Time trends of syphilis and HSV-2 co-infection among men who have sex with men in the German HIV-1 seroconverter cohort from 1996-2007.
OBJECTIVE
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 from 1996-2007.


METHODS
MSM from the cohort were included for secondary analysis, if seroconversion occurred between 1996 and 2007 and if a blood sample taken within 2 y 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 1052 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.


CONCLUSIONS
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.
Spielmann
Nadine
N
Department of Infectious Disease Epidemiology, HIV/AIDS, STI Unit, Robert Koch Institute, Berlin 13086, Germany.
Münstermann
Dieter
D
Hagedorn
Hans-Jochen
HJ
an der Heiden
Matthias
M
Houareau
Claudia
C
Gunsenheimer-Bartmeyer
Barbara
B
Kücherer
Claudia
C
Keeren
Katrin
K
Hamouda
Osamah
O
Marcus
Ulrich
U
D000328:Adult; D005858:Germany / Q000453:epidemiology; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology*; D015497:HIV-1 / Q000276:immunology*; D006558:Herpes Genitalis / Q000150:complications / Q000453:epidemiology*; D018258:Herpesvirus 2, Human / Q000276:immunology*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D016012:Poisson Distribution; D011446:Prospective Studies; D013587:Syphilis / Q000150:complications / Q000453:epidemiology*; D013997:Time Factors