scholarly journals Trends in asymptomatic STI among HIV-positive MSM and lessons for systematic screening

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0250557
Author(s):  
Eric Farfour ◽  
Svetlane Dimi ◽  
Olivier Chassany ◽  
Sébastien Fouéré ◽  
Nadia Valin ◽  
...  
Keyword(s):  
Serological Test ◽  
Asymptomatic Infection ◽  
Nucleic Acid Amplification ◽  
Hiv Positive ◽  
Self Medication ◽  
Systematic Screening ◽  
Period 2 ◽  
Asymptomatic Patients ◽  
Paris Area ◽  
Asymptomatic Hiv

The burden of STIs is particularly high in HIV-infected MSM patients. A recent increase in STIs prevalence has been noticed in the US and western European countries. We aim to assess trends in asymptomatic STIs following the publication of recommendations for STIs screening, i.e. Chlamydia (CT) and gonorrhea (NG). Seventeen centers located in the Paris area participated in the study. All asymptomatic HIV-infected MSM patients attending a follow up consultation were proposed to participated in the study. Asymptomatic patients were included over 2 periods: period 1 from April to December 2015 and period 2 from September to December 2017. Etiologic diagnosis of STIs including hepatitis B, C, syphilis, was performed using a serological test, including a non-treponemal titer with a confirmatory treponemal assay for syphilis. CT and NG were screened using a nucleic acid amplification test (NAATs) on 3 anatomical sites, i.e. urine, rectal and pharyngeal. Overall, 781 patients were included: 490 and 291 in periods 1 and 2 respectively. Asymptomatic CT, NG, and syphilis were diagnosed in 7.5%, 4.8% and, 4.2% respectively. The rate of patients having a multisite asymptomatic infection was 10.2% and 21.1% for CT and NG respectively. The most frequently involved anatomical sites for CT and NG asymptomatic infections were anorectal (66.1% and 55.2% respectively) and pharyngeal (47.4% and 60.5% respectively). CT and NG asymptomatic infection increased by 1.3- and 2-fold respectively between the two periods while syphilis decreased by 3 folds. Our results encourage to reconsider multisite screening for CT and NG in asymptomatic HIV positive MSM as the yield of screening urinary samples only might be low. Despite the more systematic STI screening of asymptomatic HIV positive MSM the prevalence of STI is increasing in MSM in France. Therefore, this strategy has not led to alter CT and NG transmission. The decrease of syphilis might involve self-medication by doxycycline, and the intensification of syphilis screening.

Radioactively labelled diethylene triamine penta acetate lung scan in Pneum ocystis carinii pneumonia and asymptomatic HIV-positive patients

1997 ◽  
Vol 8 (8) ◽  
pp. 482-488 ◽  
Author(s):  
Caroline O Dimian ◽  
Michael J O'Doherty ◽  
David Asboe ◽  
Christopher J Page ◽  
Kate Entwisle ◽  
...  
Keyword(s):  
False Positive Rate ◽  
Pneumocystis Carinii ◽  
Hiv Positive ◽  
Half Time ◽  
Diethylene Triamine ◽  
Normal Ranges ◽  
Asymptomatic Patients ◽  
Positive Rate ◽  
Lung Scan ◽  
Asymptomatic Hiv

