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Risk factors of HIV and syphilis coinfection
R. Adolf1, L. Lunardi2, T. Moresco1, M.L. Aronis2, E. Sprinz1,2
1Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, 2Hospital de Clínicas, Porto Alegre, Brazil
Background: Currently, one of the main challenges is try to decrease the incidence of other sexually transmitted infections (STI), like syphilis. Treponema pallidum infection can increase the risk of HIV transmission through genital ulcers and HIV infection can both increase the severity of syphilis and impair response to therapy. The purpose of this study is to determine risk factors for HIV/Syphilis co-infection.
Methods: Our analysis was based on 2,262 database population of the South Brazilian HIV cohort (SoBrHIV), which is part of the ART-LINC of IeDEA. Syphilis diagnosis was considered with a positive VDRL plus a positive treponemic exam (FTA-Abs). Data were analyzed using STATCALC calculator of EpiInfo6 and R program for Poisson multivariable analysis.
Results: A total of 1,012 met the inclusion criteria. The mean age of HIV diagnosis was 33 years old, and most of individuals acquired HIV through heterosexual contact (47%); and 580 were men (57%). The prevalence of having syphilis diagnosis was 20.5% (n=208). Men who had sex with men (MSM) ) and being male (3.23; 2.45 - 4.26; p < 0.001; and 3.03; 2.21 - 4.17; p < 0.001 respectively) were highly associated to both diagnosis. Patients with viral load (VL) higher than 5 log10 at baseline had more chance than those with less than 3 log10 (1.72; 1.23 - 2.53; p =0.001). CD4 count less than 200 cells/mm3 showed a tendency to have more syphilis (1.27; 0.97 - 1.66; p=0.102).
Conclusions: Not surprisingly, MSM and being men were associated to greater risk of co-infection. Interestingly, individuals with higher VL (and a trend to lower CD4 cell count) had also more chance to be co-infected. Based on our findings, in the population studied, having a prior syphilis diagnosis was also associated to a chance of more severe HIV infection according to the surrogate markers analyzed.
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