{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T05:03:41Z","timestamp":1768194221171,"version":"3.49.0"},"reference-count":11,"publisher":"BMJ","issue":"2","funder":[{"name":"German Federal Ministry of health"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2018,1,15]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Rectal infections with<jats:italic>Chlamydia trachomatis<\/jats:italic>and\/or<jats:italic>Neisseria gonorrhoeae<\/jats:italic>(CT\/NG) are common in men who have sex with men (MSM) and are linked to HIV transmission. However, rectal CT\/NG infections are often asymptomatic and it is not known how they contribute to HIV transmission. We assessed clinical and cytological signs of inflammation as well as rectal HIV-RNA in HIV-infected MSM with and without CT\/NG infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>112 HIV-positive MSM with or without rectal symptoms and with or without antiretroviral therapy who underwent high-resolution anoscopy (HRA) at the proctological outpatient centre of the University Hospital Essen, Germany, between November 2013 and February 2014 were included in this cross-sectional study. During the examination, rectal swabs for the assessment of CT\/NG, HIV-RNA and inflammatory cells (granulocytes, lymphocytes, histiocytes) were collected. 110 patients were assessed according to the study protocol, and no imputation of missing data was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Rectal infections with CT or NG were detected in 17 participants, and 4 participants were coinfected. Only symptomatic CT\/NG infections (8\/17) showed signs of inflammation in HRA. Symptomatic CT\/NG infections were also associated with the detection of lymphocytes and histiocytes in rectal cytology (both P&lt;0.001). In contrast, asymptomatic CT\/NG infections neither resulted in clinical nor cytological signs of inflammation. Rectal HIV-RNA was undetectable in all participants with rectal CT\/NG infections who received combined antiretroviral therapy (ART) when plasma HIV-RNA was below the limit of detection (n=13). Besides rectal CT\/NG infections, syphilis (n=4) and HPV-associated lesions (n=37) were frequently detected, and proctological symptoms were associated with simultaneous infection with \u22652\u2009STDs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Only symptomatic but not asymptomatic rectal infections with CT and\/or NG were associated with clinical and cytological signs of inflammation. Rectal HIV shedding was not promoted by CT\/NG infections in patients receiving ART with suppressed plasma HIV-RNA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>UTN: U1111-1150-4804. German Clinical Trials Register (DRKS): DRKS00005468.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2017-053409","type":"journal-article","created":{"date-parts":[[2018,2,3]],"date-time":"2018-02-03T17:15:12Z","timestamp":1517678112000},"page":"95-98","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Antiretroviral therapy suppresses rectal HIV-RNA shedding despite inflammation in MSM with rectal<i>C. trachomatis<\/i>and<i>N. gonorrhoeae<\/i>infections\u2014a cross-sectional, single-center study"],"prefix":"10.1136","volume":"95","author":[{"given":"Julian","family":"Storim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Verheyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Wolff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremias","family":"Wohlschlaeger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelyn","family":"Heintschel von Heinegg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Schadendorf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Esser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,2,3]]},"reference":[{"key":"2024092304402083000_95.2.95.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30310-9"},{"key":"2024092304402083000_95.2.95.2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2012-050929"},{"key":"2024092304402083000_95.2.95.3","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu184"},{"key":"2024092304402083000_95.2.95.4","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000423"},{"key":"2024092304402083000_95.2.95.5","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2015.0013"},{"key":"2024092304402083000_95.2.95.6","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1186\/1471-2334-13-436","article-title":"Modelling the impact of chlamydia screening on the transmission of HIV among men who have sex with men","volume":"13","author":"Xiridou","year":"2013","journal-title":"BMC Infect Dis"},{"key":"2024092304402083000_95.2.95.7","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir400"},{"key":"2024092304402083000_95.2.95.8","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1177\/0956462416686513","article-title":"Impact of rectal gonorrhoea and chlamydia on HIV viral load in the rectum: potential significance for onward transmission","volume":"28","author":"Davies","year":"2017","journal-title":"Int J STD AIDS"},{"key":"2024092304402083000_95.2.95.9","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00763-12"},{"key":"2024092304402083000_95.2.95.10","doi-asserted-by":"publisher","DOI":"10.1258\/095646206777323373"},{"key":"2024092304402083000_95.2.95.11","doi-asserted-by":"publisher","DOI":"10.1086\/514239"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2017-053409","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T11:41:24Z","timestamp":1727091684000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2017-053409"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,3]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2,25]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/sextrans-2017-053409"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2017-053409","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,3]]}}}