生殖支原體感染和HIV感染相關性的Meta分析_《中國循證醫學雜志》

作者：

朱一 , 吳建茹 , 張鈺 ,  王蓓

東南大學公共衛生學院環境醫學工程教育部重點實驗室（南京 210009）;

關鍵詞：

HIV 生殖支原體 Meta分析

DOI：

10.7507/1672-2531.20120206

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　系統評價生殖支原體感染和HIV感染之間的相關性。
方法　計算機檢索MEDLINE、ScienceDirect、EMbase、WanFang Data、CNKI數據庫，收集有關生殖支原體和HIV感染相關性的獨立隊列研究、病例-對照研究以及橫斷面研究，并追溯所獲文獻的參考文獻，檢索時限截至2012年3月。按納入和排除標準篩選文獻、提取資料和評價質量后，采用RevMan 4.2及SAS 9.1.3進行統計分析。
結果　最終納入19個研究，共3 430例HIV感染人群和7 656例對照人群。Meta分析結果顯示，HIV感染人群中生殖支原體檢出率明顯高于對照人群差異有統計學意義［OR=2.34，95%CI（1.68，3.28），P lt;0.000 01］。亞組分析和敏感性分析結果同上述結果一致。
結論　生殖支原體感染和HIV感染之間存在密切關聯，但具體機制仍待進一步研究。受納入研究質量和數量所限，上述結論尚需今后開展更多高質量的研究加以驗證和更新。

引用本文： 朱一,吳建茹,張鈺,王蓓. 生殖支原體感染和HIV感染相關性的Meta分析. 中國循證醫學雜志, 2012, 12(11): 1314-1319. doi: 10.7507/1672-2531.20120206 復制

