Impact of rectal GC and CT on HIV infectiousness and transmission risk
Research type
Research Study
Full title
The impact of rectal Gonorrhoea and Chlamydia on HIV infectiousness and onward transmission risk
IRAS ID
130620
Contact name
Olubanke Davies
Contact email
Sponsor organisation
Guy's & St. Thomas' NHS Foundation Trust
Research summary
The aim of the study is to investigate the effect of rectal gonorrhoea and chlamydia on rectal and plasma HIV viral load in HIV-1 infected individuals.
Whilst bacterial sexually transmitted infections (STI) have been identified as risk factors for HIV acquisition, their role in the onward transmission of HIV, particularly with regards to anal sex, is less clear. High levels of unsafe sex have been identified in men who have sex with men (MSM) HIV infected cohorts. A study done in our clinic identified an overall prevelence of gonorrhoea (GC) and chlamydia (CT) of 17.4% in this cohort, and studies have demonstrated a rise in HIV viral load in semen and blood plasma in HIV infected individuals with GC and CT.
Critical to this study is the use of reliable and acceptable methods for assessment of rectal HIV viral load. In a pre-pilot anonymised service evaluation exercise using residual samples, we will test stored rectal samples collected for HSV detection using flocked swabs for their ability to be used in the detection of HIV viral load. The first phase of the study will attempt to validate the sampling method for measurement of HIV viral load per volume of secretion in rectal specimens. The second phase of the study will aim to assess the effect of rectal CT and GC on HIV viral load and will incorporate the effect of antiretroviral therapy and mucosal inflammation and other rectal STIs.
We will use flocked swabs taken using proctoscopy for the measurement of rectal HIV VL. Should this approach prove to be sensitive, reproducible and acceptable it will be built into the assessment of future HIV transmission studies.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
13/LO/1357
Date of REC Opinion
29 Oct 2013
REC opinion
Further Information Favourable Opinion