Herpes simplex type II and Mycoplasma genitalium as risk factors for heterosexual HIV transmission: Report from the heterosexual hiv transmission study

Perez, George; Skurnick, Joan; Denny, Thomas N.; Stephens, Richard C.; Kennedy, Cheryl A.; Regivick, Nina; Nahmias, André J.; Lee, Francis K.; Lo, Shyh‐Ching; Wang, Richard Y.-H.; Weiss, Stanley H.; Louria, Donald B.

doi:10.1016/s1201-9712(98)90088-1

Cited by 59 publications

(31 citation statements)

References 26 publications

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“…Furthermore, it was noted (139) that women who had a high burden of M. genitalium organisms were more likely to shed HIV-1 DNA than were M. genitalium-negative women, an observation in keeping with the ability of mycoplasmas to stimulate HIV replication (175) and possibly enhance, as does C. trachomatis, the transmission of the virus. This suggestion is also supported by some limited serological data (166). The significant positive association between M. genitalium and HIV infection has been further strongly supported by the result of a meta-analysis of 19 eligible studies (157).…”

Section: Infection In Homosexual Men and In Immunodeficient Or Immunomentioning

confidence: 64%

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

2011

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SUMMARY The history, replication, genetics, characteristics (both biological and physical), and factors involved in the pathogenesis of Mycoplasma genitalium are presented. The latter factors include adhesion, the influence of hormones, motility, possible toxin production, and immunological responses. The preferred site of colonization, together with current detection procedures, mainly by PCR technology, is discussed. The relationships between M. genitalium and various diseases are highlighted. These diseases include acute and chronic nongonococcal urethritis, balanoposthitis, chronic prostatitis, and acute epididymitis in men and urethritis, bacterial vaginosis, vaginitis, cervicitis, pelvic inflammatory disease, and reproductive disease in women. A causative relationship, or otherwise strong association, between several of these diseases and M. genitalium is apparent, and the extent of this, on a subjective basis, is presented; also provided is a comparison between M. genitalium and two other genital tract-orientated mollicutes, namely, Mycoplasma hominis , the first mycoplasma of human origin to be discovered, and Ureaplasma species. Also discussed is the relationship between M. genitalium and infertility and also arthritis in both men and women, as is infection in homosexual and immunodeficient patients. Decreased immunity, as in HIV infections, may enhance mycoplasmal detection and increase disease severity. Finally, aspects of the antimicrobial susceptibility and resistance of M. genitalium , together with the treatment and possible prevention of mycoplasmal disease, are discussed.

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Section: Infection In Homosexual Men and In Immunodeficient Or Immunomentioning

confidence: 64%

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

2011

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“…Additionally, there are increasing numbers of studies suggesting that M. genitalium increases the risk of HIV-1 acquisition and/or transmission (2)(3)(4). Like other pathogenic mycoplasmas, M. genitalium is capable of causing chronic infections, as has been documented in cultured human endocervical epithelial cells (5), in animal models (6,7), in men with NGU (8,9), and in women with cervicitis (10).…”

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confidence: 95%

Extensive Variation and Rapid Shift of the MG192 Sequence in Mycoplasma genitalium Strains from Patients with Chronic Infection

Mancuso

Williams

et al. 2014

Infect Immun

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e Mycoplasma genitalium causes persistent urogenital tract infection in humans. Antigenic variation of the protein encoded by the MG192 gene has been proposed as one of the mechanisms for persistence. The aims of this study were to determine MG192 sequence variation in patients with chronic M. genitalium infection and to analyze the sequence structural features of the MG192 gene and its encoded protein. Urogenital specimens were obtained from 13 patients who were followed for 10 days to 14 months. The variable region of the MG192 gene was PCR amplified, subcloned into plasmids, and sequenced. Sequence analysis of 220 plasmid clones yielded 97 unique MG192 variant sequences. MG192 sequence shift was identified between sequential specimens from all but one patient. Despite great variation of the MG192 gene among and within clinical specimens from different patients, MG192 sequences were more related within M. genitalium specimens from an individual patient than between patients. The MG192 variable region consisted of 11 discrete subvariable regions with different degrees of variability. Analysis of the two most variable regions (V4 and V6) in five sequential specimens from one patient showed that sequence changes increased over time and that most sequences were present at only one time point, suggesting immune selection. Topology analysis of the deduced MG192 protein predicted a surface-exposed membrane protein. Extensive variation of the MG192 sequence may not only change the antigenicity of the protein to allow immune evasion but also alter the mobility and adhesion ability of the organism to adapt to diverse host microenvironments, thus facilitating persistent infection.A s a sexually transmitted human pathogen, Mycoplasma genitalium causes nongonococcal urethritis (NGU) in men and is associated with genital tract inflammatory diseases in women, including endometritis, cervicitis, pelvic inflammatory disease, and tubal factor infertility (reviewed in reference 1). Additionally, there are increasing numbers of studies suggesting that M. genitalium increases the risk of HIV-1 acquisition and/or transmission (2-4). Like other pathogenic mycoplasmas, M. genitalium is capable of causing chronic infections, as has been documented in cultured human endocervical epithelial cells (5), in animal models (6, 7), in men with NGU (8, 9), and in women with cervicitis (10). The mechanisms for persistence remain poorly understood.The MgPa operon in the M. genitalium genome encodes three proteins, MG190 (mgpA), MG191 (mgpB or P140), and MG192 (mgpC or P110). The latter two are the known major adhesion proteins located on the surface of the terminal structure of M. genitalium, which plays a major role in the attachment of the organism to host epithelial cells (11,12). Both proteins are highly antigenic and capable of eliciting strong antibody responses in M. genitalium-infected patients and experimentally infected animals (6,(12)(13)(14), suggesting an important role in pathogenesis. According to the genome sequence of M. genital...

