The Association of Mycoplasma genitalium with Human Immunodeficiency Virus Type-1 in Women Attending Gynecologic and Obstetrical Care in a Large Urban Tertiary Care Center

Abstract

Objective: The purpose of this study was to examine the incidence, symptomatology, and demographics of M. genitalium infection in women living with Human Immunodeficiency Virus Type-1 (HIV-1) infection and evaluate HIV-1 related associated factors in co-infected women attending obstetrical and gynecologic clinics in a large urban tertiary care center. Methods: Remnant endocervical samples of reproductive age women were collected from all patients attending clinics or presenting for triage visits at the Baylor College of Medicine in Houston, TX between September 2019 and March 2020. Samples were screened for M. genitalium by transcriptionmediated amplification. Results: The incidence of M. genitalium in women living with HIV-1 infection (7/66, 10.6%) was not significantly higher than the incidence in women without HIV-1 infection (74/1208, 6.1%) (p=0.19). The rate of co-infection with Neisseria gonorrhoeae and Chlamydia trachomatis for women living with HIV-1 was lower (2.9%, 0%) than the rate of co-infection with M. genitalium (10.6%). Conclusions: There is a higher incidence of M. genitalium co-infection among reproductive age women living with HIV-1 than N. gonorrhoeae and C. trachomatis. Infection with M. genitalium is not consistently associated with symptoms of cervicitis, complicating the diagnosis of infection. This study indicates a need for future prospective studies to further elucidate the impact of M. genitalium coinfection on the gynecologic health of women living with HIV-1 and to explore the importance of screening for M. genitalium in HIV-1 positive women.