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Prevalence of sexually transmitted infections in HIV-1 infected pregnant women in Europe

  • Infectious Diseases
  • Published:
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Abstract

We investigated prevalence of sexually transmitted infections (STI) in a cohort of HIV-1-infected pregnant women and described factors associated with STI diagnosis, as a nested study within the European Collaborative Study (ECS). The ECS is a cohort study in which HIV-infected pregnant women are enrolled and their children followed from birth, according to standard clinical and laboratory protocols. Information on STIs diagnosed during pregnancy was collected retrospectively from the antenatal records of women enrolling between January 1999 and October 2005; other variables were obtained from the ECS prospective database. A total of 1,050 women were included: 530 in Western Europe and 520 in Ukraine. Syphilis was the most common bacterial STI (2% prevalence, 95% CI 1.2–3.0). Prevalence of HPV-related genital lesions was 8.6% (95%CI 6.9–10.4) and prevalence of Trichomonas vaginalis was 12.1% (95%CI 10.2–14.2). Women in Ukraine (AOR 10.7, 95%CI 3.7–30.5), single women (AOR 3.9, 95%CI 1.2–12.7), sexual partners of injecting drug users (AOR 3.8, 95%CI 1.4–10.4) and women with CD4 counts <200 cells/mm3 (AOR 5.4, 95%CI 1.0–28.1) were at increased risk of diagnosis with Chlamydia trachomatis, syphilis or Trichomonas vaginalis. African origin (AOR 1.9, 95%CI 1.1–3.3) and CD4 count <200 cells/mm3 (AOR 3.4, 95%CI 1.5–7.8) were associated with HSV-2 and/or HPV-related genital lesions. Antenatal screening should be considered an effective tool for diagnosis, treatment and prevention of further transmission of STIs. HIV-infected women should receive adequate screening for STIs during pregnancy together with appropriate counseling and follow-up for treatment and prevention.

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Abbreviations

CDC:

Centers for Disease Control and Prevention

CI:

Confidence interval

ECS:

European Collaborative Study

HAART:

Highly active antiretroviral therapy

HIV:

Human immunodeficiency virus

HPV:

Human papillomavirus

HSV-2:

Herpes simplex virus 2

IDU:

Injecting drug use

MTCT:

Mother-to-child transmission

STI:

Sexually transmitted infections

References

  1. EuroHIV (European Centre for the Epidemiological Monitoring of AIDS). HIV/AIDS surveillance in Europe, mid-year report 2005. 72. 2006. Paris: EuroHIV.

  2. UNAIDS (2006) Report on the global AIDS epidemic, 2006. Geneva: UNAIDS.

  3. D’Arminio MA, Sabin CA, Phillips A, et al. The changing incidence of AIDS events in patients receiving highly active antiretroviral therapy. Arch Intern Med 2005;165:416–23.

    Article  Google Scholar 

  4. Sterne JA, Hernan MA, Ledergerber B, et al. Long-term effectiveness of potent antiretroviral therapy in preventing AIDS and death: a prospective cohort study. Lancet 2005;366:378–84.

    Article  PubMed  CAS  Google Scholar 

  5. European Collaborative Study: The mother-to-child HIV transmission epidemic in Europe: evolving in the East and established in the West. AIDS 2006;20:1419–27.

    Article  Google Scholar 

  6. UNAIDS. The changing HIV/AIDS epidemic in Europe and Central Asia. 2004. Geneva, UNAIDS. http://data.unaids.org/Publications/IRC-pub06/jc1038-changingepidemic_en.pdf. Accessed 1 Mar 2007.

  7. Wasserheit JN. Epidemiological synergy. Interrelationships between human immunodeficiency virus infection and other sexually transmitted diseases. Sex Transm Dis 1992;19:61–77.

