Skip to main content

Advertisement

SpringerLink
Log in

The incidence of sexually acquired reactive arthritis: a systematic literature review

  • Review Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Reactive arthritis (ReA) is an inflammatory spondyloarthritis occurring after infection at a distant site. Chlamydia trachomatis is proposed to be the most common cause of ReA, yet the incidence of sexually acquired ReA (SARA) has not been well established. We therefore carried out a systematic literature review to collate and critically evaluate the published evidence regarding the incidence of SARA. MEDLINE and EMBASE databases were searched using free-text and MeSH terms relating to infection and ReA. The title and abstract of articles returned were screened independently by two reviewers and potentially relevant articles assessed in full. Data was extracted from relevant articles and a risk of bias assessment carried out using a validated tool. Heterogeneity of study methodology and results precluded meta-analysis. The search yielded a total of 11,680 articles, and a further 17 were identified from review articles. After screening, 55 papers were assessed in full, from which 3 met the relevant inclusion criteria for the review. The studies reported an incidence of SARA of 3.0–8.1 % and were found to be of low to moderate quality. More studies are required to address the lack of data regarding the incidence of SARA. Specific and sensitive classification criteria must be developed in order for consistent classification and valid conclusions to be drawn. In clinical practice, it is recommended clinicians discuss the possibility of ReA developing at the time of STI diagnosis and to encourage patients to return if they experience any relevant symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Hamdulay SS, Glynne SJ, Keat A (2006) When is arthritis reactive? Postgrad Med J 82:446–453

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Hannu T, Inman R, Granfors K, Leirisalo-Repo M (2006) Reactive arthritis or post-infectious arthritis? Best Pract Res Clin Rheumatol 20:419–433

    Article  PubMed  Google Scholar 

  3. Pope JE, Krizova A, Garg AX, Thiessen-Philbrook H, Ouimet JM (2007) Campylobacter reactive arthritis: a systematic review. Semin Arthritis Rheum 37:48–55

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ozgul A, Dede I, Taskaynatan MA, Aydogan H, Kalyon TA (2006) Clinical presentations of chlamydial and non-chlamydial reactive arthritis. Rheumatol Int 26:879–885

    Article  PubMed  Google Scholar 

  5. Espinoza LR, Garcia-Valladares I (2013) Of bugs and joints: the relationship between infection and joints. Rheumatol Clin 9:229–238

    Google Scholar 

  6. Keat A, Thomas B, Dixey J, Osborn M, Sonnex C, Taylor-Robinson D (1987) Chlamydia trachomatis and reactive arthritis: the missing link. Lancet 1:72–74

    Article  CAS  PubMed  Google Scholar 

  7. Kvien TK, Glennas A, Melby K, Granfors K, Andrup O, Karstensen B, Thoen JE (1994) Reactive arthritis: incidence, triggering agents and clinical presentation. J Rheumatol 21:115–122

    CAS  PubMed  Google Scholar 

  8. Singh A, Karrar S (2014) The role of intracellular organisms in the pathogenesis of inflammatory arthritis. Int J Inflamm 2014:158793

    Google Scholar 

  9. Morris D, Inman RD (2012) Reactive arthritis: developments and challenges in diagnosis and treatment. Curr Rheumatol Rep 14:390–394

    Article  CAS  PubMed  Google Scholar 

  10. Carlin EM, Ziza JM, Keat A, Janier M (2014) 2014 European Guideline on the management of sexually acquired reactive arthritis. Int J STD AIDS 25:901–912

    Article  CAS  PubMed  Google Scholar 

  11. Lloyd GE (1978) Hippocratic writings (translated by J. Chadwick and W. N. Mann). Pelican Books, New York, N.Y, p. 229

    Google Scholar 

  12. Iglesias-Gammara A, Restrepo JF, Valle R, Matteson EL (2005) A brief history of Stoll-Brodie-Fiessinger-Leroy syndrome (Reiter’s syndrome) and reactive arthritis with a translation of Reiter’s Original 1916 Article into English. Curr Rheumatol Rev 1:71–79

    Article  Google Scholar 

  13. Storey GO, Scott DL (1998) Arthritis associated with venereal disease in nineteenth century London. Clin Rheumatol 17:500–504

    Article  CAS  PubMed  Google Scholar 

  14. Ahvonen P, Sievers K, Aho K (1969) Arthritis associated with Yersinia enterocolitica infection, Acta Rheumatol Scand, 15:1-4, 232-253. Acta Rheumatol Scand 15:232–53.

