Background Current evidence supports the screening of Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) in symptomatic disease in all sites with risk for carriage. The purpose is to increase the accuracy of diagnosis and prevent missed asymptomatic infections. This study aims to describe the incidence and aetiology of urethritis, proctitis and ulcers and compliance to additional screening.
Methods Retrospective study of three major syndromes diagnosed in a cohort of HIV positive patients (2430 patients) followed in a tertiary care hospital between July 2017 and June 2018.
Results We identified 86 patients with symptomatic infections. Most of them were in men who have sex with men. Twenty-nine (34%) of these infections were urethritis. Almost half (48%) were by NG, with 3 (10%) additional NG infections detected in the anus and 6 (21%) in the oropharynx. CT caused 7 cases (21%) and in 2 cases it was detected exclusively in other sites. For all urethritis cases, 13 (48%) weren’t screened for NG/CT in the anus or oropharynx. Half of NG cases did not make a cure test. There were 17 proctitis: 6 (35%) by NG and 9 (53%) by LGV CT. Nine patients (53%) didn’t perform partner screening. Finally, there were 25 diagnosis of ulcers (23 genital; 2 oral). Eleven (44%) had no identifiable cause and 8 (32%) were primary syphilis. Of all cases, 11 (44%) had no screening at other risk sites. More than half of the partners (68%) were screened.
Conclusion The prevention of these infections through screening of all at risk sites, NG cure tests and partner screening can be challenging: it is time consuming, there may be limited interested in the treated patient for cure tests and the partners may be unknown or unwilling to be tested if asymptomatic. Continued efforts to improve our practice and patient’s adherence is essential.
Disclosure No significant relationships.
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