REACTIVE ARTHRITIS IN PATIENTS ATTENDING AN URBAN SEXUALLY-TRANSMITTED DISEASES CLINIC

Objective. To assess the prevalence, clinical manifestations, associat ed genital infections, and HLA associations of reactive arthritis (ReA ) among patients attending an urban sexually transmitted diseases (STD ) clinic. Methods. Using a standardized questionnaire, 271 consecutive adults, primarily black, with possible or proven Chlamydia trachomati s genital infection were screened for symptoms of ReA, A follow-up que stionnaire was administered 6 weeks later by mail, Patients who report ed at least 1 symptom were evaluated by a rheumatologist, HLA-B typing was performed on patients with objective ReA features. Results. Nine of 217 patients (4.1%) with genital infection/inflammation had objecti ve ReA features, Chlamydial or nongonococcal STD syndromes were diagno sed in 8 of these 9 patients (88%). Genital infection/inflammation was asymptomatic in 78% of patients with ReA features, HLA-B27 or other B 7-cross-reactive group antigens were not associated with the occurrenc e of ReA. Conclusion. Nongonococcal genital infections, often asymptom atic, can trigger a relatively mild ReA in a larger number of exposed patients than previously thought, irrespective of the individual's HLA status.