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.
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.
Cicconi
P
P
Clinic of Infectious and Tropical Diseases, Department of Medicine Surgery and Dentistry, University of Milan, San Paolo Hospital, Via Rudinì, 8, 20142, Milan, Italy. paola.cicconi@unimi.it
Cozzi-lepri
A
A
Orlando
G
G
Matteelli
A
A
Girardi
E
E
Degli Esposti
A
A
Moioli
C
C
Rizzardini
G
G
Chiodera
A
A
Ballardini
G
G
Tincati
C
C
d'Arminio Monforte
A
A
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D015497:HIV-1; D006509:Hepatitis B / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D016012:Poisson Distribution; D012044:Regression Analysis; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology; D013587:Syphilis / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology