Time trends of syphilis and HSV-2 co-infection among men who have sex with men in the German HIV-1 seroconverter cohort from 1996-2007

Numbers of newly diagnosed HIV infections among men who have sex with men (MSM) in Germany increased after the year 2000. We sought to explore trends in STI co-infections around the time of HIV seroconversion in patients from the German HIV-1 seroconverter cohort from 1996-2007. MSM from the cohort...

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Bibliographic Details
Published in:	Sexually transmitted infections Vol. 86; no. 5; p. 331
Main Authors:	Spielmann, Nadine, Münstermann, Dieter, Hagedorn, Hans-Jochen, an der Heiden, Matthias, Houareau, Claudia, Gunsenheimer-Bartmeyer, Barbara, Kücherer, Claudia, Keeren, Katrin, Hamouda, Osamah, Marcus, Ulrich
Format:	Journal Article
Language:	English
Published:	England 01-10-2010
Subjects:	Adult Germany - epidemiology Herpes Genitalis - complications Herpes Genitalis - epidemiology Herpesvirus 2, Human - immunology HIV Seropositivity - complications HIV Seropositivity - epidemiology HIV-1 - immunology Homosexuality, Male - statistics & numerical data Humans Incidence Male Poisson Distribution Prospective Studies Syphilis - complications Syphilis - epidemiology Time Factors Germany
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Summary:	Numbers of newly diagnosed HIV infections among men who have sex with men (MSM) in Germany increased after the year 2000. We sought to explore trends in STI co-infections around the time of HIV seroconversion in patients from the German HIV-1 seroconverter cohort from 1996-2007. MSM from the cohort were included for secondary analysis, if seroconversion occurred between 1996 and 2007 and if a blood sample taken within 2 y after HIV infection was available for further testing. Samples were tested for antibodies against Treponema pallidum and HSV-2. A classification system was developed to assign the chronology of syphilis and HIV-1 infection. Data of 1052 MSM were eligible for analysis. Overall seroprevalence of syphilis markers was 26%, increasing from 10% (1996-1999) to 35% (2005). Among HIV seroconverters with positive syphilis antibodies, 32% (n=88) were rated as having had coincident infections with HIV and syphilis. Coincident syphilis infection at HIV diagnosis increased substantially (p<0.001) from 2.3% in 2000 to 16.9% in 2003; and thereafter declined to 4.3% in 2007. Mean HSV-2 antibody prevalence was 40.5%, mean anti-HSV-2 IgM prevalence was 11.2%, with no significant change over time. We found a stable prevalence of HSV-2 infection and increasing prevalence of syphilis infection around the time of HIV acquisition among MSM in Germany. Time course and rate of co-infections suggest that a re-emerging syphilis co-epidemic among MSM after 2000 could have contributed to an increase of HIV incidence by enhancing HIV transmission probability.
ISSN:	1472-3263
DOI:	10.1136/sti.2009.040857