P0534 Paper Poster Session III HIV/AIDS Prevalence and significance of Mycoplasma genitalium in women living with HIV in Denmark

A.M.R. Madsen1, J.S. Jensen2, K. Thorsteinsson3, M. Storgaard4, T.L. Katzenstein5, F.F. Rønsholt6, I.S. Johansen7, G. Pedersen8, L.N. Nielsen9, A. Lebech3, Å.B. Andersen6 1Department of Clinical Microbiology- Odense University Hospital, Odense, Denmark 2Statens Serum Institut, Copenhagen, Denmark 3Department of Infectious Diseases- Hvidovre, Copenhagen University Hospital, Hvidovre, Denmark 4Department of Infectious Diseases- Skejby, Aarhus University Hospital, Aarhus, Denmark 5Department of Infectiuos Diseases- Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark 6Department of Infectious Diseases- Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark 7Department of Infectious Diseases- Odense University Hospital, Odense, Denmark 8Department of Infectious Diseases- Aalborg University Hospital, Aalborg, Denmark 9Department of Infectious Diseases- Hillerød Hospital, Hillerød, Denmark

Objectives Mycoplasma genitalium (M. genitalium) is a sexually transmitted pathogen associated with urethritis in men and cervicitis and pelvic inflammatory disease in women. Several studies have shown a strong association between M. genitalium and HIV infection, especially in African study populations. M. genitalium infection has been shown to cause increased shedding of HIV virus in vaginal fluids and disruption of the genital mucosal barrier, thereby possibly enhancing HIV transmission. It has therefore been suggested that screening and treatment for M. genitalium should become part of HIV prevention strategies. There are few data on women living with HIV (WLWH) and M. genitalium from high-income countries, and none from Scandinavia. Our objective was to determine the prevalence of M. genitalium in WLWH in Denmark. Methods We tested cervical samples collected from 234 WLWH between February 2013 and February 2014. Women were recruited from six Danish HIV centers as part of a larger multicenter study focusing on Human Papillomavirus infection. The median age was 45 years (range 25 to 78 years). Samples were collected in UTM transport medium and M. genitalium was detected by TaqMan™ PCR amplifying a conserved region of the MgPa adhesin gene. Positive results were confirmed by conventional PCR amplifying the 23S rRNA gene, and the resulting PCR products were subsequently sequenced to detect macrolide resistance mediating mutations. Results Of 234 WLWH only 3 (1, 3 %) were infected with M. genitalium, and all carried a strain with a macrolide susceptible genotype. The M. genitalium positive women were 39, 42 and 44 years old respectively. The result is comparable to the prevalence of 1-4 % found in general populations in high-income countries, but much lower than in studies of African and American WLWH, where the prevalence generally has been much higher (10-30 %). The median age was high in our study population compared to other studies of both WLWH and general populations. We are currently awaiting permission to access background data on the study population in order to evaluate our results with data on sexual habits, ethnicity, HIV treatment and immune status. Conclusion The prevalence of M. genitalium infection in WLWH in Denmark is low. Systematic screening for M. genitalium in this group as part of HIV prevention strategies, therefore, does not seem relevant.