The objective of this study is to establish normal ranges for the assessment of lung permeability, using 99mTc DTPA (diethylene triamine penta acetate) aerosol by measuring the half-time of transfer from the lung in asymptomatic HIV-positive patients. Also to audit the use of the test in the clinical management of outpatients with symptoms suggestive of Pneumocystis carinii pneumonia (PCP). A retrospective analysis of data from outpatients' notes for the audit of symptomatic patients, and prospective acquisition of 'normal' data for HIVpositive asymptomatic patients who were non-smokers and smokers was performed. Over a period of 8 years, DTPA scans were performed on 400 asymptomatic HIV-positive patients (121 non-smokers and 279 smokers) and 188 symptomatic HIV-positive patients with symptoms suggestive of PCP. A biphasic curve of transfer of 99mTc DTPA with a half-time of less than 4 min, was considered diagnostic of PCP. The mean half-times ( SEM) for asymptomatic non-smokers was 61.4 3 min and for smokers was 21.9 0.8 min. In the symptomatic patients, 106 were treated for PCP and in 97 (91.5%) of these, the transfer was biphasic. Of the remaining 82 patients with respiratory pathology other than PCP, 71 (86.6%) had normal scans. The results show that smokers may have abnormal baseline scans 16/ 279 (5.7%) and therefore a baseline scan before symptoms should be recorded or a higher false positive rate can be expected. The test is however highly sensitive for the detection of PCP and allows the attending physician to initiate PCP treatment without delay.

Prevalence of Mycoplasma genitalium by anatomical site in men who have sex with men: a systematic review and meta-analysis

2020 ◽  
Vol 96 (8) ◽  
pp. 563-570
Author(s):  
Rosie L Latimer ◽  
Hannah S Shilling ◽  
Lenka A Vodstrcil ◽  
Dorothy A Machalek ◽  
Christopher K Fairley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Mycoplasma Genitalium ◽  
Nucleic Acid Amplification ◽  
Hiv Positive ◽  
Published Data ◽  
Anatomical Site ◽  
Ovid Medline ◽  
Registration Number ◽  
Sex With Men

ObjectiveTo systematically review and appraise published data, to determine the prevalence of Mycoplasma genitalium (MG) in men who have sex with men (MSM) tested at each anatomical site, that is, at the urethra, rectum and/or pharynx.DesignSystematic review and meta-analysis.Data sourcesOvid Medline, PubMed, Embase were searched for articles from 1st January 1981 (the year MG was first identified) to 1st June 2018.Review methodsStudies were eligible for inclusion if they reported MG prevalence in MSM tested at the urethra, rectum and/or pharynx, in at least 50 MSM, using nucleic acid amplification testing. Data were extracted by anatomical site, symptom and HIV status. Summary estimates (95% CIs) were calculated using random-effects meta-analysis. Subgroup analyses were performed to assess heterogeneity between studies.ResultsForty-six studies met inclusion criteria, with 34 reporting estimates of MG prevalence at the urethra (13 753 samples), 25 at the rectum (8629 samples) and 7 at the pharynx (1871 samples). MG prevalence was 5.0% (95% CI 3.5 to 6.8; I2=94.0) at the urethra; 6.2% (95% CI 4.6 to 8.1; I2=88.1) at the rectum and 1.0% (95% CI 0.0 to 5.1; I2=96.0) at the pharynx. The prevalence of MG was significantly higher at urethral and rectal sites in symptomatic versus asymptomatic MSM (7.1% vs 2.2%, p<0.001; and 16.1% vs 7.5%, p=0.039, respectively). MG prevalence at the urethra was significantly higher in HIV-positive compared with HIV-negative MSM (7.0% vs 3.4%, p=0.006).ConclusionMG was common in MSM, particularly at urethral and rectal sites (5% to 6%). MG was more commonly detected in symptomatic men at both sites, and more common in HIV-positive men at the urethra. MG was uncommonly detected in the pharynx. Site-specific estimates are similar to those for chlamydia and will be helpful in informing testing practices in MSM.PROSPERO registration numberCRD42017058326.

scholarly journals Short Communication: Evaluation of a New Rapid Diagnostic Test for Quality Assurance by Kala Azar Elimination Programme in Bangladesh

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Md Gulam Musawwir Khan ◽  
Mohammad Shafiul Alam ◽  
Abu Toha Bhuiyan ◽  
Maleka Arjumand Jamil ◽  
Bijoy Saha ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Serological Test ◽  
Rapid Test ◽  
Test Strip ◽  
Cross Reactivity ◽  
Serological Tests ◽  
Kala Azar ◽  
Asymptomatic Patients ◽  
Elimination Programme ◽  
The Government

