Recent acquired STD and the use of HAART in the Italian Cohort of Naive for Antiretrovirals (I.Co.N.A): analysis of the incidence of newly acquired hepatitis B infection and syphilis

Infection. 2008 Feb;36(1):46-53. doi: 10.1007/s15010-007-6300-z. Epub 2008 Jan 29.

Abstract

Objective: To estimate the incidence of newly acquired syphilis (n-syphilis) and hepatitis B infection (n-hepatitis B) in I.Co.N.A. and to evaluate the impact of HAART, calendar date and risk group.

Methods: Cohort study: Incidence was calculated by person-years analyses. Poisson regression was used for the multivariate model.

Results: The rate of n-syphilis was 23.4/1,000 PYFU and it increased over time; HIV transmission risk was the most important predictor: men who have sex with men (MSM) had a considerable higher risk (RR 5.92, 95% CI 2.95-12.13 vs IDU/exIDU, p<0.0001). The rate of n-hepatitis B was 12.2/1,000 PYFU; it declined in recent years and halved per 10 years age. Patients with HIV-RNA<500 copies/ml had a 60% reduced risk of n-hepatitis B if they were treated with HAART compared with not treated individuals.

Conclusions: In our population, the use of HAART was not associated with a higher risk of newly acquired sexually transmitted diseases (STD). Suppressive HAART was associated with a lower risk of HbsAg seroconversion. Incidence of n-hepatitis B has recently been declining possibly due to herd immunity provided by vaccination policies. The risk of acquiring n-syphilis has increased over time and it is higher in the population of MSM compared with other categories of HIV exposure.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active*
  • Cohort Studies
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV-1*
  • Hepatitis B / epidemiology*
  • Hepatitis B / etiology
  • Hepatitis B / immunology
  • Homosexuality, Male
  • Humans
  • Incidence
  • Italy / epidemiology
  • Male
  • Multivariate Analysis
  • Poisson Distribution
  • Regression Analysis
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / etiology
  • Syphilis / epidemiology*
  • Syphilis / etiology
  • Syphilis / immunology