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Clinical Characteristics of Mycoplasma genitalium and the Usefulness of Syndromic Management Among Women Living With Human Immunodeficiency Virus

Ong, Jason J. PhD*,†; Magooa, Mahlape Precious MSc; Chikandiwa, Admire MD§; Kelly, Helen PhD*; Didelot, Marie-Noelle MD; Muller, Etienne E. PhD; Maseko, Venessa BTech; Segondy, Michel PhD; Delany-Moretlwe, Sinead PhD§; Kularatne, Ranmini FCPath; Mayaud, Philippe MD* on behalf of the HARP Study Group

doi: 10.1097/OLQ.0000000000001054

We report the clinical symptoms and examination findings of Mycoplasma genitalium (MG) in women living with human immunodeficiency virus in South Africa. If we relied on syndromic management alone to treat MG, only 15 of 46 MG-infected women would have received. appropriate treatment: sensitivity of 32.6% (95% confidence interval, 19.5–48.0) and specificity of 67.4% (95% confidence interval, 63.4–71.2).

A study of women living with human immunodeficiency virus found that Mycoplasma genitalium is as common (~7% prevalence) as other cervical sexually transmitted infections and syndromic management would miss two thirds of infections.

From the *Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom

Central Clinical School, Monash University, Melbourne, Australia

Centre for HIV & STIs, National Institute for Communicable Diseases

§Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Pathogenesis and Control of Chronic infections, INSERM, University of Montpellier, Montpellier, France

Acknowledgments: *HARP Study Group members include: A. Chikandiwa, E. Cutler, S. Delany-Moretlwe, D. A. Lewis, M.P. Magooa, V. Maseko, P. Michelow, B. Muzah, T. Omar, A. Puren (Johannesburg, South Africa); F. Djigma, J. Drabo, O. Goumbri-Lompo, N. Meda, B. Sawadogo, J. Simporé, A. Yonli, S. Zan (Ouagadougou, Burkina Faso); V. Costes, M-N. Didelot, S. Doutre, N. Leventoux, N. Nagot, J. Ngou, M. Segondy (Montpellier, France); and A. Devine, C. Gilham, L. Gibson, H. Kelly, R. Legood, P. Mayaud, H.A. Weiss (London, UK).

The authors thank the HARP International Scientific Advisory Group (ISAG) constituted of Prof. C. Lacey (Chair, University of York, UK), Prof. Y-L. Qiao (Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China), Prof. M. Chirenje (University of Harare, Zimbabwe) and Prof. S. de Sanjosé (Catalan Institute of Oncology, Barcelona, Spain).

Sources of Funding: This work was supported by the European Commission (EC) 7th Framework Programme under grant agreement HEALTH-2010-F2–265396.

Conflict of interest: None declared.

P.M., S.D.M., and M.S. conceived and planned the study. A.C., S.D., H.K., and P.M. coordinated the study, participant recruitment, and management. M.P.M., M.N.D., and E.M. performed the laboratory testing and QC for MG and other STIs. J.J.O. analyzed the data and drafted the article, and all authors revised and approved the final article.

Ethical approval: Ethical approval was granted by the Witwatersrand University in South Africa (110707) and the London School of Hygiene and Tropical Medicine (7400).

*HARP Study Group composition at end of manuscript.

Correspondence: Philippe Mayaud, MD, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom. E-mail:; Jason Ong, PhD, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom. E-mail:

Received for publication June 18, 2019, and accepted July 12, 2019.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (

Online date: July 29, 2019

© Copyright 2019 American Sexually Transmitted Diseases Association