title: Impact of rectal gonorrhoea and chlamydia on HIV viral load in the rectum: potential significance for onward transmission.
abstract: The aim of this study was to investigate the effect of asymptomatic rectal bacterial sexually transmitted infections (STIs) on rectal HIV viral load (VL). A prospective cohort study of HIV-positive men who have sex with men attending a tertiary centre in London, UK, for their routine HIV care was performed. Forty-two HIV-positive men who have sex with men were recruited between January and August 2014. In participants on antiretroviral therapy (ART), there was no significant difference in rectal VL in those with and without STI ( p = 0.4). All rectal HIV VLs were below the limit of detection (<100 copies/µg of total RNA) whether an STI was present or not. In those not on ART, rectal HIV VL was on average 0.6log10lower post STI treatment. The presence of asymptomatic rectal chlamydia and gonorrhoea was not associated with increased rectal HIV VL in those fully suppressed on ART. In the context of effective ART, the presence of rectal gonorrhoea or chlamydia does not appear to increase rectal HIV VL and the risk of increased viral infectivity.
authors.affiliation: 1 Department of Genitourinary & HIV medicine, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge road, London, UK.
authors.forename: Olubanke
authors.initials: O
authors.lastname: Davies
authors.affiliation: 2 Directorate of Infection, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge road, London, UK.
authors.forename: Sinead
authors.initials: S
authors.lastname: Costelloe
authors.affiliation: 3 Clinical Biochemistry, Viapath Analytics, Kings College Hospital, Denmark Hill, London, UK.
authors.forename: Gemma
authors.initials: G
authors.lastname: Cross
authors.affiliation: 3 Clinical Biochemistry, Viapath Analytics, Kings College Hospital, Denmark Hill, London, UK.
authors.forename: Tracy
authors.initials: T
authors.lastname: Dew
authors.affiliation: 4 Infection Sciences, Virology Section, Viapath Analytics, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge road, London, UK.
authors.forename: Siobhan
authors.initials: S
authors.lastname: O'Shea
authors.affiliation: 1 Department of Genitourinary & HIV medicine, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge road, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: White
authors.affiliation: 1 Department of Genitourinary & HIV medicine, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge road, London, UK.
authors.forename: Julie
authors.initials: J
authors.lastname: Fox
mesh_terms: D002689:Chlamydia; D002690:Chlamydia Infections / Q000453:epidemiology / Q000382:microbiology*; D006069:Gonorrhea / Q000150:complications / Q000453:epidemiology / Q000382:microbiology*; D015658:HIV Infections / Q000150:complications / Q000517:prevention & control / Q000635:transmission*; D015497:HIV-1 / Q000235:genetics*; D018451:Homosexuality, Male; D006801:Humans; D008131:London; D008297:Male; D008403:Mass Screening; D012002:Rectal Diseases / Q000453:epidemiology / Q000382:microbiology* / Q000821:virology; D012007:Rectum / Q000821:virology*; D019562:Viral Load
keywords: HIV; chlamydia; gonorrhoea; highly active antiretroviral therapy; homosexual; rectal HIV viral load