engleski

The prevalence of syphilis in HIV-infected persons entering care in Croatia in the period 2009-2014

Background: In Croatia, all HIV infected persons are treated at the University Hospital for Infectious Diseases (UHID) in Zagreb. HIV and Treponema pallidum coinfection has important public health implications ; syphilis is a cofactor for acquiring or transmitting HIV infection and having past or current syphilis, is associated with an increased risk of HIV infection. The prevalence of syphilis in HIV infected patients in Croatia has so far not been reported. The aim of the study was to analyze the prevalence of past or current syphilis in persons entering HIV care in Croatia in the period 2009-2014. Methods: The clinical data were extracted from the HIV/AIDS electronic database at UHID. All Treponema pallidum haemagglutination (TPHA) tests and rapid plasma reagin (RPR) tests in patients entering HIV care were reviewed. We report frequencies with confidence intervals for proportions and medians for continuous variables. The analysis was done in adults (> 18 years) and persons who have not been in HIV care anywhere else before entering care at UHID. Results: Of 483 persons included into care in the period 2009-2014, 31 were already in care outside Croatia and data was not available for 5 persons. So the final study population for analysis included 447 persons. Of 447 persons, 408 (91%) were male, 367 (82%) males reported sex with another male partner (MSM), 160 (36%) lived in a rural area and 177 (40%) had less than 200 CD4+ cells per mm3. The median age was 39 years, 76 (17%) were older than 50 years ; the median CD4 cell count was 278 cells per mm3. The prevalence of TPHA seropositivity was 19.5% (87 of 447 ; 95% CI 16.0G23.4%). The prevalence of RPR seropositivity was 7.8% (35 of 447 ; 95% CI 5.7G10.7%). All persons with a reactive RPR had also a positive TPHA test. Of 35 persons with a positive RPR, syphilis was diagnosed at inclusion into HIV care in 23 (65.7%) and in 12 persons HIV testing was done after syphilis was diagnosed. Overall, newly diagnosed syphilis was present in 23 of 447 persons (5.5% [95% CI, 3.4G7.6%]). All persons with current syphilis (n=35) were males and 33 (94%) were MSM. Conclusion: The prevalence of syphilis in HIV infected patients entering care in Croatia was high. All newly diagnosed HIV infected patients should be tested for syphilis and HIV testing is also important for all patients with a new diagnosis of syphilis.

Prevalence; syphilis; Croatia; HIV

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