1.	Risbud A, Chan-Tack K, Gadkari D, et al. The etiology of genital ulcer disease by multiplex polymerase chain reaction and relationship to HIV infection among patients attending sexually transmitted disease clinics in Pune, India. Sex Transm Dis, 1999, 26(1): 55-62.
2.	Plummer FA, Simonsen JN, Cameron DW, et al. Cofactors in male-female sexual transmission of human immunodeficiency virus type 1. J Infect Dis, 1991, 163(2): 233-239.
3.	Simms I, Eastick K, Mallinson H, et al. Associations between Mycoplasma genitalium, Chlamydia trachomatis and pelvic inflammatory disease. J Clin Pathol, 2003, 56(8): 616-618.
4.	Korte JE, Baseman JB, Cagle MP, et al. Cervicitis and genitourinary symptoms in women culture positive for Mycoplasma genitalium. Am J Reprod Immunol, 2006, 55(4): 265-275.
5.	Wells GA, O’Connell D, Peterson J, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in metaanalyses. Ottawa Health Research Institute. www.ohri.ca/programs/clinical_epidemiology/oxford.asp. (accessed Oct 20, 2011).
6.	Cohen CR, Manhart LE, Bukusi EA, et al. Association between Mycoplasma genitalium and acute endometritis. Lancet, 2002, 359(9308): 765-766.
7.	Manhas A, Sethi S, Sharma M, et al. Association of genital mycoplasmas including Mycoplasma genitalium in HIV infected men with nongonococcal urethritis attending STD & HIV clinics. Indian J Med Res, 2009, 129(3): 305-310.
8.	Paz-Bailey G, Rahman M, Chen C, et al. Changes in the etiology of sexually transmitted diseases in Botswana between 1993 and 2002: implications for the clinical management of genital ulcer disease. Clin Infect Dis, 2005, 41(9): 1304-1312.
9.	Ballard RC, Fehler HG, Htun Y, et al. Coexistence of urethritis with genital ulcer disease in South Africa: influence on provision of syndromic management. Sex Transm Infect, 2002, 78(4): 274-277.
10.	Savio ML, Caruso A, Allegri R, et al. Detection of Mycoplasma genitalium from urethral swabs of human immunodeficiency virus-infected patients. New Microbiol, 1996, 19(3): 203-209.
11.	Cohen CR, Mugo NR, Astete SG, et al. Detection of Mycoplasma genitalium in women with laparoscopically diagnosed acute salpingitis. Sex Transm Infect, 2005, 81(6): 463-466.
12.	Mhlongo S, Magooa P, Muller EE, et al. Etiology and STI/HIV coinfections among patients with urethral and vaginal discharge syndromes in South Africa. Sex Transm Dis, 2010, 37(9): 566-570.
13.	Perez G, Skurnick JH, Denny TN, et al. Herpes simplex type II and Mycoplasma genitalium as risk factors for heterosexual HIV transmission: report from the heterosexual HIV transmission study. Int J Infect Dis, 1998, 3(1): 5-11.
14.	Mansson F, Camara C, Biai A, et al. High prevalence of HIV-1, HIV-2 and other sexually transmitted infections among women attending two sexual health clinics in Bissau, Guinea-Bissau, West Africa. Int J STD AIDS, 2010, 21(9): 631-635.
15.	Cordova CM, Blanchard A, Cunha RA. Higher prevalence of urogenital mycoplasmas in human immunodeficiency virus-positive patients as compared to patients with other sexually transmitted diseases. J Clin Lab Anal, 2000, 14(5): 246-253.
16.	Martinelli F, Garrafa E, Turano A, et al. Increased frequency of detection of Ureaplasma urealyticum and Mycoplasma genitalium in AIDS patients without urethral symptoms. J Clin Microbiol, 1999, 37(6): 2042-2044.
17.	Wang RY, Grandinetti T, Shih JW, et al. Mycoplasma genitalium infection and host antibody immune response in patients infected by HIV, patients attending STD clinics and in healthy blood donors. FEMS Immunol Med Microbiol, 1997, 19(3): 237-245.
18.	Lusk MJ, Konecny P, Naing ZW, et al. Mycoplasma genitalium is associated with cervicitis and HIV infection in an urban Australian STI clinic population. Sex Transm Infect, 2011, 87(2): 107-109.
19.	Labbe AC, Frost E, Deslandes S, et al. Mycoplasma genitalium is not associated with adverse outcomes of pregnancy in Guinea-Bissau. Sex Transm Infect, 2002, 78(4): 289-291.
20.	Pepin J, Labbe AC, Khonde N, et al. Mycoplasma genitalium: an organism commonly associated with cervicitis among west African sex workers. Sex Transm Infect, 2005, 81(1): 67-72.
21.	Vandepitte J, Muller E, Bukenya J, et al. Prevalence and Correlates of Mycoplasma genitalium Infection Among Female Sex Workers in Kampala, Uganda. J Infect Dis, 2012, 205(2): 289-296.
22.	Kapiga SH, Sam NE, Mlay J, et al. The epidemiology of HIV-1 infection in northern Tanzania: results from a community-based study. AIDS Care, 2006, 18(4): 379-387.
23.	Soni S, Alexander S, Verlander N, et al. The prevalence of urethral and rectal Mycoplasma genitalium and its associations in men who have sex with men attending a genitourinary medicine clinic. Sex Transm Infect, 2010, 86(1): 21-24.
24.	郭海健. 性病患者及其高危人群支原體感染的流行病學研究. 南京: 東南大學, 2007.
25.	Cohen CR, Nosek M, Meier A, et al. Mycoplasma genitalium infection and persistence in a cohort of female sex workers in Nairobi, Kenya. Sex Transm Dis, 2007, 34(5): 274-279.
26.	Blanchard A, Olson LD, Barile MF. Sexually transmitted mycoplasmas in humans. Mol Cell Biol Hum Dis Ser, 1992, 1: 55-83.
27.	Sasaki Y, Honda M, Makino M, et al. Mycoplasmas stimulate replication of human immunodeficiency virus type 1 through selective activation of CD4+ T lymphocytes. AIDS Res Hum Retroviruses, 1993, 9(8): 775-780.
28.	Phillips DM, Pearce-Pratt R, Tan X, et al. Association of mycoplasma with HIV-1 and HTLV-I in human T lymphocytes. AIDS Res Hum Retroviruses, 1992, 8(11): 1863-1868.
29.	McGowin CL, Popov VL, Pyles RB. Intracellular Mycoplasma genitalium infection of human vaginal and cervical epithelial cells elicits distinct patterns of inflammatory cytokine secretion and provides a possible survival niche against macrophage-mediated killing. BMC Microbiol, 2009, 9: 139.
30.	Manhart LE, Mostad SB, Baeten JM, et al. High Mycoplasma genitalium organism burden is associated with shedding of HIV-1 DNA from the cervix. J Infect Dis, 2008, 197(5): 733-736.
31.	Al-Harthi L, Kovacs A, Coombs RW, et al. A menstrual cycle pattern for cytokine levels exists in HIV-positive women: implication for HIV vaginal and plasma shedding. AIDS, 2001, 15(12): 1535-1543.