  15. Kuipers JG, Kohler L, Zeidler H (1999) Reactive or infectious arthritis. Ann Rheum Dis 58:661–664

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Townes JM (2010) Reactive arthritis after enteric infections in the United States: the problem of definition. Clin Infect Dis 50:247–254

    Article  PubMed  Google Scholar 

  17. Inman RD, Whittum-Hudson JA, Schumacher HR, Hudson AP (2000) Chlamydia and associated arthritis. Curr Opin Rheumatol 12:254–262

    Article  CAS  PubMed  Google Scholar 

  18. Owlia MB, Eley AR (2010) Is the role of Chlamydia trachomatis underestimated in patients with suspected reactive arthritis? Int J Rheum Dis 13:27–38

    Article  PubMed  Google Scholar 

  19. Selmi C, Gershwin ME (2014) Diagnosis and classification of reactive arthritis. Autoimmun Rev 13:546–549

    Article  CAS  PubMed  Google Scholar 

  20. Pacheco-Tena C, Burgos-Vargas R, Vazquez-Mellado J, Cazarin J, Perez-Diaz JA (1999) A proposal for the classification of patients for clinical and experimental studies on reactive arthritis. J Rheumatol 26:1338–1346

    CAS  PubMed  Google Scholar 

  21. Ajene AN, Fischer Walker CL, Black RE (2013) Enteric pathogens and reactive arthritis: a systematic review of Campylobacter, Salmonella and Shigella-associated reactive arthritis. J Health Popul Nutr 31:299–307

    Article  PubMed  PubMed Central  Google Scholar 

  22. Keithlin J, Sargeant J, Thomas MK, Fazil A (2014) Systematic review and meta-analysis of the proportion of Campylobacter cases that develop chronic sequelae. BMC Public Health 14:1203

    Article  PubMed  PubMed Central  Google Scholar 

  23. Keithlin J, Sargeant JM, Thomas MK, Fazil A (2015) Systematic review and meta-analysis of the proportion of non-typhoidal Salmonella cases that develop chronic sequelae. Epidemiol Infect 143:1333–1351

    Article  CAS  PubMed  Google Scholar 

  24. Systematic Reviews: CRD’s guidance for undertaking reviews in health care. Centre for Reviews and Dissemination, University of York, 2009. ISBN 978–1–900640-47-3 https://www.york.ac.uk/crd/guidance [Accessed 28.03.16].

  25. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol 62:1006–1012

    Article  PubMed  Google Scholar 

  26. Lawson E, Walker-Bone K (2012) The changing spectrum of rheumatic disease in HIV infection. Br Med Bull 103:203–221

    Article  CAS  PubMed  Google Scholar 

  27. Viswanathan M, Berkman ND (2012) Development of the RTI item bank on risk of bias and precision of observational studies. J Clin Epidemiol 65:163–178

    Article  PubMed  Google Scholar 

  28. Catterall RD (1958) Incidence of chronic genital infection in male patients with uveitis. A preliminary report. Br J Vener Dis 34:254–255

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Keat AC, Maini RN, Nkwazi GC, Pegrum GD, Ridgway GL, Scott JT (1978) Role of Chlamydia trachomatis and HLA-B27 in sexually acquired reactive arthritis. Br Med J 1:605–607

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Rich E, Hook IEW, Alarcon GS, Moreland LW (1996) Reactive arthritis in patients attending an urban sexually transmitted diseases clinic. Arthritis Rheum 39:1172–1177

