Document Detail

Results of a 25-year longitudinal analysis of the serologic incidence of syphilis in a cohort of HIV-infected patients with unrestricted access to care.
MedLine Citation:
PMID:  22592829     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The well-described biologic and epidemiologic associations of syphilis and HIV are particularly relevant to the military, as service members are young and at risk for sexually transmitted infections. We therefore used the results of serial serologic testing to determine the prevalence, incidence, and risk factors for incident syphilis in a cohort of HIV-infected Department of Defense beneficiaries.
METHODS: Participants with a positive nontreponemal test at HIV diagnosis that was confirmed on treponemal testing were categorized as prevalent cases, and participants with an initial negative nontreponemal test who subsequently developed a confirmed positive nontreponemal test were categorized as incident cases.
RESULTS: At HIV diagnosis, the prevalence of syphilis was 5.8% (n = 202). A total of 4239 participants contributed 27,192 person-years (PY) to the incidence analysis and 347 (8%) developed syphilis (rate, 1.3/100 PY; [1.1, 1.4]). Syphilis incidence was highest during the calendar years 2006 to 2009 (2.5/100 PY; [2.0, 2.9]). In multivariate analyses, younger age (per 10 year increase hazard ratio [HR], 0.8; [0.8-0.9]), male gender (HR, 5.6; [2.3-13.7]), non-European-American ethnicity (African-American HR, 3.2; [2.5-4.2]; Hispanic HR, 1.9; [1.2-3.0]), and history of hepatitis B (HR, 1.5; [1.2-1.9]) or gonorrhea (HR, 1.4; [1.1-1.8]) were associated with syphilis.
CONCLUSIONS: The significant burden of disease both at and after HIV diagnosis, observed in this cohort, suggests that the cost-effectiveness of extending syphilis screening to at-risk military members should be assessed. In addition, HIV-infected persons continue to acquire syphilis, emphasizing the continued importance of prevention for positive programs.
Anuradha Ganesan; Ann Fieberg; Brian K Agan; Tahaniyat Lalani; Michael L Landrum; Glenn Wortmann; Nancy F Crum-Cianflone; Alan R Lifson; Grace Macalino;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Sexually transmitted diseases     Volume:  39     ISSN:  1537-4521     ISO Abbreviation:  Sex Transm Dis     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-17     Completed Date:  2012-08-14     Revised Date:  2013-12-06    
Medline Journal Info:
Nlm Unique ID:  7705941     Medline TA:  Sex Transm Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  440-8     Citation Subset:  IM    
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MeSH Terms
African Americans / statistics & numerical data
Cohort Studies
HIV Seropositivity / blood,  economics,  epidemiology*
Health Services Accessibility
Hispanic Americans / statistics & numerical data
Longitudinal Studies
Military Personnel / statistics & numerical data*
Multivariate Analysis
Risk Factors
Sexual Behavior / statistics & numerical data*
Syphilis / blood,  economics,  epidemiology*
United States / epidemiology
Young Adult
Grant Support
Susan Banks / ; Irma Barahona / ; Mary Bavaro / ; Helen Chun / ; Cathy Decker / ; Lynn Eberly / ; Conner Eggleston / ; Tomas Ferguson / ; Susan Fraser / ; Joshua Hartzell / ; Joshua Hawley / ; Gunther Hsue / ; Arthur Johnson / ; Mark Kortepeter / ; Michelle Linfesty / ; Scott Merritt / ; Robert O'Connell / ; Jason Okulicz / ; Sheila Peel / ; Michael Polis / ; John Powers / ; Roseanne Ressner / ; Edmund Tramont / ; Tyler Warkentien / ; Paige Waterman / ; Amy Weintrob / ; Timothy Whitman / ; Michael Zapor /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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