Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: Merai R[original query] |
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Risk of HIV acquisition among high-risk heterosexuals with nonviral sexually transmitted infections: A systematic review and meta-analysis
Barker EK , Malekinejad M , Merai R , Lyles CM , Sipe TA , DeLuca JB , Ridpath AD , Gift TL , Tailor A , Kahn JG . Sex Transm Dis 2022 49 (6) 383-397 BACKGROUND: Nonviral sexually transmitted infections (STIs) increase risk of sexually-acquired HIV infection. Updated risk estimates carefully scrutinizing temporality bias of studies are needed. METHODS: We conducted a systematic review (PROSPERO # CRD42018084299) of peer-reviewed studies evaluating variation in risk of HIV infection among high-risk heterosexuals diagnosed with any of: Chlamydia trachomatis, Mycoplasma genitalium, Neisseria gonorrhoeae, Treponema pallidum, and/or Trichomonas vaginalis. We searched PubMed, Web of Science, and Embase databases through December 2017 and included studies where STIs and HIV were assessed using laboratory tests or medical exams and where STI was diagnosed before HIV. After dual screening, data extraction, and risk of bias assessment, we meta-analytically pooled risk ratios (RR). RESULTS: We found 32 eligible studies reporting k = 97 effect size estimates of HIV acquisition risk due to infection with one of the above STIs. Most data were based on females engaged in sex work or other high-risk occupations in developing countries. Many studies did not measure or adjust for known confounders including drug injection and condom use and most were at medium or high risk of bias due to potential for undetected HIV infection to have occurred prior to STI infection. HIV acquisition risk increased among females infected with any pathogen; the effect was greatest for females infected with Mycoplasma genitalium (RR = 3.10; 95% CI 1.63, 5.92; k = 2) and gonorrhea (RR = 2.81; 95% CI 2.25, 3.50; k = 16) but also statistically significant for females infected with syphilis (RR = 1.67; 95% CI 1.23, 2.27; k = 17), trichomonas (RR = 1.54; 95% CI 1.31, 1.82; k = 17) and chlamydia (RR = 1.49; 95% CI 1.08, 2.04; k = 14). For males, data were space except for syphilis (RR = 1.77; 95% CI 1.22, 2.58; k = 5). CONCLUSION: Nonviral STI increases risk of heterosexual HIV acquisition, although uncertainty remains due to risk of bias in primary studies. |
Risk of HIV acquisition among men who have sex with men infected with bacterial sexually transmitted infections: A systematic review and meta-analysis
Malekinejad M , Barker EK , Merai R , Lyles CM , Bernstein KT , Sipe TA , DeLuca JB , Ridpath AD , Gift TL , Tailor A , Kahn JG . Sex Transm Dis 2021 48 (10) e138-e148 BACKGROUND: Men who have sex with men (MSM) who have bacterial sexually transmitted infections (STIs) are at increased risk for HIV infection. We enhanced and updated past summary risk estimates. METHODS: We systematically reviewed (PROSPERO No. CRD42018084299) peer-reviewed studies assessing the risk of HIV infection among MSM attributable to Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and/or Trichomonas vaginalis (TV). We searched 3 databases through December 2017. We excluded studies with self-reported data or simultaneous STI and HIV assessment. We conducted dual screening and data extraction, meta-analytically pooled risk ratios (RRs), and assessed potential risk of bias. RESULTS: We included 26 studies yielding 39 RR (k) for HIV acquisition due to one of TP, NG, or CT. We did not identify eligible data for MG or TV, or for HIV transmission. HIV acquisition risk increased among MSM infected with TP (k = 21; RR, 2.68, 95% confidence interval [CI], 2.00-3.58), NG (k = 11; RR, 2.38; 95% CI, 1.56-3.61), and CT (k = 7; RR, 1.99; 95% CI, 1.59-2.48). Subanalysis RRs for all 3 pathogens were ≥1.66 and remained statistically significant across geography and methodological characteristics. Pooled RR increased for data with the lowest risk of bias for NG (k = 3; RR, 5.49; 95% CI, 1.11-27.05) and TP (k = 4; RR, 4.32; 95% CI, 2.20-8.51). We observed mostly moderate to high heterogeneity and moderate to high risk of bias. CONCLUSIONS: Men who have sex with men infected with TP, NG, or CT have twice or greater risk of HIV acquisition, although uncertainties exist because of data heterogeneity and risk of bias. |
CDC Grand Rounds: A public health approach to detect and control hypertension
Merai R , Siegel C , Rakotz M , Basch P , Wright J , Wong B , Thorpe P . MMWR Morb Mortal Wkly Rep 2016 65 (45) 1261-1264 Hypertension is generally defined as systolic blood pressure ≥140 mmHg, or diastolic blood pressure ≥90 mmHg. A person who currently uses blood pressure-lowering medication is also defined as having hypertension. Hypertension is a leading risk factor for cardiovascular disease and stroke. Hypertension affects nearly one third of U.S. residents aged ≥18 years (approximately 75 million persons), and in approximately one half of adults with hypertension (nearly 35 million persons), it is uncontrolled. Among these 35 million U.S. residents with uncontrolled hypertension, 33% (11.5 million persons) are not aware of their hypertension, 20% (7 million persons) are aware of their hypertension, but are not being treated for it, and approximately 47% (16.1 million persons) are aware of their hypertension and being treated for it, but treatment (by medication and/or lifestyle modification) is not adequately controlling their blood pressure. |
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