Natural history of Mycoplasma genitalium Infection in a Cohort of Female Sex Workers in Kampala, Uganda
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Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
Sexually transmitted diseases
Abstract
There have been few studies of the natural history of Mycoplasma genitalium in
women. We investigated patterns of clearance and recurrence of untreated M. genitalium infection
in a cohort of female sex workers in Uganda.
Methods—Women diagnosed as having M. genitalium infection at enrollment were retested for
the infection at 3-month intervals. Clearance of infection was defined as testing negative after
having a previous positive result: persistence was defined as testing positive after a preceding
positive test result, and recurrence as testing positive after a preceding negative test result.
Adjusted hazard ratios for M. genitalium clearance were estimated using Cox proportional hazards
regression.
Results—Among 119 participants infected with M. genitalium at enrollment (prevalence, 14%),
55% had spontaneously cleared the infection within 3 months; 83%, within 6; and 93%, within 12
months. The overall clearance rate was 25.7/100 person-years (pyr; 95% confidence interval,
21.4–31.0). HIV-positive women cleared M. genitalium infection more slowly than did HIVnegative
women (20.6/100 pyr vs. 31.3/100 pyr, P = 0.03). The clearance rate was slower among
HIV-positive women with CD4 counts less than 350/mL3 than among those with higher CD4
counts (9.88/100 pyr vs. 29.5/100 pyr, P < 0.001). After clearing the infection, M. genitalium
infection recurred in 39% women.
Conclusions—M. genitalium is likely to persist and recur in the female genital tract. Because of
the urogenital tract morbidity caused by the infection and the observed association with HIV
acquisition, further research is needed to define screening modalities, especially in populations at
high risk for HIV, and to optimize effective and affordable treatment options.
Description
Keywords
Natural history, Mycoplasma genitalium Infection, Female Sex Workers, Uganda
Citation
Vandepitte, J., Weiss, H. A., Kyakuwa, N., Nakubulwa, S., Muller, E., Buvé, A., ... & Grosskurth, H. (2013). Natural history of Mycoplasma genitalium infection in a cohort of female sex workers in Kampala, Uganda. Sexually transmitted diseases, 40(5), 422. doi:10.1097/OLQ.0b013e31828bfccf.