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HIV Seropositivity: HELP
Articles by Etienne E. Müller
Based on 6 articles published since 2008
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Between 2008 and 2019, Etienne Muller wrote the following 6 articles about HIV Seropositivity.
 
+ Citations + Abstracts
1 Review Clinical characteristics associated with Mycoplasma genitalium infection among women at high risk of HIV and other STI in Uganda. 2012

Vandepitte, Judith / Bukenya, Justine / Hughes, Peter / Muller, Etienne / Buvé, Anne / Hayes, Richard / Weiss, Helen A / Grosskurth, Heiner. ·MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda. Judith.vandepitte@mrcuganda.org ·Sex Transm Dis · Pubmed #22592838.

ABSTRACT: BACKGROUND: Mycoplasma genitalium is a common infection of the genitourinary tract, but its pathogenic effects have not been well described, especially in women. The increasing evidence that M. genitalium is associated with HIV infection calls for an urgent consensus on how best to control this infection. The aim of this study was to describe symptoms and signs associated with M. genitalium infection among high-risk women in Uganda. METHODS: A cohort of 1027 female sex workers was recruited in Kampala in 2008. At enrollment, HIV testing was performed, genital specimens were tested for other sexually transmitted infection, and urogenital symptoms and signs were recorded. Endocervical swabs were tested for M. genitalium using a commercial Real-TM PCR assay (Sacace Biotechnologies, Como, Italy). The associations of clinical signs and symptoms with prevalent M. genitalium were investigated using multivariable logistic regression models. RESULTS: Reported dysuria and presence of mucopurulent vaginal discharge were significantly associated with M. genitalium infection (OR: 1.85, 95% confidence interval: 1.13-3.03 and OR: 1.55, 95% confidence interval: 1.06-2.29, respectively). There was little evidence for an association with cervicitis or with pelvic inflammatory disease. CONCLUSIONS: In this specific population, we found evidence that symptoms of urethritis and mucopurulent vaginal discharge were associated with M. genitalium infection. This supports earlier studies showing that M. genitalium may lead to clinically relevant genitourinary disorders and should be treated. In the absence of sensitive screening tests, further work is needed to validate clinical findings as possible indicators of M. genitalium infection to guide a possible syndromic approach for its control.

2 Article Association between Mycoplasma genitalium infection and HIV acquisition among female sex workers in Uganda: evidence from a nested case-control study. 2014

Vandepitte, Judith / Weiss, Helen A / Bukenya, Justine / Kyakuwa, Nassim / Muller, Etienne / Buvé, Anne / Van der Stuyft, Patrick / Hayes, Richard J / Grosskurth, Heiner. ·MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda. · MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK. · Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa. · Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium. · Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium University of Ghent, Ghent, Belgium. · MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK. ·Sex Transm Infect · Pubmed #24687129.

ABSTRACT: OBJECTIVES: Cross-sectional studies have shown a strong association between Mycoplasma genitalium and HIV infections. We previously reported that in a cohort of female sex workers in Uganda, M genitalium infection at baseline was associated with HIV seroconversion. Here we examine the temporal association between the M genitalium infection status shortly before HIV seroconversion and HIV acquisition. METHODS: A nested case-control study was conducted within a cohort of women at high risk for HIV in Kampala. Cases were those of women acquiring HIV within 2 years of enrolment. For each of the 42 cases, 3 controls were selected from women HIV negative at the visit when the corresponding case first tested HIV seropositive. The association between HIV acquisition and M genitalium infection immediately prior to HIV testing was analysed using conditional logistic regression. RESULTS: There was weak evidence of an association between M genitalium infection and HIV acquisition overall (crude OR=1.57; 95% CI 0.67 to 3.72, aOR=2.28: 95% CI 0.81 to 6.47). However, time of M genitalium testing affected the association (p value for effect-modification=0.004). For 29 case-control sets with endocervical samples tested 3 months prior to the first HIV-positive result, M genitalium infection increased the risk of HIV acquisition (crude OR=3.09; 95% CI 1.06 to 9.05, aOR=7.19; 95% CI 1.68 to 30.77), whereas there was little evidence of an association among the 13 case-control sets with samples tested at an earlier visit (crude OR=0.30: 95% CI 0.04 to 2.51; aOR=0.34; 95% CI 0.02 to 5.94). CONCLUSIONS: Our study showed evidence of a temporal relationship between M genitalium infection and HIV acquisition that suggests that M genitalium infection may be a co-factor in the acquisition of HIV infection.