    PubMed  CAS  Google Scholar 

  8. Cohen MS. HIV and sexually transmitted diseases: lethal synergy. Top HIV Med 2004;12:104–7.

    PubMed  Google Scholar 

  9. McClelland RS, Lavreys L, Katingima C, et al. Contribution of HIV-1 infection to acquisition of sexually transmitted disease: a 10-year prospective study. J Infect Dis 2005;191:333–8.

    Article  PubMed  Google Scholar 

  10. Rottingen JA, Cameron DW, Garnett GP. A systematic review of the epidemiologic interactions between classic sexually transmitted diseases and HIV: how much really is known? Sex Transm Dis 2001;28:579–97.

    Article  PubMed  CAS  Google Scholar 

  11. Radcliffe KW, Ahmad S, Gilleran G, Ross JD. Demographic and behavioural profile of adults infected with chlamydia: a case-control study. Sex Transm Infect 2001;77:265–70.

    Article  PubMed  CAS  Google Scholar 

  12. Mavrov GI, Bondarenko GM. The evolution of sexually transmitted infections in the Ukraine. Sex Transm Infect 2002;78:219–21.

    Article  PubMed  CAS  Google Scholar 

  13. Brown AE, Sadler KE, Tomkins SE, et al. Recent trends in HIV and other STIs in the United Kingdom: data to the end of 2002. Sex Transm Infect 2004;80:159–66.

    Article  PubMed  CAS  Google Scholar 

  14. Leszczynska-Gorzelak B, rmochwal-Kolarz D, Borowiec-Blinowska A, Oleszczuk J: The prevalence of Chlamydia trachomatis infection in pregnant women. Med Wieku Rozwoj 2005;9:27–35.

    PubMed  Google Scholar 

  15. Ickovics JR, Niccolai LM, Lewis JB, Kershaw TS, Ethier KA: High postpartum rates of sexually transmitted infections among teens: pregnancy as a window of opportunity for prevention. Sex Transm Infect 2003;79:469–73.

    Article  PubMed  CAS  Google Scholar 

  16. van Benthem BH, Prins M, Larsen C, Delmas MC, Brunet JB, van den HA. Sexually transmitted infections in European HIV-infected women: incidence in relation to time from infection. European Study on the Natural History of HIV Infection in Women. AIDS 2000;14:595–603.

    Article  PubMed  Google Scholar 

  17. Magnus M, Clark R, Myers L, Farley T, Kissinger PJ. Trichomonas vaginalis among HIV-Infected women: are immune status or protease inhibitor use associated with subsequent T. vaginalis positivity? Sex Transm Dis 2003;30:839–43.

    Article  PubMed  CAS  Google Scholar 

  18. European Collaborative Study. Mother-to-child transmission of HIV infection in the era of highly active antiretroviral therapy. Clin Infect Dis 2005;40:458–65.

    Article  Google Scholar 

  19. Centers For Disease Control and Prevention. 1998 Guidelines for treatment of sexually transmitted diseases. MMWR 1998;47:1–116.

    Google Scholar 

  20. Centers For Disease Control and Prevention. Guidelines for the treatment of sexually transmitted diseases - 2002. MMWR 2002;51:1–78.

    Google Scholar 

  21. Mbopi-Keou FX, Gresenguet G, Mayaud P, et al. Interactions between herpes simplex virus type 2 and human immunodeficiency virus type 1 infection in African women: opportunities for intervention. J Infect Dis 2000;182:1090–6.

    Article  PubMed  CAS  Google Scholar 

  22. World Health Organisation Regional Office for Europe. Centralized Information Service for Infectious Disease. 2006. http://data.euro.who.int/cisid/?TabID = 48830. Accessed 1 Mar 2007.

  23. Rhodes T, Simic M. Transition and the HIV risk environment. BMJ 2005;331:220–3.

    Article  PubMed  Google Scholar 

  24. Celum C, Levine R, Weaver M, Wald A. Genital herpes and human immunodeficiency virus: double trouble. Bull World Health Organ 2004;82:447–53.

