SpondyloarthropathiesMicrobial factors in spondyloarthropathies: insights from population studiesLeirisalo-Repo, Marjatta MD, PhD*; Hannu, Timo MD, PhD*; Mattila, Leena MD, PhD†Author Information Divisions of *Rheumatology and †Infectious Diseases, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. Correspondence to Marjatta Leirisalo-Repo, MD, PhD, Helsinki University Central Hospital, Department of Medicine, Division of Rheumatology, P. O. Box 263, Kasarmikatu 11-13, FIN-00130 Helsinki, Finland; e-mail: email@example.com Supported in part by Helsinki University Central Hospital Research Funds. Current Opinion in Rheumatology: July 2003 - Volume 15 - Issue 4 - p 408-412 Buy Abstract Infections and genetics play a role in the development of reactive arthritis. The clinical manifestations and severity of the features depend on the triggering infections and the epidemiologic setting. Reports from hospital-based series show the lowest frequency of reactive arthritis, but often, patients have severe arthritis associated with a high frequency of HLA-B27. At the population level, reactive arthritis occur in 7 to 15% of the infected subjects. The disease is usually mild, affects small joints, can be polyarticular, often rapidly disappears, and has a low association with HLA-B27. There also seems to be a change in the spectrum of triggering infections. Reports of Yersinia arthritis are less common, whereas arthritis in association with Campylobacter or Salmonella infections seems to be increasing. The role of early antimicrobial chemotherapy for the prevention of reactive arthritis needs to be studied. © 2003 Lippincott Williams & Wilkins, Inc.