1. Risbud A, Chan-Tack K, Gadkari D, et al. The etiology of genital ulcer disease by multiplex polymerase chain reaction and relationship to HIV infection among patients attending sexually transmitted disease clinics in Pune, India. Sex Transm Dis, 1999, 26(1): 55-62.
2. Plummer FA, Simonsen JN, Cameron DW, et al. Cofactors in male-female sexual transmission of human immunodeficiency virus type 1. J Infect Dis, 1991, 163(2): 233-239.
3. Simms I, Eastick K, Mallinson H, et al. Associations between Mycoplasma genitalium, Chlamydia trachomatis and pelvic inflammatory disease. J Clin Pathol, 2003, 56(8): 616-618.
4. Korte JE, Baseman JB, Cagle MP, et al. Cervicitis and genitourinary symptoms in women culture positive for Mycoplasma genitalium. Am J Reprod Immunol, 2006, 55(4): 265-275.
5. Wells GA, O’Connell D, Peterson J, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in metaanalyses. Ottawa Health Research Institute. www.ohri.ca/programs/clinical_epidemiology/oxford.asp. (accessed Oct 20, 2011).
6. Cohen CR, Manhart LE, Bukusi EA, et al. Association between Mycoplasma genitalium and acute endometritis. Lancet, 2002, 359(9308): 765-766.
7. Manhas A, Sethi S, Sharma M, et al. Association of genital mycoplasmas including Mycoplasma genitalium in HIV infected men with nongonococcal urethritis attending STD & HIV clinics. Indian J Med Res, 2009, 129(3): 305-310.
8. Paz-Bailey G, Rahman M, Chen C, et al. Changes in the etiology of sexually transmitted diseases in Botswana between 1993 and 2002: implications for the clinical management of genital ulcer disease. Clin Infect Dis, 2005, 41(9): 1304-1312.
9. Ballard RC, Fehler HG, Htun Y, et al. Coexistence of urethritis with genital ulcer disease in South Africa: influence on provision of syndromic management. Sex Transm Infect, 2002, 78(4): 274-277.
10. Savio ML, Caruso A, Allegri R, et al. Detection of Mycoplasma genitalium from urethral swabs of human immunodeficiency virus-infected patients. New Microbiol, 1996, 19(3): 203-209.
11. Cohen CR, Mugo NR, Astete SG, et al. Detection of Mycoplasma genitalium in women with laparoscopically diagnosed acute salpingitis. Sex Transm Infect, 2005, 81(6): 463-466.
12. Mhlongo S, Magooa P, Muller EE, et al. Etiology and STI/HIV coinfections among patients with urethral and vaginal discharge syndromes in South Africa. Sex Transm Dis, 2010, 37(9): 566-570.
13. Perez G, Skurnick JH, Denny TN, et al. Herpes simplex type II and Mycoplasma genitalium as risk factors for heterosexual HIV transmission: report from the heterosexual HIV transmission study. Int J Infect Dis, 1998, 3(1): 5-11.
14. Mansson F, Camara C, Biai A, et al. High prevalence of HIV-1, HIV-2 and other sexually transmitted infections among women attending two sexual health clinics in Bissau, Guinea-Bissau, West Africa. Int J STD AIDS, 2010, 21(9): 631-635.
15. Cordova CM, Blanchard A, Cunha RA. Higher prevalence of urogenital mycoplasmas in human immunodeficiency virus-positive patients as compared to patients with other sexually transmitted diseases. J Clin Lab Anal, 2000, 14(5): 246-253.
