Silva Guilherme Almeida Rosa da, Motta Heloisa Loureiro de Sá Neves, Souza Erik Friedrich Alex de, Cardoso Pedro Afonso Nogueira Moises, Pilotto José Henrique, Eyer-Silva Walter Araujo, Ribeiro Luiz Cláudio Pereira, Santos Mônica Soares Dos, Azevedo Marcelo Costa Velho Mendes de, Pinto Jorge Francisco da Cunha, Motta Rogerio Neves, Ferry Fernando Raphael de Almeida
Universidade Federal do Estado do Rio de Janeiro, Serviço de Clínica Médica 10ª Enfermaria, Rio de Janeiro, Rio de Janeiro, Brazil.
Fundação Oswaldo Cruz, Laboratório de AIDS e Imunologia, Rio de Janeiro, Rio de Janeiro, Brazil.
Rev Inst Med Trop Sao Paulo. 2018 Mar 8;60:e11. doi: 10.1590/S1678-9946201860011.
The increase in HIV transmissibility in non-ulcerative sexually transmitted infection is already well-established. It is estimated that symptomatic carriers of N. gonorrhoeae and C. trachomatis have a relative risk of 4.8-fold and 3.6-fold, respectively, for the sexual acquisition of HIV. This type of evaluation for asymptomatic urethritis is necessary to reinforce strategies to combat HIV transmission. This study aims to assess the prevalence of patients with asymptomatic urethritis among men diagnosed with HIV-1 and determine the risk factors associated with this infection.
We enrolled a total of 115 male patients aged 18 years or older who have been diagnosed with HIV infection and have no symptoms of urethritis or other sexually transmitted infections and who have been evaluated between May and August 2015 in a follow-up visit at the Immunology Outpatient Clinic of a Brazilian University Hospital.
Four asymptomatic patients were positive for C. trachomatis and were considered asymptomatic carriers of urethritis. Prevalence was 3.47%. Patients who were positive for C. trachomatis urethritis had a lower mean age (p = 0.015).
The presence of asymptomatic sexually transmitted infection is a challenge in clinical practice. We recommend that, in outpatient practice, the habit of inquiring on previous sexual behavior to obtain more information about risks and associations with asymptomatic sexually transmitted infection, a routine physical examination and complementary tests to detect STI pathogens should be performed to discard these conditions. The development of rapid tests for this purpose should also be encouraged.
非溃疡性性传播感染中艾滋病毒传播性增加这一情况已得到充分证实。据估计，淋病奈瑟菌和沙眼衣原体的有症状携带者通过性行为感染艾滋病毒的相对风险分别为4.8倍和3.6倍。对无症状尿道炎进行此类评估对于加强抗击艾滋病毒传播的策略十分必要。本研究旨在评估在诊断为HIV-1的男性中无症状尿道炎患者的患病率，并确定与这种感染相关的危险因素。
我们共纳入了115名18岁及以上的男性患者，他们已被诊断出感染艾滋病毒，没有尿道炎或其他性传播感染的症状，并且于2015年5月至8月间在巴西一家大学医院的免疫门诊进行随访时接受了评估。
4名无症状患者沙眼衣原体检测呈阳性，被视为无症状尿道炎携带者。患病率为3.47%。沙眼衣原体尿道炎呈阳性的患者平均年龄较低（p = 0.015）。
无症状性传播感染的存在是临床实践中的一项挑战。我们建议，在门诊实践中，应养成询问既往性行为习惯的做法，以获取更多关于风险以及与无症状性传播感染关联的信息，应进行常规体格检查和补充检测以检测性传播感染病原体，从而排除这些情况。还应鼓励为此目的开发快速检测方法。
