title: Asymptomatic genitourinary Chlamydia trachomatis infection in women seropositive for human immunodeficiency virus infection.
abstract: OBJECTIVE
  To evaluate the prevalence of asymptomatic Chlamydia trachomatis genitourinary infection in women with human immunodeficiency virus (HIV) infection.
  
  
  METHODS
  The prevalence of asymptomatic chlamydial genitourinary infection in HIV-seropositive women was compared with both HIV-seronegative controls and women with unknown HIV status. Chlamydia trachomatis was isolated in cell culture from endocervical and urethral specimens.
  
  
  RESULTS
  The prevalence of genitourinary C trachomatis infection among HIV-seropositive women was 18.3% (21 of 115), a rate significantly higher than in both HIV-negative women (11 of 136; P = .016) and controls with unknown HIV status (18 of 326; P = .0001). Crude odds ratios for endocervical and urethral chlamydial infection in HIV-seropositive women compared to HIV-seronegative controls were 2.6 (95% confidence interval [CI] 1.13-6.08) and 3.3 (95% CI 1.15-9.67), respectively. After adjustment for variables related to sexual habits, there was no difference in the risk of cervical C trachomatis infection between HIV-seropositive cases and HIV-seronegative controls (Mantel-Haenszel odds ratio 1.04, 95% CI 0.93-1.14; P = .41). Finally, in HIV-seropositive patients, both the severity of immunosuppression evaluated by CD4+, CD8+, and total lymphocyte counts and the detection of p24 HIV-related antigen did not correlate with the presence of chlamydial infection.
  
  
  CONCLUSIONS
  Women infected with HIV are at high risk for asymptomatic genitourinary chlamydial colonization. To prevent a possible "epidemic" of pelvic inflammatory disease, appropriate screening programs and therapeutic strategies should be planned.
authors.affiliation: Istituto di Clinica Ostetrica e Ginecologica, Università di Pavia School of Medicine, IRCCS Policlinico S. Matteo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Spinillo
authors.forename: G
authors.initials: G
authors.lastname: Gorini
authors.forename: A
authors.initials: A
authors.lastname: Regazzetti
authors.forename: F
authors.initials: F
authors.lastname: De Seta
authors.forename: S
authors.initials: S
authors.lastname: Nicola
authors.forename: C
authors.initials: C
authors.lastname: Zara
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000382:microbiology; D002690:Chlamydia Infections / Q000150:complications* / Q000175:diagnosis; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D016017:Odds Ratio; D012307:Risk Factors; D014521:Urethra / Q000382:microbiology