3 Article Natural history of Mycoplasma genitalium infection in a cohort of female sex workers in Kampala, Uganda. 2013

Vandepitte, Judith / Weiss, Helen A / Kyakuwa, Nassim / Nakubulwa, Susan / Muller, Etienne / Buvé, Anne / Van der Stuyft, Patrick / Hayes, Richard / Grosskurth, Heiner. ·MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda. Judith.vandepitte@mrcuganda.org ·Sex Transm Dis · Pubmed #23588134.

ABSTRACT: BACKGROUND: There have been few studies of the natural history of Mycoplasma genitalium in women. We investigated patterns of clearance and recurrence of untreated M. genitalium infection in a cohort of female sex workers in Uganda. METHODS: Women diagnosed as having M. genitalium infection at enrollment were retested for the infection at 3-month intervals. Clearance of infection was defined as testing negative after having a previous positive result: persistence was defined as testing positive after a preceding positive test result, and recurrence as testing positive after a preceding negative test result. Adjusted hazard ratios for M. genitalium clearance were estimated using Cox proportional hazards regression. RESULTS: Among 119 participants infected with M. genitalium at enrollment (prevalence, 14%), 55% had spontaneously cleared the infection within 3 months; 83%, within 6; and 93%, within 12 months. The overall clearance rate was 25.7/100 person-years (pyr; 95% confidence interval, 21.4-31.0). HIV-positive women cleared M. genitalium infection more slowly than did HIV-negative women (20.6/100 pyr vs. 31.3/100 pyr, P = 0.03). The clearance rate was slower among HIV-positive women with CD4 counts less than 350/mL than among those with higher CD4 counts (9.88/100 pyr vs. 29.5/100 pyr, P <; 0.001). After clearing the infection, M. genitalium infection recurred in 39% women. CONCLUSIONS: M. genitalium is likely to persist and recur in the female genital tract. Because of the urogenital tract morbidity caused by the infection and the observed association with HIV acquisition, further research is needed to define screening modalities, especially in populations at high risk for HIV, and to optimize effective and affordable treatment options.

4 Article Prevalence and associations of genital ulcer and urethral pathogens in men presenting with genital ulcer syndrome to primary health care clinics in South Africa. 2012

Lewis, David A / Müller, Etienne / Steele, Lisa / Sternberg, Maya / Radebe, Frans / Lyall, Michael / Ballard, Ronald C / Paz-Bailey, Gabriela. ·Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases, National Health Laboratory Service, Sandringham, South Africa. davidl@nicd.ac.za ·Sex Transm Dis · Pubmed #23064538.

ABSTRACT: BACKGROUND: This study aimed to determine the prevalence of genital ulcer and urethral pathogens, as well as their association with clinical features, in men with genital ulcer disease (GUD) enrolled in a clinical trial. METHODS: Clinical data were collected by questionnaire. Ulcer swabs were tested for herpes simplex viruses (HSV-1/2), Treponema pallidum, Haemophilus ducreyi, and Chlamydia trachomatis L1-L3. First-pass urine was tested for urethral pathogens, namely Neisseria gonorrhoeae, C. trachomatis, Trichomonas vaginalis, and Mycoplasma genitalium. Pathogens were detected by real-time molecular assays. Blood was tested for HIV, HSV-2, and syphilis-associated antibodies. Pathogens and clinical associations were investigated using the χ test. RESULTS: A total of 615 men with GUD were recruited. Herpes simplex virus (HSV-1, 4.2%; HSV-2, 98.2%) and bacterial pathogens were detected in 451 (73.6%) and 48 (7.8%) of genital ulcers, respectively. Human immunodeficiency virus, HSV-2, and treponemal antibodies were detected in 387 (62.9%), 434 (70.6%), and 141 (23.0%) men, respectively, whereas 54 men (8.8%) were rapid plasmin reagin (RPR) seropositive. A total of 223 urethral infections were diagnosed in 188 men (30.6%), including 69 (11.2%) M. genitalium, 64 (10.4%) T. vaginalis, 60 (9.8%) C. trachomatis, and 30 (4.9%) N. gonorrhoeae infections. Dysuria was reported by 170 men (27.6%), and 69 men (11.5%) had urethral discharge on examination. Urethral pathogens were detected in 102/409 (24.9%) men without these clinical features. CONCLUSIONS: Herpes accounted for most GUD cases and urethral pathogen coinfections were common. Erythromycin, dispensed to treat infrequent chancroid and lymphogranuloma venereum cases, provided additional treatment of some asymptomatic urethral pathogens. Additional antibiotics would be required to treat asymptomatic trichomoniasis and gonorrhea.