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“…M. genitalium may also increase the risk of HIV transmission and associated shedding (10)(11)(12)(13).…”

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confidence: 99%

Clinical Characteristics Associated with Mycoplasma genitalium among Female Sex Workers in Nairobi, Kenya

et al. 2014

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eThe prevalence of Mycoplasma genitalium is high in vulnerable populations of women in low-resource settings. However, the epidemiology of infection in these populations is not well established. To determine the prevalence of Mycoplasma genitalium and its association with cervical cytology and other correlates, we recruited 350 female sex workers (FSW) who were 18 to 50 years old in Nairobi, Kenya, for a cross-sectional study. A questionnaire was administered at baseline to obtain information on sociodemographics and sexual behaviors. Women underwent a pelvic exam, during which a physician collected cervical-exfoliation samples for conventional cytology and sexually transmitted infection (STI) testing. Samples were tested for M. genitalium Mycoplasma genitalium is an emergent bacterium that is transmitted via sexual activity and has been associated with complications in the female genital tract, including endometritis, tubal-factor infertility, pelvic inflammatory disease (PID), cervicitis, and ectopic pregnancy (1-9). M. genitalium may also increase the risk of HIV transmission and associated shedding (10-13).Vulnerable populations of women in low-resource settings have a higher-than-average susceptibility to sexually transmitted infections (STIs) and subsequent complications of the reproductive tract, including those caused by M. genitalium, Chlamydia trachomatis, and Neisseria gonorrhoeae (14). In the case of female sex workers (FSWs), STI risk is increased due to a greater exposure to unsafe sexual behaviors, such as unprotected sexual intercourse and high numbers of clients/sexual partners (15).The prevalence and associated risk factors for M. genitalium have been investigated both in the general population and among populations at high risk for STIs in sub-Saharan Africa, Asia, the United Kingdom, and the United States (4, 16-23). Across many of these studies, a young age, little education, single marital status, and high numbers of sex partners remained consistently associated with infection (4,9,16,18,21,23,24). Findings are less consistent among the few studies that examined risk factors among FSWs. In the literature, studies have shown similar associations of M. genitalium infection with basic demographic factors, such as education and marital status. However, there is less agreement for sexual-behavioral and clinical correlates, such as condom use, duration of sex work, and history of STIs (16,18,23). Chinese sex workers who did not present STI symptoms in the year prior to the study were more likely to have infection with M. genitalium than those who did (23). In contrast, a study conducted in sub-Saharan Africa found that sex workers who presented clinical symptoms were more likely to have M. genitalium infection than those who were asymptomatic (18).In studies examining concurrent M. genitalium infection with other STIs in the general population, M. genitalium was found to be associated with urethritis, cervicitis, and PID (25-28). However, more-recent research indicates the role of M. genitalium ...

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Herpes simplex type II and Mycoplasma genitalium as risk factors for heterosexual HIV transmission: Report from the heterosexual hiv transmission study

Abstract: These data support the role of HSV-2 in transmission of HIV and, for the first time, suggest a role for M. genitalium as an independent risk factor.

Cited by 59 publications

References 26 publications

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

Extensive Variation and Rapid Shift of the MG192 Sequence in Mycoplasma genitalium Strains from Patients with Chronic Infection

Clinical Characteristics Associated with Mycoplasma genitalium among Female Sex Workers in Nairobi, Kenya

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