Risk factors and time-trends of cytomegalovirus (CMV), syphilis, toxoplasmosis and viral hepatitis infection and seroprevalence in human immunodeficiency virus (HIV) infected patients.
BACKGROUND
Chronic bacterial, viral and parasitic infections contribute to the morbidity and mortality associated with human immunodeficiency virus (HIV) infection. This study investigated risk factors and time-trends of the seroprevalence of cytomegalovirus (CMV), toxoplasmosis and hepatitis A total antibody; and co-infection with syphilis, hepatitis B and hepatitis C among newly diagnosed HIV individuals in Singapore.


METHODS
This was a cross-sectional study. A random sample of 50% of HIV infected patients who visited the Communicable Disease Centre (CDC), Singapore for first-time care from January 2006 to December 2011 were analysed.


RESULTS
Among the 793 study subjects, 93.4% were male; 77.9% of them were of Chinese ethnicity; mean age at HIV diagnosis was 41.4 years; and the mean baseline CD4+ T-cell count was 222 cells/mm³. The prevalence of sero-reactivity for CMV was 96.8%; hepatitis A: 40.9%; and toxoplasmosis: 23.7%. Co-infection with syphilis was identified in 12.3%; hepatitis B: 8.1%; and hepatitis C: 2%. Among those co-infected with hepatitis C, 73.3% of them were intravenous drug user (IVDU). Syphilis co-infection was significantly more common among men who have sex with men (MSM) (multivariate OR: 2.53, 95% CI, 1.31 to 4.90, P = 0.006).


CONCLUSIONS
This study described the baseline rates of HIV co-infection with syphilis, hepatitis B and C in Singapore, and sero-reactivity to CMV, toxoplasmosis and hepatitis A. The increased rates compared to the general population may have important consequences for disease progression, response to antiretroviral treatment and long-term general health.
Institute of Infectious Disease and Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore.
Raymond Bt
RB
Lim
Mei Ting
MT
Tan
Barnaby
B
Young
Cheng Chuan
CC
Lee
Yee Sin
YS
Leo
Arlene
A
Chua
Oon Tek
OT
Ng
D000328:Adult; D060085:Coinfection / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000097:blood / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D016174:Hepacivirus / Q000302:isolation & purification; D006525:Hepatitis, Viral, Human / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012846:Singapore / Q000453:epidemiology; D013587:Syphilis / Q000097:blood / Q000453:epidemiology*; D013997:Time Factors; D014123:Toxoplasmosis / Q000097:blood / Q000453:epidemiology*