccine ◽  
Sexually Active ◽  
Phase 3 ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hpv Types ◽  
Vaccination Campaigns

Human papillomavirus (HPV), a sexually transmitted infection and the etiologic cause of genital warts and cervical cancer, is highly prevalent in sexually active men and women. Although cervical screening procedures have significantly reduced the disease burden associated with HPV infection, they are expensive and abnormal results cause significant emotional distress. Therefore, prevention may be an effective strategy for reducing the economic, psychosocial, and disease burden of HPV infection. Multivalent vaccines are now in clinical development. A bivalent vaccine that protects against HPV 16 and 18, and a quadrivalent vaccine which protects against HPV types 6, 11, 16, and 18, have been shown to significantly reduce the occurrence of incident and persistent HPV infections in phase 2 clinical trials; phase 3 trials are currently underway. HPV vaccines will be most effective when administered prior to initiation of sexual activity, and vaccination campaigns should aggressively target preadolescent and adolescent populations.

scholarly journals Prevalence of urogenital, anal, and pharyngeal infections with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium: a cross-sectional study in Reunion island

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
A. Calas ◽  
N. Zemali ◽  
G. Camuset ◽  
J. Jaubert ◽  
R. Manaquin ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Mycoplasma Genitalium ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Urogenital Infection ◽  
High Prevalence

Abstract Background Recommendations for sexually transmitted infection (STI) screening vary significantly across countries. This study evaluated the prevalence of urogenital and extragenital infections with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) in patients visiting a French STI clinic in the Indian Ocean region to determine whether current STI screening practices should be updated. Methods This cross-sectional study examined all patients who visited the STI clinic between 2014 and 2015. Triplex polymerase chain reaction screening for CT, NG, and MG was performed on urine, vaginal, pharyngeal, and anal specimens (FTD Urethritis Basic Kit, Fast Track Diagnostics, Luxembourg). Results Of the 851 patients enrolled in the study, 367 were women (367/851, 43.2%) and 484 were men (484/851, 56.0%). Overall, 826 urogenital specimens (826/851, 97.1%), 606 pharyngeal specimens (606/851, 71.2%), and 127 anal specimens (127/851, 14.9%) were taken from enrolled patients. The prevalence of urogenital CT and MG was high in women ≤25 years (19/186, 10.21%; 5/186, 2.69%) and in men who have sex with women ≤30 years (16/212, 7.54%; 5/212, 2.36%). Among patients with urogenital CT infection, 13.7% (7/51) had urethritis. All patients with urogenital MG infection were asymptomatic. Men who have sex with men had a high prevalence of pharyngeal CT (2/45, 4.44%) and NG (3/44, 6.81%) and a high prevalence of anal CT (2/27, 7.41%), NG (2/27, 7.40%), and MG (1/27, 3.70%). After excluding patients with concomitant urogenital infection, extragenital infections with at least 1 of the 3 pathogens were found in 20 swabs (20/91, 21.9%) taken from 16 patients (16/81, 19.7%), all of them asymptomatic. Conclusions Routine multisite screening for CT, NG, and MG should be performed to mitigate the transmission of STIs in high-risk sexually active populations.

scholarly journals Chlamydia trachomatis and urogenital mycoplasms in nonconococcal urethirits in men

2010 ◽  
Vol 63 (1-2) ◽  
pp. 47-50
Author(s):  
Sonja Vesic ◽  
Jelica Vukicevic ◽  
Eleonora Gvozdenovic ◽  
Dusan Skiljevic ◽  
Slobodanka Janosevic ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Ureaplasma Urealyticum ◽  
Mycoplasma Hominis ◽  
Sexually Active ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Nongonococcal Urethritis ◽  
Etiological Agents ◽  
The One

Introduction. Nongonococcal urethritis is the most common sexually transmitted infection in men, with vast majority of the etiological agents such as Chlamydia trachomatis, followed by urogenital mycoplasmas. The aim of this study was to determine the prevalence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis in nongonococcal urethritis in men, and to examine infections associated with these agents. Material and methods. 299 sexually active, heterosexual men with nongonococcal urethritis were included into the study. Urethral samples were taken with a dacron swab placed into the urethra up to 2-3 cm. The Direct immunojluorescence tehnique was performed for identification of Chlamydia trachomatis. Ureaplasma urealyticum and Mycoplasma hominis were detected with Mycoplasma 1ST assay. Results. Chlamydia trachomatis was detected in 22.75%, Uraeplasma urealyticum in 21.08% and Mycoplasma hominis in 8.02% cases. We found no significant differences in prevalence between Chlamydia trachomatis and Ureaplasma urealyticym (p>0.05). Monoinjections were found in 51.85% with significantly higher rate (p<0.01) than associated infections (11.70%). Among associated infections, coinfection of Chlamydia trahomatis and Ureaplasma urealyticum was predominant. Association of Chlamydia trachomatis with urogenital mycoplasmas was significantly higher (p<0.05) than the one between Ureaplasma urealyticum and Mycoplasma hominis. In 36.45% patients no patogenic microorganisms were detected. Conclusion. These results confirmed the etiological role of Chlamydia trachomatis and urogenital mycoplasmas in nongonococcal urethritis with prevalence of 51.85% in monoinfections and 11.70% in associated infections. In 36.45% of cases the etiology of urethritis was not elucidated. These results suggest that more sensitive diagnostic tool should be applied when searching for the detailed etiology of nongonococcal urethritis.

