Co-infections of HIV, syphilis and HSV-2 among men who have sex with men at the voluntary HIV counseling and testing clinics in Shanghai / 中华流行病学杂志

Objective To understand the prevalence rates of HIV-syphilis and HIV-herpes simplex virus 2 (HSV-2) co-infections and related factors among men having sex with men (MSM)who had visited the voluntary HIV counseling and testing (VCT) clinics in Shanghai,China.Methods 756 eligible MSM who attended the VCT clinics of Shanghai Municipality and Putuo district during March to August,2015 were recruited to participate in a cross-sectional survey with questionnaire interview and blood testing for HIV,syphilis and HSV-2.Results A total of 732 participants completed a valid questionnaire survey.The prevalence rates were 3.3％ (24/732) for HIV/Syphilis co-infection,1.9％ (14/732) for HIV/HSV-2 co-infection,and 0.7％ (5/732) for HIWSyphilis/HSV-2 co-infection,respectively.HIV prevalence appeared significantly higher among syphilis-infected participants (45.3％,24/53) than those without Syphilis (7.2％,61/679) (x2=63.11,P＜0.001),and was also significantly higher among HSV-2 infected participants (34.1％,14/41) than those without the HSV-2 infection (10.3 ％,71/691) (x2 =21.49,P ＜ 0.001).Results from the Multivariate regression analysis indicated that participants who were migrants (0R=3.50,95％CI:1.01-12.17),having had middle school or lower levels of education (OR=4.46,95％CI:1.54-12.87) or ever used illicit drugs (OR=4.25,95％ CI:1.67-10.82,P=0.002) were under possible risks on HIV and Syphilis co-infection.Those participants who had high middle school or lower levels of education (OR=6.87,95％CI:1.86-25.42;OR=9.82,95％CI:2.25-42.85) were under risk on HIV and HSV-2 co-infection.Conclusion HIV/Syphilis and HIV/HSV-2 co-infection were seen among MSM who attended the VCT clinics in Shanghai that called for special attention,especially on migrants,those with low education or illicit drug users.

Co-infections of HIV, syphilis and HSV-2 among men who have sex with men at the voluntary HIV counseling and testing clinics in Shanghai / 中华流行病学杂志

Objective To understand the prevalence rates of HIV-syphilis and HIV-herpes simplex virus 2 (HSV-2) co-infections and related factors among men having sex with men (MSM)who had visited the voluntary HIV counseling and testing (VCT) clinics in Shanghai,China.Methods 756 eligible MSM who attended the VCT clinics of Shanghai Municipality and Putuo district during March to August,2015 were recruited to participate in a cross-sectional survey with questionnaire interview and blood testing for HIV,syphilis and HSV-2.Results A total of 732 participants completed a valid questionnaire survey.The prevalence rates were 3.3％ (24/732) for HIV/Syphilis co-infection,1.9％ (14/732) for HIV/HSV-2 co-infection,and 0.7％ (5/732) for HIWSyphilis/HSV-2 co-infection,respectively.HIV prevalence appeared significantly higher among syphilis-infected participants (45.3％,24/53) than those without Syphilis (7.2％,61/679) (x2=63.11,P＜0.001),and was also significantly higher among HSV-2 infected participants (34.1％,14/41) than those without the HSV-2 infection (10.3 ％,71/691) (x2 =21.49,P ＜ 0.001).Results from the Multivariate regression analysis indicated that participants who were migrants (0R=3.50,95％CI:1.01-12.17),having had middle school or lower levels of education (OR=4.46,95％CI:1.54-12.87) or ever used illicit drugs (OR=4.25,95％ CI:1.67-10.82,P=0.002) were under possible risks on HIV and Syphilis co-infection.Those participants who had high middle school or lower levels of education (OR=6.87,95％CI:1.86-25.42;OR=9.82,95％CI:2.25-42.85) were under risk on HIV and HSV-2 co-infection.Conclusion HIV/Syphilis and HIV/HSV-2 co-infection were seen among MSM who attended the VCT clinics in Shanghai that called for special attention,especially on migrants,those with low education or illicit drug users.