    Article  CAS  PubMed  Google Scholar 

  31. Carter JD, Rehman A, Guthrie JP, Gerard HC, Stanich J, Hudson AP (2013) Attack rate of Chlamydia-induced reactive arthritis and effect of the CCR5-Delta-32 mutation: a prospective analysis. J Rheumatol 40:1578–1582

    Article  PubMed  Google Scholar 

  32. Thomson G, Thomson B, Inman R (1993) Validation of a screening questionnaire for epidemic reactive arthritis (QUEST-2). Arthritis Rheum 36:S

  33. Dougados M, van der Linden S, Juhlin R, et al. (1991) The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum 34:1218–1227

    Article  CAS  PubMed  Google Scholar 

  34. Adams EJ, Charlett A, Edmunds WJ, Hughes G (2004) Chlamydia trachomatis in the United Kingdom: a systematic review and analysis of prevalence studies. Sex Transm Infect 80:354–362

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. World Health Organisation. Global incidence and prevalence of selected curable sexually transmitted infections 2008. WHO 2012.

  36. DL H (ed) (2008) Control of communicable diseases manual, 19th edn. American Public Health Association, Washington, DC

    Google Scholar 

  37. Pease E, Pease B, Pease C (2013) Do rheumatologists think about sex? Rheumatol Clin 9:255

    Google Scholar 

  38. Collantes E, Zarco P, Munoz E, et al. (2007) Disease pattern of spondyloarthropathies in Spain: description of the first national registry (REGISPONSER) extended report. Rheumatology 46:1309–1315

    Article  CAS  PubMed  Google Scholar 

  39. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP (2008) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61:344–349

    Article  Google Scholar 

  40. Aggarwal R, Ringold S, Khanna D, et al. (2015) Distinctions between diagnostic and classification criteria? Arthritis Care Res (Hoboken) 67:891–897

    Article  Google Scholar 

  41. Amor B, Dougados M, Mijiyawa M (1990) Criteria of the classification of spondylarthropathies. Rev Rhum Mal Osteoartic 57:85–89

    CAS  PubMed  Google Scholar 

  42. Rudwaleit M, van der Heijde D, Landewe R, et al. (2011) The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis 70:25–31

    Article  CAS  PubMed  Google Scholar 

  43. Zeidler H, Amor B (2011) The Assessment in Spondyloarthritis International Society (ASAS) classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general: the spondyloarthritis concept in progress. Ann Rheum Dis 70:1–3

    Article  PubMed  Google Scholar 

  44. Zeidler H, Hudson AP (2016) Causality of Chlamydiae in arthritis and spondyloarthritis: a plea for increased translational research. Curr Rheumatol Rep 18:9

    Article  PubMed  Google Scholar 

  45. Townes JM, Deodhar AA, Laine ES, et al. (2008) Reactive arthritis following culture-confirmed infections with bacterial enteric pathogens in Minnesota and Oregon: a population-based study. Ann Rheum Dis 67:1689–1696

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand

    Hayley J. Denison & Elaine M. Dennison

  2. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom

    Elizabeth M. Curtis, Michael A Clynes & Elaine M. Dennison

  3. College of Health, Massey University, Wellington, New Zealand

    Collette Bromhead

  4. Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago Wellington, Wellington, New Zealand

    Rebecca Grainger

Authors
  1. Hayley J. Denison
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elizabeth M. Curtis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael A Clynes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Collette Bromhead
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elaine M. Dennison
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rebecca Grainger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hayley J. Denison.

Ethics declarations

Disclosures

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Denison, H.J., Curtis, E.M., Clynes, M.A. et al. The incidence of sexually acquired reactive arthritis: a systematic literature review. Clin Rheumatol 35, 2639–2648 (2016). https://doi.org/10.1007/s10067-016-3364-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-016-3364-0

Keywords

Search

Navigation