title: Mycoplasma genitalium is associated with increased genital HIV type 1 RNA in Zimbabwean women.
abstract: BACKGROUND
  Mycoplasma genitalium is a common sexually transmitted infection associated with human immunodeficiency virus (HIV) infection. Some studies suggest that M. genitalium may increase the risk of HIV acquisition. However, results have been inconsistent, and this association has never been examined longitudinally.
  
  
  METHODS
  Stored endocervical samples from a longitudinal cohort study of 131 Zimbabwean women in whom HIV-1 seroconversion recently occurred were tested for detection and quantity of M. genitalium using polymerase chain reaction analysis. The associations between M. genitalium and the detection and quantity of genital HIV type 1 (HIV-1) RNA, the detection and quantity of plasma HIV-1 RNA, and the CD4(+) T-cell count was analyzed using mixed-effects regression analysis.
  
  
  RESULTS
  M. genitalium was detected in 10.5% of stored specimens (44 of 420), and infection persisted for up to 300 days. M. genitalium was independently associated with detection of genital HIV-1 RNA (adjusted odds ratio, 2.67; 95% confidence interval, .99-7.20), after adjustment for plasma viral load, viral set point, CD4(+) T-cell count, herpes simplex virus type 2 detection, and gonorrhea. There was no evidence of an association between M. genitalium detection or quantity and either plasma HIV-1 RNA load or CD4(+) T-cell count.
  
  
  CONCLUSIONS
  The growing evidence for an association between M. genitalium and HIV genital shedding and the high prevalence and persistence of M. genitalium in this population suggest that further research into this association is important. Consideration of the cost-effectiveness of M. genitalium screening interventions may be warranted.
authors.affiliation: Women's Global Health Imperative, RTI International, San Francisco, California.
authors.forename: Sue
authors.initials: S
authors.lastname: Napierala Mavedzenge
authors.affiliation: Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases.
authors.forename: Etienne E
authors.initials: EE
authors.lastname: Müller
authors.affiliation: Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg Division of Medical Microbiology, University of Cape Town, South Africa.
authors.forename: David A
authors.initials: DA
authors.lastname: Lewis
authors.affiliation: University of Zimbabwe College of Health Science, Harare.
authors.forename: Tsungai
authors.initials: T
authors.lastname: Chipato
authors.affiliation: Clinical Sciences, FHI 360, Durham, North Carolina.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Morrison
authors.affiliation: MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Weiss
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D009175:Mycoplasma Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology*; D045704:Mycoplasma genitalium / Q000302:isolation & purification*; D012367:RNA, Viral / Q000302:isolation & purification; D019562:Viral Load; D017201:Virus Shedding; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D012367:RNA, Viral
keywords: HIV; Mycoplasma genitalium; Zimbabwe; epidemiology; genital HIV-1 RNA