In Bangladesh, serological tests have been widely used for the primary screening of visceral leishmaniasis (VL). Several serologic tests are available for the diagnosis of VL. Selection of the best test is important to permit diagnostic differentiation between symptomatic and asymptomatic patients and to reduce cross-reactivity. We evaluated the effectiveness of a new serological test “Onsite Leishmania Ab Rapid Test” as a part of “quality assurance” activities for the kala azar elimination programme of the Government of Bangladesh. Plasma samples of 100 parasitologically confirmed cases of VL along with 101 healthy controls were tested, and “Onsite Leishmania Ab Rapid Test” strip tests were positive in 94 out of 100 confirmed VL cases, whereas four out of 51 healthy subjects from the VL endemic areas also tested positive. All the 50 healthy volunteers tested negative. Thus, the sensitivity and specificity of “Onsite Leishmania Ab Rapid Test” strip test were found to be 94% (95% CI: 87–98) and 96% (95% CI: 90–99), respectively. This study showed that the performance of the “Onsite Leishmania Ab Rapid Test” strip tests was up to the recommended level.

scholarly journals Standardized Urine-Based Tuberculosis (TB) Screening With TB-Lipoarabinomannan and Xpert MTB/RIF Ultra in Ugandan Adults With Advanced Human Immunodeficiency Virus Disease and Suspected Meningitis

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Fiona V Cresswell ◽  
Jayne Ellis ◽  
Enock Kagimu ◽  
Ananta S Bangdiwala ◽  
Michael Okirwoth ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Odds Ratio ◽  
Virus Disease ◽  
Extrapulmonary Tuberculosis ◽  
Hiv Positive ◽  
Systematic Screening ◽  
Immunodeficiency Virus ◽  
Cell Pellet ◽  
Hiv Positive Adults ◽  
Advanced Hiv Disease

Abstract Background Diagnosis of extrapulmonary tuberculosis (TB) remains challenging. We sought to determine the prevalence of disseminated TB by testing urine with TB-lipoarabinomannan (TB-LAM) lateral flow assay and Xpert MTB/RIF Ultra (Ultra) in hospitalized adults. Methods We prospectively enrolled human immunodeficiency virus (HIV)-positive adults with suspected meningitis in Uganda during 2018–2020. Participants underwent standardized urine-based TB screening. Urine (60 mcL) was tested with TB-LAM (Alere), and remaining urine was centrifuged with the cell pellet resuspended in 2 mL of urine for Xpert Ultra testing. Results We enrolled 348 HIV-positive inpatients with median CD4 of 37 cells/mcL (interquartile range, 13–102 cells/mcL). Overall, 26% (90 of 348; 95% confidence interval [CI], 21%–30%) had evidence of disseminated TB by either urine assay. Of 243 participants with both urine TB-LAM and Ultra results, 20% (48 of 243) were TB-LAM-positive, 12% (29 of 243) were Ultra-positive, and 6% (14 of 243) were positive by both assays. In definite and probable TB meningitis, 37% (14 of 38) were TB-LAM-positive and 41% (15 of 37) were Ultra-positive. In cryptococcal meningitis, 22% (40 of 183) were TB-LAM-positive and 4.4% (6 of 135) were Ultra-positive. Mortality trended higher in those with evidence of disseminated TB by either assay (odds ratio = 1.44; 95% CI, 0.83–2.49; P = .19) and was 6-fold higher in those with definite TB meningitis who were urine Ultra-positive (odds ratio = 5.67; 95% CI, 1.13–28.5; P = .04). Conclusions In hospitalized Ugandans with advanced HIV disease and suspected meningitis, systematic screening with urine TB-LAM and Ultra found a high prevalence of urine TB test positivity (26%). In those with TB meningitis, urine tests were positive in over one third. There was little concordance between Ultra and TB-LAM, which warrants further investigation.

scholarly journals Increasing syphilis rates among men who have sex with men and screening to detect asymptomatic infection

