Generic placeholder image

Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Research Article

Evaluation of HIV and Syphilis Co-infected Cases, Data from a University Hospital

Author(s): Süheyla Kömür*, Damla Ertürk, Sezin Sevdimbaş, Ferit Kuşcu, Ayşe Seza İnal, Behice Kurtaran, Aslıhan Candevir and Yeşim Taşova

Volume 22, Issue 3, 2024

Published on: 16 May, 2024

Page: [153 - 157] Pages: 5

DOI: 10.2174/011570162X313718240514042111

conference banner
Abstract

Background: HIV and syphilis are sexually transmitted infections with overlapping risk factors, potentially leading to increased HIV transmission and treatment challenges. Understanding the clinical management of syphilis co-infection among people living with HIV is crucial for public health interventions.

Objective: This retrospective cohort study aimed to assess the prevalence of syphilis co-infection, clinical characteristics, treatment response, and public health implications among people living with HIV in southern Turkey.

Methods: Records of 1352 people living with HIV 18 years and older, followed at a tertiary infectious diseases clinic between 2013 and 2023, were analyzed. Data on demographics, clinical stage of syphilis and HIV/AIDS, laboratory parameters, treatment response, and co-infections were collected. Statistical analyses were performed using SPSS 20.0 software.

Results: Among the people living with HIV, 103 (7.6%) were diagnosed with syphilis. Most cases were male (97.1%), with a median age of 33 (IQR 28-49) years. Heterosexual transmission was predominant (60.2%), with a history of condomless sexual intercourse in 90.3% of cases. The majority (88.3%) were asymptomatic with latent syphilis. Syphilis was diagnosed concurrently with HIV in 77.7% of cases. Serological response to syphilis treatment was observed in 46.8% of patients, while 53.2% showed a serofast reaction. Neurosyphilis was rare, diagnosed in only one patient. Co-infections with hepatitis B and C were detected in 3.9% and 1.9% of patients, respectively.

Conclusion: Syphilis co-infection among people living with HIV is a significant public health concern in southern Turkey. Routine screening for syphilis, along with comprehensive education on sexually transmitted infection prevention, is essential for early detection and optimal management. Further research is needed to improve treatment outcomes and address emerging challenges in HIV-syphilis co-infection management.

Keywords: HIV, co-infection, public health, sexually transmitted infection, syphilis, treatment response.

