Current status of HIV/AIDS-syphilis co-infections: a retrospective multicentre study

Abstract

Objective: Treponema pallidum and HIV are transmitted frequently through sexual contact, these agents with epidemiological similarities coinfect the same host. The current number of HIV-infected cases in Turkey is increasing. For this reason, we aimed to reveal the characteristics of syphilis in HIV/AIDS cases. Methods: A retrospective longitudinal cohort study was performed, patients were followed up at 24 clinics in 16 cities from all seven regions of Turkey between January 2010 to April 2018. We examined the socio-demographic characteristics, laboratory parameters and neurosyphilis association in HIV/AIDS-syphilis co-infected cases. Results: Among 3,641 patients with HIV-1 infection, 291 (8%) patients were diagnosed with syphilis co-infection. Most patients were older than 25 years (92%), 96% were males, 74% were working, 23% unemployed, and 3% were students. The three highest prevalence of syphilis were in Black Sea (10.3%), Mediterranean (8.4%) and Marmara Regions (7.4%). As for sexual orientation, 46% were heterosexuals, 42% men who have sex with men (MSM), and no data available for 12%. Patients with the number of CD4+ ≤ 350 mm 3 reached 46%, 17% of the patients received antiretroviral therapy and neurosyphilis association reached 9%. Conclusion: Although HIV/AIDS-syphilis co-infection status appeared high in heterosexuals, MSM had a moderate level increase in cases. Our results suggested syphilis co-infection in HIV/AIDS cases should be integral part of monitoring in a national sexual transmitted diseases surveillance system. However, our data may provide base for HIV/syphilis prevention and treatment efforts in the future.

Consequences of HIV/Syphilis Co-Infection on HIV Viral Load and Immune Response to Antiretroviral Therapy

“…The proportion of co-infected MSM decreased from 80% to 30% from 2009 to 2019, which was inconsistent with a previous study. 1,33,35,[37][38][39] Effective education in the correct use of latex condoms may be responsible for this phenomenon. This study had several limitations.…”

“…Syphilis, a sexually transmitted infection caused by the bacterium Treponema pallidum, is frequently encountered amongst human immunodeficiency virus (HIV)-infected individuals. The prevalence of co-infection with HIV and syphilis varies from 8% to 25%, 1,2 depending on the prevalence of both infections within the community and the group of patients studied. In China, the prevalence of HIV and syphilis among men who have sex with men (MSM) was recently shown to be higher than that in heterosexual men (about 6.5% and 11.2%, respectively).…”

Factors associated with sexually transmitted infection/HIV diagnosis among a predominantly university population in Brazil

“…A high prevalence of syphilis and HIV coinfection has been commonly detected in clinical practice, since the two diseases share the same transmission route. 25,26 In addition, syphilis coinfection can increase HIV transmission, both by increasing viral spread by open mucosal sores and by increasing the patient’s viral load. HIV-positive patients tend to have unusual primary lesions, a higher rate of asymptomatic infection, more aggressive secondary syphilis, and early neurological involvement.…”

Evaluation of Syphilis Coinfection in HIV-Infected Individuals

“…Bu doğrultuda, çalışmamızda izlemi yapılan HIV ile infekte bireylerin %10.7'sinde sifilis saptanmıştır. Her ne kadar ülkemizde bu konuda sınırlı veri olsa da yapılan çalışmalar Tablo 2'de özetlenmiştir (15)(16)(17)(18)(19)(20)(21). Altuntaş Aydın ve arkadaşları (17)'nın yapmış olduğu çalışmada, HIV ile infekte bireylerde sifilis prevalansı %12.9 olarak saptanmış olup, olguların tamamı erkek hastalardan oluşmaktadır.…”

“…Altuntaş Aydın ve arkadaşları (17)'nın yapmış olduğu çalışmada, HIV ile infekte bireylerde sifilis prevalansı %12.9 olarak saptanmış olup, olguların tamamı erkek hastalardan oluşmaktadır. 2018 yılında Türkiye'nin 16 ilinden 24 merkezin dahil olduğu bir çalışmada ise, HIV/sifilis koinfeksiyonu prevalansı %8 olarak saptanmıştır (19). Sarıgül ve arkadaşları (21) gerçekleştirdikleri çalışmada, üç yıllık dönemde yeni HIV infeksiyonu tanısı alan hastalarda sifilis birlikteliğini %25 olarak belirtmişlerdir.…”