    PubMed  Google Scholar 

  25. Greenblatt RM, Lukehart SA, Plummer FA et al. Genital ulceration as a risk factor for human immunodeficiency virus infection. AIDS 1988;2:47–50.

    Article  PubMed  CAS  Google Scholar 

  26. Weiss HA, Buve A, Robinson NJ et al. The epidemiology of HSV-2 infection and its association with HIV infection in four urban African populations. AIDS 2001;15 Suppl 4:S97–108.

    Article  PubMed  Google Scholar 

  27. Freeman EE, Glynn JR. Factors affecting HIV concordancy in married couples in four African cities. AIDS 2004;18:1715–21.

    Article  PubMed  Google Scholar 

  28. Greenblatt RM, Bacchetti P, Barkan S, et al. Lower genital tract infections among HIV-infected and high-risk uninfected women: findings of the Women’s Interagency HIV Study (WIHS). Sex Transm Dis 1999;26:143–51.

    Article  PubMed  CAS  Google Scholar 

  29. Palefsky JM, Minkoff H, Kalish LA et al. Cervicovaginal human papillomavirus infection in human immunodeficiency virus-1 (HIV)-positive and high-risk HIV-negative women. J Natl Cancer Inst 1999;91:226–36.

    Article  PubMed  CAS  Google Scholar 

  30. Chen KT, Segu M, Lumey LH, et al. Genital herpes simplex virus infection and perinatal transmission of human immunodeficiency virus. Obstet Gynecol 2005;106:1341–8.

    PubMed  Google Scholar 

  31. Wilson TE, Minkoff H, McCalla S, Petterkin C, Jaccard J: The relationship between pregnancy and sexual risk taking. Am J Obstet Gynecol 1996;174:1033–6.

    Article  PubMed  CAS  Google Scholar 

  32. Niccolai LM, Ethier KA, Kershaw TS, Lewis JB, Ickovics JR. Pregnant adolescents at risk: sexual behaviors and sexually transmitted disease prevalence. Am J Obstet Gynecol 2003;188:63–70.

    Article  PubMed  Google Scholar 

  33. Fiore S. HIV infected women in Europe. PhD thesis. University of London; 2005.

  34. Sorvillo F, Kovacs A, Kerndt P, Stek A, Muderspach L, Sanchez-Keeland L. Risk factors for trichomoniasis among women with human immunodeficiency virus (HIV) infection at a public clinic in Los Angeles County, California: implications for HIV prevention. Am J Trop Med Hyg 1998;58:495–500.

    PubMed  CAS  Google Scholar 

  35. Rosengard C, Anderson B, Stein MD. Intravenous drug users’ HIV-risk behaviors with primary/other partners. Am J Drug Alcohol Abuse 2004;30:225–36.

    Article  PubMed  Google Scholar 

  36. Silverberg MJ, Ahdieh L, Munoz A, et al. The impact of HIV infection and immunodeficiency on human papillomavirus type 6 or 11 infection and on genital warts. Sex Transm Dis 2002;29:427–35.

    Article  PubMed  Google Scholar 

  37. Fennema JS, van Ameijden EJ, Coutinho RA, van den Hoek AA. HIV, sexually transmitted diseases and gynaecologic disorders in women: increased risk for genital herpes and warts among HIV-infected prostitutes in Amsterdam. AIDS 1995;9:1071–8.

    Article  PubMed  CAS  Google Scholar 

  38. Corey L, Wald A, Celum CL, Quinn TC. The effects of herpes simplex virus-2 on HIV-1 acquisition and transmission: a review of two overlapping epidemics. J Acquir Immune Defic Syndr 2004;35:435–45.

    Article  PubMed  Google Scholar 

  39. Strickler HD, Burk RD, Fazzari M et al. Natural history and possible reactivation of human papillomavirus in human immunodeficiency virus-positive women. J Natl Cancer Inst 2005;97:577–86.