16. Martinelli F, Garrafa E, Turano A, et al. Increased frequency of detection of Ureaplasma urealyticum and Mycoplasma genitalium in AIDS patients without urethral symptoms. J Clin Microbiol, 1999, 37(6): 2042-2044.
17. Wang RY, Grandinetti T, Shih JW, et al. Mycoplasma genitalium infection and host antibody immune response in patients infected by HIV, patients attending STD clinics and in healthy blood donors. FEMS Immunol Med Microbiol, 1997, 19(3): 237-245.
18. Lusk MJ, Konecny P, Naing ZW, et al. Mycoplasma genitalium is associated with cervicitis and HIV infection in an urban Australian STI clinic population. Sex Transm Infect, 2011, 87(2): 107-109.
19. Labbe AC, Frost E, Deslandes S, et al. Mycoplasma genitalium is not associated with adverse outcomes of pregnancy in Guinea-Bissau. Sex Transm Infect, 2002, 78(4): 289-291.
20. Pepin J, Labbe AC, Khonde N, et al. Mycoplasma genitalium: an organism commonly associated with cervicitis among west African sex workers. Sex Transm Infect, 2005, 81(1): 67-72.
21. Vandepitte J, Muller E, Bukenya J, et al. Prevalence and Correlates of Mycoplasma genitalium Infection Among Female Sex Workers in Kampala, Uganda. J Infect Dis, 2012, 205(2): 289-296.
22. Kapiga SH, Sam NE, Mlay J, et al. The epidemiology of HIV-1 infection in northern Tanzania: results from a community-based study. AIDS Care, 2006, 18(4): 379-387.
23. Soni S, Alexander S, Verlander N, et al. The prevalence of urethral and rectal Mycoplasma genitalium and its associations in men who have sex with men attending a genitourinary medicine clinic. Sex Transm Infect, 2010, 86(1): 21-24.
24. 郭海健. 性病患者及其高危人群支原體感染的流行病學研究. 南京: 東南大學, 2007.
25. Cohen CR, Nosek M, Meier A, et al. Mycoplasma genitalium infection and persistence in a cohort of female sex workers in Nairobi, Kenya. Sex Transm Dis, 2007, 34(5): 274-279.
26. Blanchard A, Olson LD, Barile MF. Sexually transmitted mycoplasmas in humans. Mol Cell Biol Hum Dis Ser, 1992, 1: 55-83.
27. Sasaki Y, Honda M, Makino M, et al. Mycoplasmas stimulate replication of human immunodeficiency virus type 1 through selective activation of CD4+ T lymphocytes. AIDS Res Hum Retroviruses, 1993, 9(8): 775-780.
28. Phillips DM, Pearce-Pratt R, Tan X, et al. Association of mycoplasma with HIV-1 and HTLV-I in human T lymphocytes. AIDS Res Hum Retroviruses, 1992, 8(11): 1863-1868.
29. McGowin CL, Popov VL, Pyles RB. Intracellular Mycoplasma genitalium infection of human vaginal and cervical epithelial cells elicits distinct patterns of inflammatory cytokine secretion and provides a possible survival niche against macrophage-mediated killing. BMC Microbiol, 2009, 9: 139.
30. Manhart LE, Mostad SB, Baeten JM, et al. High Mycoplasma genitalium organism burden is associated with shedding of HIV-1 DNA from the cervix. J Infect Dis, 2008, 197(5): 733-736.
31. Al-Harthi L, Kovacs A, Coombs RW, et al. A menstrual cycle pattern for cytokine levels exists in HIV-positive women: implication for HIV vaginal and plasma shedding. AIDS, 2001, 15(12): 1535-1543.

《中國循證醫學雜志》

生殖支原體感染和HIV感染相關性的Meta分析

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《中國循證醫學雜志》

生殖支原體感染和HIV感染相關性的Meta分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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