Increased repeat syphilis among HIV-infected patients

Abstract

Among human immunodeficiency virus (HIV)–infected individuals, syphilis is an important sexually transmitted infection (STI), and repeat infections are common. Identifying risk factors for delineating the trends in repeat syphilis are essential for STI and HIV prevention. This study is to investigate the dynamic of the syphilis epidemic among HIV-infected patients and to identify the risk factors associated with repeat syphilis. A population-based cohort design was used to analyze claim data between January 2000 and December 2010 using the Taiwan National Health Insurance Research Database. The Poisson regression test was used to identify risk factors for repeat syphilis. Of 13,239 HIV-infected patients, annual syphilis screen tests have been performed in 4,907 (37.1%) of these patients. Syphilis has been diagnosed in 956 (19.5%) patients, and 524 (10.7%) had repeat syphilis. The annual trend in repeat syphilis showed a significant increase in the study period ( β = 0.23, P < .001). Younger age (adjusted incidence rate ratio [aIRR] 1.43; 95% CI 1.11–1.86), male gender (aIRR 11.14, 95% CI 4.16–29.79), a history of STIs (aIRR 1.39, 95% CI 1.21–1.59) were independently associated with repeat syphilis. The retention in HIV care and adherence to antiretroviral therapy ≥85% ([aIRR] 0.77, 95% CI 0.61–0.98; P < .001) were associated with a reduced risk of repeat syphilis. The incidence of repeat syphilis increased during 11 years of follow-up. The screening of syphilis for early diagnosis and retention in HIV care with medication adherence should be encouraged to minimize the risk of repeat syphilis in the targeted population.

Sero-prevalence of syphilis infection among people living with HIV in Sierra Leone: a cross-sectional nationwide hospital-based study

“…It is encouraging that the reported prevalence of syphilis in this study is similar to the prevalence of syphilis among PLHIV reported in Ethiopia [ 23 ]. Although the prevalence of syphilis in our study may have been overestimated due to the limitations of the test kits in reacting to non-treponemal infections, studies in other African countries such as Nigeria (14.0%), Ghana (14.8%), Morocco (16.4%), Chad (14.0%), and Tanzania (9.6%) reported a higher prevalence [ 8 – 10 , 24 – 26 ]. The disparities in these findings may be due to the different composition of the study populations and differences in the methods applied for the detection of syphilis or perhaps may reflect the variations in the risky behavioral practices across the African region.…”

Fatores associados à sífilis adquirida em pessoas idosas: uma revisão integrativa

“…Outro resultado importante foi a maior ocorrência de sífilis em homens. E isso é mencionado em outros estudos especificamente entre os homens que fazem sexo com outros homens (HSH) (Lee et al, 2020) 16 . É importante conhecer os fatores relevantes para as diferentes populações, não só em termos de faixa etária e orientação sexual, mas também conhecer os cenários em que vivem, para propor intervenções intersetoriais e, no setor saúde.…”

Avaliação das ações de enfrentamento da sífilis adquirida no período de 2016 a 2019, numa capital do sudeste brasileiro

“…The increased detection rate means that the syphilis epidemic is on the rise in the municipality. Several studies have emphasized the resurgence of syphilis in specific populations, including men who have sex with men (MSM), in various parts of the world 22,23 . Notified cases can be considered to be either prevalent or incident, since it is not always possible to identify the clinical stage of the disease 6 .…”