Department of Infectious Disease Epidemiology, HIV/AIDS, STI Unit, Robert Koch Institute, Berlin 13086, Germany.
Sex Transm Infect. 2010 Oct;86(5):331-6. doi: 10.1136/sti.2009.040857.
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.
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.
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.
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.
自 2000 年以来，德国男男性行为者（MSM）中新诊断出的 HIV 感染人数有所增加。我们试图探索在 1996 年至 2007 年间德国 HIV-1 血清转换队列中患者 HIV 血清转换时性传播感染的趋势。
如果 1996 年至 2007 年间发生血清转换并且在 HIV 感染后 2 年内有血样可供进一步检测，则将队列中的 MSM 纳入二次分析。样本检测梅毒螺旋体和单纯疱疹病毒 2 （HSV-2）抗体。制定了一个分类系统来确定梅毒和 HIV-1 感染的时间顺序。
共有 1052 名 MSM 的数据符合分析条件。梅毒标志物的总体血清阳性率为 26%，从 1996 年至 1999 年的 10%增加到 2005 年的 35%。在具有阳性梅毒抗体的 HIV 血清转换者中，32%（n=88）被评为 HIV 和梅毒同时感染。在 HIV 诊断时同时感染梅毒的比例显著增加（p<0.001），从 2000 年的 2.3%增加到 2003 年的 16.9%；随后在 2007 年下降至 4.3%。平均 HSV-2 抗体阳性率为 40.5%，平均抗 HSV-2 IgM 阳性率为 11.2%，无明显时间变化。
我们发现德国 MSM 在获得 HIV 时，HSV-2 感染的流行率稳定，梅毒感染的流行率增加。合并感染的时间进程和速率表明，2000 年后 MSM 中梅毒再次流行可能通过增加 HIV 传播概率而导致 HIV 发病率增加。
