(P496) A preliminary examination of longer-term non-infectious conditions associated with chlamydia and gonorrhea infections in adolescence and young adulthood

Background: Chlamydia (CT) and gonorrhea (NG) are the most widely reported bacterial infections in the world, with their distribution highly heterogeneous within a population. Research examining longer-term outcomes from CT/NG infection has mostly focussed on sexual and reproductive health issues such as infertility. Risk and vulnerability to non-reproductive health issues associated with earlier CT/NG infections has been relatively unexplored.

Methods: Data were from linked population-based administrative databases housed in Manitoba, Canada. A case-cohort approach was used whereby cases were defined as having a positive laboratory test for CT or NG between the ages of 15 to 24 from fiscal year (FY) 1992/93 to 2003/04. Controls, or those without any evidence of a positive test for CT/NG were matched by age, sex, geographic area, and socioeconomic status at a 5:1 ratio. Validated algorithms were used to flag non-infectious conditions, such as diabetes, kidney disease, and injuries up to 40 years, or FY 2020/21, whichever came first. Incidence rates, using person-years as the denominator were calculated. In addition to descriptive statistics, Cox and negative binomial regression models were used to model the association between CT/NG infection and non-infectious conditions, as appropriate. Models were adjusted for physician utilization and previous non-infectious conditions; hazard ratios (HR) and relative rates (RR), and their 95% confidence intervals are reported (95% CI).

Results: Total sample size was 88,152 (14,692 cases and 73,460 controls). Cases had higher incidences of several non-infectious conditions. For example, for those without any pre-existing conditions, the incidence of diabetes was 0.82 per 100 person-years (95% CI: 0.80-0.86) in cases, compared to controls (0.59 per 100 person-years, 95% CI: 0.58-0.61; HR: 1.3, 95% CI: 1.3-1.4). HR was 2.1 (95% CI: 2.0-2.2) for kidney disease.

Conclusions: This preliminary examination found those with CT/NG infections in their adolescence had a higher rate of non-infectious conditions in later adulthood, compared to those without any evidence of infections. Although biological mechanisms are plausible, underlying determinants that place populations at risk for CT/NG likely also place these same populations at higher risk for certain non-infectious conditions, warranting a life-course approach to care, to better address inequalities.