Graphical Abstract
[2]
Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA. Sexually transmitted infections treatment guidelines, 2021. MMWR. Recommendations and Reports: Morbidity and mortality weekly report. Recommendations and rep 2021; 70(4): 1-187.
[http://dx.doi.org/10.15585/mmwr.rr7004a1]
[3]
Zarakolu P. Current developments in laboratory diagnosis of syphilis. Mikrobiyol Bul 2023; 57(1): 141-55.
[http://dx.doi.org/10.5578/mb.20239912] [PMID: 36636853]
[5]
Yaylali E, Erdogan ZM, Calisir F, et al. Modeling the future of HIV in Turkey: Cost-effectiveness analysis of improving testing and diagnosis. PLoS One 2023; 18(6): e0286254.
[http://dx.doi.org/10.1371/journal.pone.0286254] [PMID: 37390076]
[6]
European AIDS clinical society. Guidelines. Version 9.0. EACS 2023. Available from: https://www.eacsociety.org/media/guidelines-12.0.pdf
[7]
Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6303a1.htm (Accessed February 2, 2024).
[8]
Yurdakul Ş, Mehmet N. Epidemiological studies on HIV/AIDS in Türkiye: A review. ESTUDAM. Halk Sağlığı Dergisi 2023; 8(1): 80-6.
[http://dx.doi.org/10.35232/estudamhsd.1137597]
[9]
Johnson LF, Dorrington RE, Bradshaw D, Coetzee DJ. The effect of syndromic management interventions on the prevalence of sexually transmitted infections in South Africa. Sex Reprod Healthc 2011; 2(1): 13-20.
[http://dx.doi.org/10.1016/j.srhc.2010.08.006] [PMID: 21147454]
[10]
Chesson HW, Dee TS, Aral SO. AIDS mortality may have contributed to the decline in syphilis rates in the United States in the 1990s. Sex Transm Dis 2003; 30(5): 419-24.
[http://dx.doi.org/10.1097/00007435-200305000-00008] [PMID: 12916133]
[11]
European Centre for Disease Prevention and Control. “Syphilis. In: ECDC. Annual epidemiological report for 2018.” Stockholm: ECDC. 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/syphilis-aer-2018.pdf
[12]
Chen G, Cao Y, Yao Y, et al. Syphilis incidence among men who have sex with men in China: Results from a meta-analysis. Int J STD AIDS 2017; 28(2): 170-8.
[http://dx.doi.org/10.1177/0956462416638224] [PMID: 26992411]
[13]
Sofuoğlu Z, Baysan C, Gülmez H, Palanbek Yavaş S, Ayvat P. The relationship between sexual behavior and well-being during the COVID-19 pandemic: an online survey study. Pamukkale Medical journal 2023; 16(2): 248-56.
[http://dx.doi.org/10.31362/patd.1216204]
[14]
Sarigül F, Sayan M, İnan D, et al. Current status of HIV/AIDS-syphilis co-infections: A retrospective multicentre study. Cent Eur J Public Health 2019; 27(3): 223-8.
[http://dx.doi.org/10.21101/cejph.a5467] [PMID: 31580558]
[15]
Çabalak M, Bal T. Examination of the seroprevalence of viral hepatitis and syphilis coinfection in HIV positive cases. Flora 2020; 25(3): 354-60.
[http://dx.doi.org/10.5578/flora.69247]
[16]
Djomand G, Schlefer M, Gutreuter S, et al. Prevalence and correlates of genital infections among newly diagnosed human immunodeficiency virus–infected adults entering human immunodeficiency virus care in windhoek, namibia. Sex Transm Dis 2016; 43(11): 698-705.
[http://dx.doi.org/10.1097/OLQ.0000000000000513] [PMID: 27893600]
[17]
Agmon-Levin N, Elbirt D, Asher I, Gradestein S, Werner B, Sthoeger Z. Syphilis and HIV co-infection in an Israeli HIV clinic: Incidence and outcome. Int J STD AIDS 2010; 21(4): 249-52.
[http://dx.doi.org/10.1258/ijsa.2009.009011] [PMID: 20378895]
[18]
Ren M, Dashwood T, Walmsley S. The intersection of HIV and syphilis: Update on the key considerations in testing and management. Curr HIV/AIDS Rep 2021; 18(4): 280-8.
[http://dx.doi.org/10.1007/s11904-021-00564-z] [PMID: 34091858]
[19]
Sarıgül F, Üser U, Öztoprak N. Seroprevalence and risk factors in HIV/AIDS patients coinfected with syphilis. Klimik Derg 2019; 32(2): 161-4.
[http://dx.doi.org/10.5152/kd.2019.35]
[20]
Gökengin D, Çalık S, Öktem P. Analysis of HIV/AIDS-related stigma and discrimination in Turkey: Results of the people living with hiv stigma index. Klimik Derg 2017; 30(1): 15-21.
[http://dx.doi.org/10.5152/kd.2017.03]
[21]
Wu MY, Gong HZ, Hu KR, Zheng H, Wan X, Li J. Effect of syphilis infection on HIV acquisition: A systematic review and meta-analysis. Sex Transm Infect 2021; 97(7): 525-33.
[http://dx.doi.org/10.1136/sextrans-2020-054706] [PMID: 33219164]
[22]
Tozun N, Ozdogan O, Cakaloglu Y, et al. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: A fieldwork TURHEP study. Clin Microbiol Infect 2015; 21(11): 1020-6.
[http://dx.doi.org/10.1016/j.cmi.2015.06.028] [PMID: 26163105]
[23]
Janier M, Unemo M, Dupin N, Tiplica GS, Potočnik M, Patel R. 2020 European guideline on the management of syphilis. J Eur Acad Dermatol Venereol 2021; 35(3): 574-88.
[http://dx.doi.org/10.1111/jdv.16946] [PMID: 33094521]
[24]
Brown ST, Zaidi A, Larsen SA, Reynolds GH. Serological response to syphilis treatment. A new analysis of old data. JAMA 1985; 253(9): 1296-9.
[http://dx.doi.org/10.1001/jama.1985.03350330094030] [PMID: 3155812]
[25]
Magri F, Donà MG, Panetta C, et al. Unusual clinical manifestation and challenging serological interpretation of syphilis: Insights from a case report. BMC Infect Dis 2021; 21(1): 521.
[http://dx.doi.org/10.1186/s12879-021-06199-0] [PMID: 34078297]
[26]
Harman R, Horasan EŞAHİN, Kandemi̇r Ö. Investigation on HIV infection among syphilis patients. Turk Hij Deney Biyol Derg 2021; 78(1): 25-30.
[http://dx.doi.org/10.5505/TurkHijyen.2020.71598]

© 2024 Bentham Science Publishers | Privacy Policy