Syphilis in patients with HIV infection followed in a reference hospital in Brazil
DOI:
https://doi.org/10.11606/issn.1679-9836.v102i3e-203426Keywords:
syphilis, coinfection, HIV, Acquired Immunodeficiency SyndromeAbstract
Introduction: Syphilis and HIV/AIDS co-infection is widely diagnosed in Brazil, since primary syphilis lesions amplify the chances of HIV/AIDS dissemination, in addition to the sharing of risk factors between diseases. However, studies on the clinical, laboratory, and epidemiological variables of coinfection are scarce, especially in Brazil. Objective: To describe the clinical, laboratory, and epidemiological characteristics of patients with syphilis and HIV/AIDS coinfection in a hospital in Recife, between 2015 and 2020. Material and Methods: This was a cross-sectional, retrospective study, carried out using a questionnaire produced by the researchers themselves, related to clinical, epidemiological, laboratory, and therapeutic variables related to syphilis in patients living with HIV. Results: There was a predominance of non-white men (p: 0.017), unmarried (p<0.001), with income below the poverty line (p: 0.032), bisexual or homosexual (p<0.001), and who do not use illicit drugs (p: 0.026), and who perform anal sex (p<0.001) and, among women, a predominance of non-employed women (p<0.001). The most frequently diagnosed clinical stage of syphilis in HIV/AIDS patients was latent syphilis. Conclusion: There was a predominance of patients with specific sociodemographic characteristics, demonstrating a vulnerability profile in homosexual and bisexual men, and brown people, who do not use illicit drugs, who perform anal sex, and who are below the poverty line. Among women, there was a predominance of non-employed. The clinical stage of syphilis most diagnosed among patients with HIV/AIDS infection was latent syphilis.
Keywords (MeSH): syphilis; coinfection; HIV; Acquired Immunodeficiency Syndrome
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Chen G, Cao Y, Yao Y, Li M, Tang W, Li J, Babu GR, Jia Y, Huan X, Xu G, Yang H, Fu G, Li L. Syphilis incidence among men who have sex with men in China: results from a meta-analysis. Int J STD AIDS. 2017;28(2):170-8. doi: 10.1177/0956462416638224
Abara WE, Hess KL, Neblett Fanfair R, Bernstein KT, Paz-Bailey G. Syphilis Trends among men who have sex with men in the United States and Western Europe: a systematic review of trend studies published between 2004 and 2015. PLoS One. 2016;11(7):e0159309. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957774/pdf/pone.0159309.pdf doi: 10.1371/journal.pone.0159309
World Health Organization. (2018). Report on global sexually transmitted infection surveillance, 2018. [cited 2023 Apr 27] https://www.who.int/publications/i/item/9789241565691
Ministério da Saúde, Secretaria de Vigilância em Saúde. Boletim Epidemiológico [Internet]. 2022 [cited 2023 Apr 12]. https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos/especiais/2022/boletim-epidemiologico-de-sifilis-numero-especial-out-2022/view
Cunha CB, Friedman RK, de Boni RB, Gaydos C, Guimarães MRC, Siqueira BH, et al. Chlamydia trachomatis, Neisseria gonorrhoeae and syphilis among men who have sex with men in Brazil. BMC Public Health. 2015;15(1):686. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-2002-0 doi: 10.1186/s12889-015-2002-0
Secretaría de Saúde, Governo de Pernambuco. Boletim Sífilis 2019. 2019 [cited 2023 Apr 12]. http://portal.saude.pe.gov.br/sites/portal.saude.pe.gov.br/files/boletim_sifilis_-_pernambuco_2019-.pdf
Frank TD, Carter A, Jahagirdar D, Biehl MH, Douwes-Schultz D, Larson SL, et al. Global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. Lancet HIV. 2019;6(12):e831–59. https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(19)30196-1/fulltext doi: 10.1016/S2352-3018(19)30196-1
UNAIDS. In Danger: UNAIDS Global AIDS Update 2022. 2022 [cited 2023 Apr 12]. https://www.unaids.org/sites/default/files/media_asset/2022-global-aids-update_en.pdf
Luppi CG, Gomes SEC, Silva RJC da, Ueno AM, Santos AMK dos, Tayra Â, et al. Fatores associados à coinfecção por HIV em casos de sífilis adquirida notificados em um Centro de Referência de Doenças Sexualmente Transmissíveis e Aids no município de São Paulo, 2014*. Epidemiologia e Serviços de Saúde. 2018;10;27(1). https://www.scielo.br/j/ress/a/KJdVD8FNTMn6DQp9PjYgCgg/abstract/?lang=pt doi: 10.5123/S1679-49742018000100008
Melo CBB, de Lima JTS, Silva JF da Silva EF, Assy JGPL, Said RC, Berretta OCP, Gouvêa-e-Silva LF. HIV infection in the west region of Pará. Sci Med, 31(1), e38938. https://doi.org/10.15448/1980-6108.2021.1.38938
Caixeta, A. K. dos S., Souza, L. S. M. de, Fernandes, E. V., Dias, R. F. G., Menezes Filho, H. R. de, & Gouvêa-e-Silva, L. F. (2023). Pessoas vivendo com HIV/Aids no Sudoeste Goiano: caracterização sociodemográfica, clínica e laboratorial no ano de 2018. Rev Med, 102(1). https://doi.org/10.11606/issn.1679-9836.v102i1e-195987
Wang H, Wang X, Li S. A case of lues maligna in an AIDS patient. Int J STD AIDS. 2012;23(8):599–600. https://journals.sagepub.com/doi/10.1258/ijsa.2012.011413?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed doi: 10.1258/ijsa.2012.011413
Lejman K, Starzycki Z. Syphilis maligna praecox. A case report. Sex Transm Infect. 1972;48(3):194–9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1048307/ doi: 10.1136/sti.48.3.
