INFLAMMATORY CYTOKINES IN RECTAL GONORRHEA/CHLAMYDIA INFECTION AND TREATMENT: TOWARDS STI CONTROL AS HIV PREVENTION FOR MSM

Background Rectal gonorrhea (GC) and chlamydia (CT) infection are associated with mucosal inflammation and HIV transmission. To determine the impact of GC/CT infection and treatment on rectal tissue inflammation, we assessed levels of inflammatory cytokines in MSM with and without rectal GC/CT in Lima, Peru. Methods We screened 605 behaviorally high-risk MSM for rectal GC/CT using Hologic TMA between July-December, 2017. We identified 101 GC/CT(+) cases among 469 HIV-uninfected candidates (101/469; 21.5%). Prior to antibiotic treatment, we randomly selected 50 GC/CT(+) cases and matched 52 GC/CT(-) controls according to age and number of receptive anal intercourse partners during the prior 30 day period. Participants underwent anoscopy and sponge collection of rectal secretions for inflammatory cytokine quantification (IL-1b, IL-6, IL-8, and TNF-a) via Luminex multiplex assays. HIV and rectal GC/CT testing, and mucosal cytokine assessments were repeated at 3- and 6-month Follow-up Visits. Pre- and post-treatment cytokine levels in cases were compared against levels in uninfected controls using Wilcoxon Rank-Sum tests for non-parametric data. Results At baseline, MSM with GC/CT had elevated levels of all inflammatory cytokines in rectal mucosa compared with uninfected controls (all p-values 0.05). Conclusion Rectal tissue inflammation and cytokine recruitment is associated with GC/CT infection and resolves following antibiotic treatment. Our data provides ‘proof of concept’ for use of rectal STI screening as part of an integrated bio-behavioral HIV prevention program for MSM. Disclosure No significant relationships.