title: High Prevalence and High Incidence of Coinfection with Hepatitis B, Hepatitis C, and Syphilis and Low Rate of Effective Vaccination against Hepatitis B in HIV-Positive Men Who Have Sex with Men with Known Date of HIV Seroconversion in Germany.
abstract: OBJECTIVE
  Men who have sex with men (MSM) are at higher risk for coinfection with hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis than the general population. HIV infection and these coinfections accelerate disease progression reciprocally. This study evaluated the prevalence and incidence of these coinfections in HIV1-positive MSM in Germany.
  
  
  METHODS
  As part of a nationwide, multicenter, prospective cohort study of HIV-infected MSM, plasma samples collected yearly were screened for HBsAg and antibodies to HBc, HBs, HCV, and syphilis. Samples with indications of active HBV or HCV infection were confirmed by polymerase chain reaction. Prevalence and incidence of each infection and incidence rates per study participant were calculated, and incidences over 4-year time intervals compared.
  
  
  RESULTS
  This study screened 5,445 samples from 1,843 MSM. Median age at HIV seroconversion was 33 years. Prevalences of active, cleared, and occult HBV, and of active/cleared HCV were 1.7%, 27.1%, 0.2%, and 8.2%, respectively, and 47.5% had been effectively vaccinated against HBV. Prevalence of antibodies to Treponema pallidum and of triple or quadruple sexually transmitted infections (STIs) were 39.6% and 18.9%, respectively. Prevalence of STI, cleared HBV, HBV vaccination, and history of syphilis differed significantly among age groups. Incidences of HBV, HCV, and syphilis were 2.51, 1.54, and 4.06 per 100 person-years, respectively. Incidences of HCV and syphilis increased over time. HCV incidence was significantly higher in MSM coinfected with syphilis and living in Berlin, and syphilis incidence was significantly higher for MSM living in Berlin.
  
  
  CONCLUSIONS
  Despite extensive HBV vaccination campaigns, fewer than 50% of screened MSM were effectively vaccinated, with a high proportion of HIV-positive MSM coinfected with HBV. High rates of STI coinfections in HIV-positive MSM and increasing incidences emphasize the need for better tailored campaigns for HBV vaccination and STI prevention.
authors.affiliation: Robert Koch Institute, Berlin, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Jansen
authors.affiliation: Robert Koch Institute, Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Thamm
authors.affiliation: Robert Koch Institute, Berlin, Germany.
authors.forename: Claus-Thomas
authors.initials: CT
authors.lastname: Bock
authors.affiliation: Robert Koch Institute, Berlin, Germany.
authors.forename: Ramona
authors.initials: R
authors.lastname: Scheufele
authors.affiliation: Robert Koch Institute, Berlin, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Kücherer
authors.affiliation: Labor Krone, Bad Salzuflen, Germany.
authors.forename: Dieter
authors.initials: D
authors.lastname: Muenstermann
authors.affiliation: Labor Krone, Bad Salzuflen, Germany.
authors.forename: Hans-Jochen
authors.initials: HJ
authors.lastname: Hagedorn
authors.affiliation: Medical Care Centre Jessen, Berlin, Germany.
authors.forename: Heiko
authors.initials: H
authors.lastname: Jessen
authors.affiliation: Medical Care Centre Driesener Strasse, Berlin, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Dupke
authors.affiliation: Robert Koch Institute, Berlin, Germany.
authors.forename: Osamah
authors.initials: O
authors.lastname: Hamouda
authors.affiliation: Robert Koch Institute, Berlin, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Gunsenheimer-Bartmeyer
authors.affiliation: Robert Koch Institute, Berlin, Germany.
authors.forename: Karolin
authors.initials: K
authors.lastname: Meixenberger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005858:Germany; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006509:Hepatitis B / Q000150:complications*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006526:Hepatitis C / Q000150:complications*; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D000069078:Seroconversion; D013587:Syphilis / Q000150:complications*; D055815:Young Adult
chemical_list: D017325:Hepatitis B Vaccines