    Article  PubMed  Google Scholar 

  40. Dunn EF, Markowitz LE. Genital human papillomavirus infection. Clin Inf Dis 2006;43: 624–9.

    Article  Google Scholar 

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Acknowledgements

Sources of support: The European Collaborative Study is a coordination action of the European Commission (Framework 6) (PENTA/ECS 018865). The Medical Research Council (UK) Sexual Health and HIV Research Strategy Committee provided support to the ECS coordinating centre. The views expressed are those of the authors and not necessarily those of the MRC or the Health Departments.

ECS collaborators: We thank Deven Patel and Kirsty England at the ECS coordinating centre. The ECS collaborators at the participating centres were Professor J. Levy, Dr M. Hainaut, Dr T.Goetghebuer, Dr P. Barlow, Dr Y. Manigart (Brussels); Dr V. Savasi, Dr S. Fiore, Prof E. Ferrazzi, Dr A. Viganò, Dr V. Giacomet, Dr M. Crivelli (Milan); Prof P. Martinelli, Dr A. Agangi, Drssa W. Buffolano, Dr R. Tiseo, Drssa M. Sansone (Naples); Dr C. Tibaldi, Dr S. Marini, Dr G. Masuelli, Prof C. Benedetto (Turin); Prof I. Grosch-Wörner, Dr C. Feiterna-Sperling, Dr S. Casteleyn (Berlin); Dr A.B. Bohlin, Dr S. Lindgren, Dr K. Elfgren, Dr B. Anzén and Dr K. Lidman (Huddinge and Solna); Prof A. Mûr, Dr A. Payà, Dr M.A. López-Vilchez, Dr R. Carreras (Barcelona); Dr J. Jimenez (Madrid); Dr O. Coll, Dr S. Hernández, Dr J. Pascual (Barcelona); Dr S. Alberico, Dr M. Rabusin, M. Bernardon (Trieste). Dr R. Malyuta, Dr I. Semenenko, Dr. I. Shevchenko, T. Pilipenko, Dr. D. Richko, Y. Khomout (Perinatal Prevention of AIDS Initiative, Odessa), Dr S. Posokhova, Dr T. Kaleeva, Dr. A. Shelyag, Dr. S. Servetsky (Odessa), Dr A. Stelmah, Dr. G. Kiseleva, Dr O.A. Zalata (Crimean Republic).

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Authors and Affiliations

  1. Department of Family and Community Medicine, University of Toronto, Toronto, Canada

    Megan Landes

  2. Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK

    Claire Thorne, Simona Fiore & Marie-Louise Newell

  3. Department of Obstetrics and Gynecology, Hospital St Pierre, Brussels, Belgium

    Patricia Barlow

  4. Department of Obstetrics and Gynecology, Hospital L.Sacco, University of Milan, Milan, Italy

    Simona Fiore & Valeria Savasi

  5. Prevention of Perinatal AIDS Initiative, Odessa, Ukraine

    Ruslan Malyuta & Igor Semenenko

  6. Department of Gynecology and Obstetrics, University of Naples, Federico II, Naples, Italy

    Pasquale Martinelli

  7. Department of Obstetrics and Gynecology, Odessa Regional Hospital, Odessa, Ukraine

    Svetlana Posokhova

  8. AIDS Centre of Crimea, Simferopol, Ukraine

    Andrej Stelmah

  9. Department of Obstetrics and Gynecology, Hospital S Anna, Turin, Italy

    Cecilia Tibaldi

Authors
  1. Megan Landes
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  2. Claire Thorne
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  3. Patricia Barlow
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  4. Simona Fiore
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  8. Valeria Savasi
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  12. Marie-Louise Newell
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Correspondence to Claire Thorne.

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Landes, M., Thorne, C., Barlow, P. et al. Prevalence of sexually transmitted infections in HIV-1 infected pregnant women in Europe. Eur J Epidemiol 22, 925–936 (2007). https://doi.org/10.1007/s10654-007-9188-0

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  • DOI: https://doi.org/10.1007/s10654-007-9188-0

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