Division of Infectious Diseases, Department of Medicine II, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
Department of Infection Medicine, Medical Service Centre Clotten, Freiburg, Germany.
Infection. 2023 Aug;51(4):897-907. doi: 10.1007/s15010-022-01946-0. Epub 2022 Nov 9.
Annual screening for asymptomatic infections with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) is recommended by international guidelines in people living with HIV but uptake in routine care remains poor. This study analyzed the effects of the implementation of a CT/NG screening program in a primary HIV treatment center.
In this single-center cohort study, we included men having sex with men (MSM) living with HIV during the study period from January 2016 to December 2019. From January 2018 on, annual sexual health counseling including CT/NG screening was proactively offered to all MSM presenting at the center. CT/NG screening rates, test positivity rates and case detection rates in the years 2018 and 2019 were compared to those in the years 2016 and 2017.
A total of 234 patients were enrolled in the study contributing to 798.7 patient years (py) during the four-year study period. Screening rates increased from 3.1% and 3.9% in 2016 and 2017 to 51.1% in 2018 and decrease to 35.4% in 2019. Over the study period, 19.7% (46/234) had at least one positive CT/NG result. After the intervention, case detection per 100 py increased for CT (2016: 2.6, 2017: 3.7, 2018: 7.7, 2019: 7.1) and NG (2016: 3.2, 2017: 3.1, 2018: 5.3, 2019: 7.6). The number needed to test was 8.9 for CT and 10.4 for NG.
Regular CT/NG screening is feasible in a primary care setting, leads to an increase in case detection and may contribute to decrease transmission and complications of CT/NG.
The trial is registered in ClinicalTrials.gov (NCT02149004).
国际指南建议对艾滋病毒感染者进行无症状沙眼衣原体（CT）和淋病奈瑟菌（NG）感染的年度筛查，但在常规护理中的接受率仍然很低。本研究分析了在一个初级艾滋病毒治疗中心实施 CT/NG 筛查项目的效果。
在这项单中心队列研究中，我们纳入了在研究期间（2016 年 1 月至 2019 年 12 月）接受艾滋病毒治疗的男男性行为者（MSM）。自 2018 年 1 月起，向所有到中心就诊的 MSM 主动提供年度性健康咨询，包括 CT/NG 筛查。将 2018 年和 2019 年的 CT/NG 筛查率、阳性率和病例检出率与 2016 年和 2017 年进行比较。
共有 234 名患者参与了这项研究，在四年的研究期间共提供了 798.7 名患者年（py）。筛查率从 2016 年和 2017 年的 3.1%和 3.9%上升到 2018 年的 51.1%，但在 2019 年下降到 35.4%。在研究期间，19.7%（46/234）至少有一次 CT/NG 阳性结果。干预后，每 100 py 的 CT 病例检出率增加（2016 年：2.6，2017 年：3.7，2018 年：7.7，2019 年：7.1），NG 病例检出率增加（2016 年：3.2，2017 年：3.1，2018 年：5.3，2019 年：7.6）。CT 检测所需的数量为 8.9，NG 为 10.4。
在初级保健环境中定期进行 CT/NG 筛查是可行的，可增加病例检出率，并有助于减少 CT/NG 的传播和并发症。
该试验在 ClinicalTrials.gov 注册（NCT02149004）。