scholarly journals Sero-epidemiology and risk factors of syphilis in Makassar, Indonesia

2019 ◽  
Vol 11 (2) ◽  
pp. 43-49
Author(s):  
Maryam Kusumawaty ◽  
Khairuddin Djawad ◽  
Muh Nasrum Massi ◽  
Andi Muhammad Adam ◽  
Siswanto Wahab ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hiv Transmission ◽  
Treponema Pallidum ◽  
Public Health Problem ◽  
Sexual Relationships ◽  
Capital City ◽  
Major Public Health Problem ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Increased Risk

Abstract Introduction. Syphilis is an infectious disease caused by Treponema pallidum spirochete and is mainly transmitted by sexual contact. Syphilis has the potential to cause serious complications and is closely related to human immunodeficiency virus (HIV) infection thus making syphilis still a major public health problem. In Indonesia, surveys of high-risk populations in 2007 and 2011 reported an increase in the prevalence of syphilis, especially in men who have sexual relationships with other men (MSM). Moreover, studies have described risk factors for HIV transmission including MSM, heterosexual contacts, Intravenous (IV) drug use, and infected partners. Objectives. To assess the epidemiological aspects and risk factors for syphilis in Makassar, as well as the correlation with a coinfection of other sexually transmitted infections. Material and Methods. This study is a multi-centre cross-sectional descriptive study with consecutive sampling. We evaluated cases for eligibility by confirming the diagnosis based on the serological result using rapid plasma reagin assay (RPR), Treponema pallidum haemagglutination (TPHA), and HIV screening kit. The cases were analyzed based on epidemiological features, risk factors and clinical findings, co-infection with other sexually transmitted infection (ST), and stadium of the disease. Results. A total of 79 serologically confirmed syphilis cases were collected between January 2017 and December 2018 in Makassar, the capital city of South Sulawesi province in Indonesia. Of the 63 male subjects (79.7%), 38 (48.1%) were homosexual/MSM, and in 41 cases of HIV-infected subjects, 25 (60.9%) of them were also MSM. Conclusion. Our study showed there was a significant correlation between syphilis and an increased risk of HIV transmission in MSM groups. The higher number of cases of syphilis and HIV co-infection among MSM can increase transmission of both infections and should be considered a major risk factor for syphilis in Makassar.

scholarly journals Sexual behaviours and sexually transmitted infection outcomes in a cohort of HIV-negative men who have sex with men attending sexual health clinics in England

2018 ◽  
Vol 29 (14) ◽  
pp. 1407-1416 ◽  
Author(s):  
S Desai ◽  
F Burns ◽  
G Schembri ◽  
D Williams ◽  
A Sullivan ◽  
...  
Keyword(s):  
High Risk ◽  
Sexual Health ◽  
Receptive Anal Intercourse ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual Behaviours ◽  
Increased Risk ◽  
Sex With Men ◽  
Clinical Records ◽  
Hiv Negative

Men who have sex with men (MSM) attending sexual health (SH) clinics are at high risk for HIV acquisition and are disproportionately affected by sexually transmitted infections (STIs). We collected standardised behavioural data from MSM attending clinics to characterise sexual behaviours and identify predictors for HIV and STIs. In 2012–2013, HIV-negative MSM attending five SH clinics in England reported sexual behaviours in the previous three months via a self-administered questionnaire. Behaviours were linked to the individual’s clinical records using national surveillance. The prevalence and incidence of bacterial STIs (gonorrhoea, Chlamydia, lymphogranuloma venereum and syphilis) and incidence of HIV were calculated. Adjusted odds ratios and hazard ratios with 95% confidence interval (CI) were reported for significant predictors. Of 1278 HIV-negative MSM, 54% were of white ethnicity and UK-born and 43% were 25–34 years old. Almost all men reported at least one partner in the last three months. Half reported condomless anal sex and 36% condomless receptive anal intercourse (CRAI). Incidence of bacterial STIs was 46/100 (95%CI 39–54) person years (py) and of HIV was 3.1/100 (95%CI 1.7–5.6) py. A STI at baseline and CRAI with increasing numbers of partners were associated with both incident infections. In this cohort of MSM high-risk behaviours and STIs were prevalent. Engagement in CRAI increased the likelihood of subsequent infection, while men diagnosed with a bacterial STI were at increased risk of a future STI. Clinical and behavioural risk assessments to determine an individual’s risk of infection could allow a more nuanced prevention approach that has greater success in reducing transmission.

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