Department of Dermatology, Venereology and Allergology, Ruhr University Bochum, Gudrunstraße 56, 44791, Bochum, Germany.
Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Kerpener Straße 62, 50924, Köln, Germany.
Br J Dermatol. 2016 Apr;174(4):831-8. doi: 10.1111/bjd.14288. Epub 2016 Jan 9.
HIV-positive men who have sex with men (HIV+MSM) have an increased risk for anal dysplasia and for sexually transmitted infections (STIs).
We determined the positivity rates of Chlamydia trachomatis (CT), Neisseria gonorrhoea (NG), Mycoplasma genitalium (MG) and syphilis in HIV+MSM participating in an anal cancer screening programme.
In total, 852 intra-anal swabs were collected from 503 HIV+MSM between 2012 and 2014. Anal cytology and polymerase chain reaction assays for human papillomavirus (HPV), CT, NG and MG detection were performed. The syphilis status was determined serologically. Risk factors for STIs were explored by multiple logistic regression analysis.
In total 20·7% (104 of 503) of the patients had an STI other than HPV within the study period. The most common was CT, found in 10·9%, followed by NG (8·9%) and MG (4·2%). Early syphilis was detected in 4·6% and past syphilis in 44·5% of the HIV+MSM. Eighteen patients (3·6%) had more than one STI episode, and 90·6% of the 127 cases of STIs were asymptomatic. Age, anal HPV infection, abnormal anal cytology and previous syphilis were risk factors for STI.
Anal STIs are frequent and mostly asymptomatic in HIV+MSM participating in anal cancer screening. STI screening should be incorporated into anal cancer screening programmes for HIV+MSM.
男男性行为者（MSM）中的 HIV 阳性者（HIV+MSM）发生肛门发育不良和性传播感染（STI）的风险增加。
我们确定了参与肛门癌筛查计划的 HIV+MSM 中沙眼衣原体（CT）、淋病奈瑟菌（NG）、生殖支原体（MG）和梅毒的阳性率。
2012 年至 2014 年期间，共从 503 名 HIV+MSM 中采集了 852 个肛内拭子。进行了肛门细胞学和聚合酶链反应检测人乳头瘤病毒（HPV）、CT、NG 和 MG。梅毒的状态通过血清学检测确定。通过多因素逻辑回归分析探讨了 STI 的危险因素。
在研究期间，20.7%（503 例患者中有 104 例）的患者患有除 HPV 以外的 STI。最常见的是 CT，发现率为 10.9%，其次是 NG（8.9%）和 MG（4.2%）。4.6%的 HIV+MSM 检测出早期梅毒，44.5%的 HIV+MSM 检测出既往梅毒。18 名患者（3.6%）有超过一次 STI 发作，127 例 STI 中有 90.6%为无症状。年龄、肛门 HPV 感染、异常肛门细胞学和既往梅毒是 STI 的危险因素。
在参与肛门癌筛查的 HIV+MSM 中，肛门 STI 很常见且大多数无症状。STI 筛查应纳入 HIV+MSM 的肛门癌筛查计划。