Coinfection of Epstein-Barr virus, cytomegalovirus, herpes simplex virus, human papillomavirus and anal intraepithelial neoplasia in HIV patients in Amazon, Brazil

OBJECTIVE: The prevention of anal cancer is a goal of worldwide Aids support centers. Despite the efforts that have been made and progress in the antiretroviral therapy, effective disease control remains elusive. Difficulty in preventing anal cancer may result from the ineffectiveness of highly active antiretroviral therapy on the human papillomavirus (HPV) since the coinfection with HIV and HPV appears to increase the risk of HPV-infected cells, becoming cancerous. METHODS: We evaluated 69 HIV-positive and 30 HIV-negative male patients who underwent cytological evaluation by RT-PCR for the presence of HPV, Epstein-Barr virus, cytomegalovirus and herpes virus types (HSV) 1 and 2, and histopathology analysis of the anal canal. RESULTS: The prevalence of anal intraepithelial neoplasia was 35% and it was restricted to HIV-positive patients. Patients infected with high-risk HPV and with fewer than 50 TCD4 cells/µL showed an anal intraepithelial neoplasia rate of 85.7% compared to those with TCD4 cells > 200 cells/µL (p<0.01). The rate of viral coinfection was 16.9% of the sexual transmitted diseases cases and it was correlated with HIV-1 viral load of more than 10.001 copies/mL (p=0.017). The rate of AIN in coinfected patients was 36.4% (p=0.047). CONCLUSIONS: In this study, at the main institution for the treatment of HIV/AIDS in the Amazon region of Brazil, anal coinfection with HPV, cytomegalovirus, HSV-1, HSV-2 and Epstein-Barr virus occurred only in HIV-positive patients and it was directly influenced by the viral load of HIV-1. In this study, anal viral coinfection showed no additional risk for the development of anal intraepithelial neoplasia. (AU)

OBJETIVO: A prevenção do câncer anal tem sido aplicada pelos centros de apoio a pacientes com Aids em todo o mundo. Apesar dos esforços empregados, o eficaz controle da doença permanece distante. A dificuldade na prevenção do câncer anal pode resultar, em parte, da ineficácia da ação da terapia antirretroviral sobre o papilomavírus humano (HPV), pois a coinfecção com HIV e HPV parece aumentar o risco das células infectadas pelo HPV em tornarem-se cancerosas. MÉTODOS: Foram avaliados 69 HIV-positivos e 30 pacientes HIV-negativos do sexo masculino, que foram submetidos à avaliação citológica anal por real time-PCR para a presença de HPV, vírus Epstein-Barr, citomegalovírus e herpes vírus tipos (HSV) 1 e 2 além da análise histopatológica de fragmento de mucosa do canal anal. RESULTADOS: A prevalência de neoplasia intraepitelial anal foi de 35% e foi restrita a pacientes HIV-positivos. Os pacientes infectados com o HPV de alto risco e com contagem inferior a 50 células TCD4/µL mostraram taxa de neoplasia intraepitelial anal de 85,7%. A diferença foi significativa quando comparado a pacientes com células TCD4 > 200 células/µL (p<0,01). A taxa de coinfecção viral foi de 16,9% dos casos de doenças sexualmente transmissíveis e diretamente correlacionada à carga viral HIV-1 superior a 10,001 cópias/mL (p=0,017). A taxa de neoplasia intraepitelial anal em pacientes coinfectados foi de 36,4% (p=0,047). CONCLUSÕES: Neste estudo, realizado na principal instituição para o tratamento de HIV/Aids na região amazônica do Brasil, a coinfecção anal com HPV, citomegalovírus, HSV-1, HSV-2 e vírus Epstein-Barr ocorreu somente em pacientes HIV-positivos e foi influenciada pela carga viral do HIV-1. Neste estudo, a coinfecção viral anal não representou risco adicional ao desenvolvimento da neoplasia intraepitelial anal. (AU)