Sexual Health ◽  
2017 ◽  
Vol 14 (4) ◽  
pp. 301 ◽  
Author(s):  
Marcus Chen ◽  
Rebecca Guy
Keyword(s):  
Viral Load ◽  
Hiv Testing ◽  
Asymptomatic Infection ◽  
Hiv Positive ◽  
Load Testing ◽  
Serological Testing ◽  
Hiv Viral Load ◽  
Ocular Syphilis ◽  
Syphilis Screening ◽  
Sex With Men

With reports of increasing syphilis rates among men who have sex with men in various countries and complications such as ocular syphilis and neurosyphilis, greater efforts for promoting frequent syphilis screening of higher risk men are required. This should include serological testing for syphilis every time HIV testing is undertaken and each time HIV viral load testing is performed in HIV-positive men who have sex with men. Systems-based approaches tailored to particular contexts should be explored, evaluated and, if shown to be effective, implemented.

Assessment of Cognitive Function in Asymptomatic HIV-Positive Subjects

1999 ◽  
Vol 42 (4) ◽  
pp. 225-229 ◽  
Author(s):  
Maria Pia Grassi ◽  
Cecilia Perin ◽  
Monica Borella ◽  
Alfonso Mangoni
Keyword(s):  
Cognitive Function ◽  
Hiv Positive ◽  
Asymptomatic Hiv

PCR detection of HIV proviral DNA in the brain of an asymptomatic HIV-positive patient

1992 ◽  
Vol 239 (8) ◽  
pp. 469-470 ◽  
Author(s):  
Elizabeth Sinclair ◽  
Fran�oise Gray ◽  
Francesco Scaravilli
Keyword(s):  
Pcr Detection ◽  
Positive Patient ◽  
Hiv Positive ◽  
Proviral Dna ◽  
The Brain ◽  
Hiv Proviral Dna ◽  
Asymptomatic Hiv

scholarly journals Detection of Clostridium difficile in Feces of Asymptomatic Patients Admitted to the Hospital

2016 ◽  
Vol 55 (2) ◽  
pp. 403-411 ◽  
Author(s):  
Elisabeth M. Terveer ◽  
Monique J. T. Crobach ◽  
Ingrid M. J. G. Sanders ◽  
Margreet C. Vos ◽  
Cees M. Verduin ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Predictive Value ◽  
Health Care Facilities ◽  
Nucleic Acid Amplification ◽  
Content Type ◽  
Asymptomatic Patients ◽  
Toxigenic Culture ◽  
Stool Samples ◽  
Sensitivity Specificity ◽  
Low Prevalence

ABSTRACTRecent evidence shows that patients asymptomatically colonized withClostridium difficilemay contribute to the transmission ofC. difficilein health care facilities. Additionally, these patients may have a higher risk of developingC. difficileinfection. The aim of this study was to compare a commercially available PCR directed to both toxin A and B (artusC. difficileQS-RGQ kit CE; Qiagen), an enzyme-linked fluorescent assay to glutamate dehydrogenase (GDH ELFA) (Vidas, bioMérieux), and an in-house-developed PCR totcdB, with (toxigenic) culture ofC. difficileas the gold standard to detect asymptomatic colonization. Test performances were evaluated in a collection of 765 stool samples obtained from asymptomatic patients at admission to the hospital. TheC. difficileprevalence in this collection was 5.1%, and 3.1% contained toxigenicC. difficile. Compared toC. difficileculture, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of theC. difficileGDH ELFA were 87.2%, 91.2%, 34.7%, and 99.3%, respectively. Compared with results of toxigenic culture, the sensitivity, specificity, PPV, and NPV of the commercially available PCR and the in-house PCR were 95.8%, 93.4%, 31.9%, 99.9%, and 87.5%, 98.8%, 70%, and 99.6%, respectively. We conclude that in a low-prevalence setting of asymptomatically colonized patients, both GDH ELFA and a nucleic acid amplification test can be applied as a first screening test, as they both display a high NPV. However, the low PPV of the tests hinders the use of these assays as stand-alone tests.

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