Back to Search
Start Over
Increasing incidence of syphilis among patients engaged in HIV care in Alberta, Canada: a retrospective clinic-based cohort study.
- Source :
- BMC Infectious Diseases; 3/13/2018, Vol. 18, p1-1, 1p, 3 Charts, 2 Graphs
- Publication Year :
- 2018
-
Abstract
- <bold>Background: </bold>Syphilis is a global health concern disproportionately affecting HIV-infected populations. In Alberta, Canada, the incidence of syphilis in the general population has recently doubled with 25% of these infections occurring in HIV-infected patients. The Southern Alberta HIV Clinic (SAC) and Calgary STI Program (CSTI) analyzed the epidemiologic characteristics of incident syphilis infections in our well-defined, HIV-infected population over 11 years.<bold>Methods: </bold>Since 2006, as routine practice of both the Southern Alberta Clinic (SAC) and Calgary STI Programs (CSTI), syphilis screening has accompanied HIV viral load measures every four months. All records of patients who, while in HIV care, either converted from being syphilis seronegative to a confirmed seropositive or were re-infected as evidenced by a four-fold increase in rapid plasma reagin (RPR) after past successful treatment, were reviewed.<bold>Results: </bold>Incident syphilis was identified 249 times in 194 HIV-infected individuals. There were 36 individuals with repeated infections (28.5% of episodes). Following a prior decline in annual incident syphilis rates, the rates have tripled from 8.08/1000 patient-years (95% confidence interval (CI): 4.14-14.75) in 2011, to 27.04 per 1000 person-years (95% CI: 19.45-36.76) in 2016. Half of the syphilis episodes were asymptomatic. Patients diagnosed with syphilis were twice as likely not to be taking ART and had a higher likelihood of having plasma HIV RNA viral loads > 1000 copies/mL (19%). Incident syphilis was seen predominantly in Caucasians (72%, P < 0.001), males (94%, P < 0.001) and men who have sex with men (MSM) as their HIV risk activity (75%, P < 0.001).<bold>Conclusions: </bold>We have highlighted the importance of a regular syphilis screening program in HIV-infected individuals demonstrated by increasing rates of incident syphilis in our region. Targeted preventative strategies should be directed towards HIV-infected populations identified at highest risk, including; MSM, prior alcohol abuse, prior recreational drug use and those with prior syphilis diagnoses. [ABSTRACT FROM AUTHOR]
- Subjects :
- HIV infections
EPIDEMICS
BLOOD plasma
SYPHILIS
SEXUALLY transmitted diseases
COMPLICATIONS of alcoholism
DIAGNOSIS of HIV infections
SYPHILIS complications
DIAGNOSIS of syphilis
HIV infection complications
SYPHILIS epidemiology
HIV infection epidemiology
CLINICS
HIV
HOMOSEXUALITY
RNA
VIRAL load
DISEASE incidence
RETROSPECTIVE studies
Subjects
Details
- Language :
- English
- ISSN :
- 14712334
- Volume :
- 18
- Database :
- Complementary Index
- Journal :
- BMC Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 128477783
- Full Text :
- https://doi.org/10.1186/s12879-018-3038-4