5 Article Prevalence and correlates of Mycoplasma genitalium infection among female sex workers in Kampala, Uganda. 2012

Vandepitte, Judith / Muller, Etienne / Bukenya, Justine / Nakubulwa, Susan / Kyakuwa, Nassim / Buvé, Anne / Weiss, Helen / Hayes, Richard / Grosskurth, Heiner. ·MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda. judith.vandepitte@mrcuganda.org ·J Infect Dis · Pubmed #22102734.

ABSTRACT: BACKGROUND: The importance of Mycoplasma genitalium in human immunodeficiency virus (HIV)-burdened sub-Saharan Africa is relatively unknown. We assessed the prevalence and explored determinants of this emerging sexually transmitted infection (STI) in high-risk women in Uganda. METHODS: Endocervical swabs from 1025 female sex workers in Kampala were tested for Mycoplasma genitalium using a commercial Real-TM polymerase chain reaction assay. Factors associated with prevalent Mycoplasma genitalium, including sociodemographics, reproductive history, risk behavior, and HIV and other STIs, were examined using multivariable logistic regression. RESULTS: The prevalence of Mycoplasma genitalium was 14% and higher in HIV-positive women than in HIV-negative women (adjusted odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12-2.41). Mycoplasma genitalium infection was less prevalent in older women (adjusted OR, 0.61; 95% CI, .41-.90 for women ages 25-34 years vs <25 years; adjusted OR, 0.32; 95% CI, .15-.71 for women ≥ 35 years vs those <25 years) and in those who had been pregnant but never had a live birth (adjusted OR, 2.25; 95% CI, 1.04-4.88). Mycoplasma genitalium was associated with Neisseria gonorrhoeae (adjusted OR, 1.84; 95% CI, 1.13-2.98) and with Candida infection (adjusted OR, 0.41; 95% CI, .18-.91), and there was some evidence of association with Trichomonas vaginalis (adjusted OR, 1.56; 95% CI, 1.00-2.44). CONCLUSIONS: The relatively high prevalence of Mycoplasma genitalium and its association with prevalent HIV urgently calls for further research to explore the potential role this emerging STI plays in the acquisition and transmission of HIV infection.

6 Article Human papillomavirus (HPV) infection in heterosexual South African men attending sexual health services: associations between HPV and HIV serostatus. 2010

Müller, Etienne E / Chirwa, Tobias F / Lewis, David A. ·Sexually Transmitted Infections Reference Centre, National Institute for Communicable Diseases of the National Health Laboratory Service, Sandringham, Johannesburg, South Africa. etiennem@nicd.ac.za ·Sex Transm Infect · Pubmed #19880970.

ABSTRACT: OBJECTIVES: To investigate the distribution of human papillomavirus (HPV) genotypes and determine the associations between HPV infection and HIV coinfection in sexually active heterosexual men with anogenital warts (GW), male urethral discharge or asymptomatic men. METHODS: Valid specimens for HPV genotyping were obtained from three patient groups consisting of 108 men with GW, 56 men with urethral discharge syndrome and 50 asymptomatic men attending for HIV voluntary counselling and testing. The Linear Array HPV Genotyping Test was used to determine the HPV genotype distribution among study participants. Sera were tested for HIV antibodies using two commercial rapid tests. RESULTS: The prevalence of anogenital HPV among study participants was 78% (166). HPV DNA was detected in 100% (108) of GW, 48% (27) of men with urethral discharge syndrome and 62% (31) of voluntary counselling and testing participants. HPV types 6, 11, 16 and 18 were prevalent as either single or combined infections in 81% (134) of all HPV-positive study participants. HPV types 6 and/or 11 were significantly higher among GW patients (p<0.001). After adjusting for patient groups, HIV seropositivity was significantly associated with multiple HPV infections (OR=3.98, 95% CI 1.58 to 10.03) but not with the presence of a foreskin (OR=0.67, 95% CI 0.32 to 1.40). CONCLUSIONS: Infections with HPV were prevalent among sexually active heterosexual men attending the men's sexual health clinic. Associations were observed between HIV coinfection and multiple HPV infections. Further population-based studies on the prevalence of HPV genotypes are required to determine if men should be included in any future national HPV vaccination programme in South Africa.