Increasing Detection of Asymptomatic Syphilis in HIV Patients
August 15, 2005
Noting that new syphilis diagnoses in London were mainly in men who have sex with men, many of whom also had HIV, researchers at Chelsea and Westminster Hospital introduced regular serological screening for syphilis in the HIV unit during routine follow-up care to detect patients who might be at risk for asymptomatic syphilis infection. The doctors used a prospectively collected database to identify all HIV outpatients with newly positive syphilis serology between May 1, 2002-April 30, 2003. Only patients who were asymptomatic at the time of screening were included (cohort B). They were compared to patients in the exact preceding year (cohort A).
The investigators found that 2,655 patients had at least one CD4 count measured in the period (a surrogate marker for patients having routine follow-up blood work), and that 2,389 of those patients had syphilis serology performed. Forty patients showed early asymptomatic infection (two were re-infections), compared to 26 patients in cohort A. "These 40 patients represented 36 percent of all patients with infectious syphilis treated within our department and 56 percent of those who were HIV positive," the researchers found. "The event rate in cohort B was 7.3 per 1000 patient years (CI 5.2 to 9.9) compared to 2.8 (CI 1.8 to 4.0) in cohort A," according to the study.
"Routine screening is effective and has detected increasing numbers of HIV outpatients with early asymptomatic syphilis," the scientists concluded. "Our department will continue this strategy for all HIV patients during their follow-up care. We recommend that other units adopt similar initiatives that assist with regional control of the UK syphilis epidemic."
Sexually Transmitted Infections
06.05; Vol. 81: P. 217-219; C.E. Cohen; A. Winston; D. Asboe; F. Boag; S. Mandalia; B. Azadian; D.A. Hawkins
Transmission of Multidrug-Resistant HIV Will Not Become More Frequent in United Kingdom Through 2010, Statistical Model Suggests
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.