Barker EK, Malekinejad M, Merai R, Lyles CM, Sipe TA, DeLuca JB, Ridpath AD, Gift TL, Tailor A, Kahn JG. Risk of Human Immunodeficiency Virus Acquisition Among High-Risk Heterosexuals With Nonviral Sexually Transmitted Infections: A Systematic Review and Meta-Analysis. Sex Transm Dis. 2022 Jun 1;49(6):383-397. doi: 10.1097/OLQ.0000000000001601
Köksal MO, Beka H, Evlice O, Çiftçi S, Keskin F, Başaran S, Akgül B, Eraksoy H, Ağaçfidan A. Syphilis seroprevalence among HIV-infected males in Istanbul, Turkey. Rev Argent Microbiol. 2020 Oct-Dec;52(4):266-271. doi: 10.1016/j.ram.2020.01.002.
Wu MY, Gong HZ, Hu KR, Zheng HY, Wan X, Li J. Effect of syphilis infection on HIV acquisition: a systematic review and meta-analysis. Sex Transm Infect. 2021 Nov;97(7):525-533. doi: 10.1136/sextrans-2020-054706
Gállego-Lezáun C, Arrizabalaga Asenjo M, González-Moreno J, Ferullo I, Teslev A, Fernández-Vaca V, Payeras Cifre A. Syphilis in Men Who Have Sex With Men: A Warning Sign for HIV Infection. Actas Dermosifiliogr. 2015 Nov;106(9):740-5. English, Spanish. doi: 10.1016/j.ad.2015.05.010
Aydin ÖA, Karaosmanoğlu HK, Sayan M, İnce ER, Nazlıcan Ö. Seroprevalence and risk factors of syphilis among HIV/AIDS patients in Istanbul, Turkey. Cent Eur J Public Health. 2015 Mar;23(1):65-8. doi: 10.21101/cejph.a4001.
Spornraft-Ragaller P, Schmitt J, Stephan V, Boashie U, Beissert S. Characteristics and coinfection with syphilis in newly HIV-infected patients at the University Hospital Dresden 1987-2012. J Dtsch Dermatol Ges. 2014 Aug;12(8):707-16. doi: 10.1111/ddg.12382.
Santos AMG, Souza Júnior VR, Melo FL, Aquino AECA, Ramos MOA, Araújo LM, Lira CR, Sobral PM, Figueiroa F, Melo HRL, Araújo PSR. Prevalence and risk factors of syphilis and human immunodeficiency virus co-infection at a university hospital in Brazil. Rev Soc Bras Med Trop. 2018 Nov-Dec;51(6):813-8. doi: 10.1590/0037-8682-0097-2018.
Pires CAA, Lopes NS, Fayal SP, Lopes L da S, Martins BV de O. Aspectos clínicos e epidemiológicos de pacientes com coinfecção HIV/sífilis atendidos em um centro de referência. Braz J Hea Rev. 2020;3(4):7635-53. https://brazilianjournals.com/ojs/index.php/BJHR/article/view/12814 doi: 10.34119/bjhrv3n4-035
Karp G, Schlaeffer F, Jotkowitz A, Riesenberg K. Syphilis and HIV co-infection. Eur J Intern Med. 2009;20(1):9-13. https://www.ejinme.com/article/S0953-6205(08)00130-1/fulltext doi: 10.1016/j.ejim.2008.04.002
Sands M, Markus A. Lues maligna, or ulceronodular syphilis, in a Man Infected with Human Immunodeficiency Virus: Case Report and Review. Clin Infect Dis. 1995;20(2):387-90. https://academic.oup.com/cid/article-abstract/20/2/387/376905?redirectedFrom=fulltext&login=false doi: 10.1093/clinids/20.2.387
Nnoruka EN, Ezeoke ACJ. Evaluation of syphilis in patients with HIV infection in Nigeria. Trop Med Int Health. 2005;10(1):58-64. https://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2004.01344.x doi: 10.1111/j.1365-3156.2004.01344.x
Marra CM. Neurosyphilis. CONTINUUM: Lifelong Learn Neurol. 2015;21:1714-28. Available from: https://journals.lww.com/continuum/Abstract/2015/12000/Neurosyphilis.17.aspx doi: 10.1212/CON.0000000000000250
Hook EW. Syphilis. Lancet. 2017;389(10078):1550-7. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32411-4/fulltext doi: 10.1016/S0140-6736(16)32411-4
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Copyright (c) 2023 Arthur Alves Rodrigues Alencar, Matheus de Andrade Magalhães, Hugo Vinícius Carvalho de Abreu e Lima, Flávia Patrícia Morais de Medeiros, Jéssica Menezes Gomes de Melo, Edvaldo da Silva Souza

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