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 through 2007

Nadine Spielmann (1) , Dieter Muenstermann (2) , Hans-Jochen Hagedorn (2) , Matthias an Der Heiden (1) , Claudia Houareau (1) , Barbara Gunsenheimer-Bartmeier (1) , Claudia Kuecherer (1) , Katrin Keeren (1) , Osamah Hamouda (1) , Ulrich Marcus (1)

1 RKI - Robert Koch Institute [Berlin]
2 Labor Krone and Partner

Objectives 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 in the years 1996 through 2007. Methods MSM from the cohort were included for secondary analysis, if seroconversion occurred between 1996 and 2007 and if a blood sample taken within two years 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. Results Data of 1,052 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. Discussion 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.

Mots clés: HIV; HOMOSEXUAL; HSV-2; SYPHILIS; TRANSMISSION

Nadine Spielmann, Dieter Muenstermann, Hans-Jochen Hagedorn, Matthias an Der Heiden, Claudia Houareau, et al.. 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 through 2007. Sexually Transmitted Infections, 2010, 86 (5), pp.331. ⟨10.1136/sti.2009.040857⟩. ⟨hal-00570213⟩