Incidence of syphilis seroconversion among HIV-infected persons in Asia: Results from the TREAT Asia HIV Observational Database

Jin Young Ahn, David Boettiger, Sasisopin Kiertiburanakul, Tuti Parwati Merati, Bui Vu Huy, Wing Wai Wong, Rossana Ditangco, Man Po Lee, Shinichi Oka, Nicolas Durier, Jun Yong Choi, C. V. Mean, V. Saphonn, K. Vohith, F. J. Zhang, H. X. Zhao, N. Han, P. C.K. Li, W. Lam, Y. T. ChanN. Kumarasamy, S. Saghayam, C. Ezhilarasi, S. Pujari, K. Joshi, S. Gaikwad, A. Chitalikar, D. N. Wirawan, F. Yuliana, E. Yunihastuti, D. Imran, A. Widhani, J. Tanuma, T. Nishijima, S. Na, J. M. Kim, B. L.H. Sim, Y. M. Gani, R. David, A. Kamarulzaman, S. F. Syed Omar, S. Ponnampalavanar, I. Azwa, E. Uy, R. Bantique, W. W. Ku, P. C. Wu, O. T. Ng, P. L. Lim, L. S. Lee, P. S. Ohnmar, P. Phanuphak, K. Ruxrungtham, A. Avihingsanon, P. Chusut, S. Sirivichayakul, S. Sungkanuparph, L. Chumla, N. Sanmeema, R. Chaiwarith, T. Sirisanthana, W. Kotarathititum, J. Praparattanapan, P. Kantipong, P. Kambua, W. Ratanasuwan, R. Sriondee, V. K. Nguyen, V. H. Bui, T. H.D. Nguyen, T. T. Pham, D. D. Cuong, H. L. Ha, A. H. Sohn, B. Petersen, D. A. Cooper, M. G. Law, A. Jiamsakul

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10 Citations (Scopus)


Introduction: Outbreaks of syphilis have been described among HIV-infected men who have sex with men (MSM) in Western communities, whereas reports in Asian countries are limited. We aimed to characterize the incidence and temporal trends of syphilis among HIV-infected MSM compared with HIV-infected non-MSM in Asian countries. Methods: Patients enrolled in the TREAT Asia HIV Observational Database cohort and with a negative non-treponemal test since enrolment were analyzed. Incidence of syphilis seroconversion, defined as a positive non-treponemal test after previously testing negative, was evaluated among patients at sites performing non-treponemal tests at least annually. Factors associated with syphilis seroconversion were investigated at sites doing non-treponemal testing in all new patients and subsequently testing routinely or when patients were suspected of having syphilis. Results: We included 1010 patients from five sites that performed non-treponemal tests in all new patients; those included had negative non-treponemal test results during enrolment and subsequent follow-ups. Among them, 657 patients were from three sites conducting regular non-treponemal testing. The incidence of syphilis seroconversion was 5.38/100 person-years (PY). Incidence was higher in MSM than non-MSM (7.64/100 PY vs. 2.44/100 PY, p<0.001). Among MSM, the incidence rate ratio (IRR) for every additional year from 2009 was 1.19 (p=0.051). MSM status (IRR 3.48, 95% confidence interval (CI) 1.88-6.47), past syphilis diagnosis (IRR 5.15, 95% CI 3.69-7.17) and younger age (IRR 0.84 for every additional 10 years, 95% CI 0.706-0.997) were significantly associated with syphilis seroconversion. Conclusions: We observed a higher incidence of syphilis seroconversion among HIV-infected MSM and a trend to increasing annual incidence. Regular screening for syphilis and targeted interventions to limit transmission are needed in this population.

Original languageEnglish
Article number20965
JournalJournal of the International AIDS Society
Issue number1
Publication statusPublished - 2016

Bibliographical note

Funding Information:
The TREAT Asia HIV Observational Database is an initiative of TREAT Asia, a programme of amfAR, The Foundation for AIDS Research, with support from the US National Institutes of Health's National Institute of Allergy and Infectious Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development and National Cancer Institute, as part of the International Epidemiologic Databases to Evaluate AIDS (IeDEA; U01AI069907). TREAT Asia receives additional support from ViiV Healthcare. The Kirby Institute is funded by the Australian Government Department of Health and Ageing and is affiliated with the Faculty of Medicine, UNSW Australia (The University of New South Wales). JYC's involvement was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education, Science and Technology (NRF-2013R1A1A2005412), and BioNano Health-Guard Research Center, funded by the Ministry of Science, ICT, and Future Planning of Korea as a Global Frontier Project (Grant H-GUARD-2013M3A6B2078953). The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the governments or institutions mentioned above.

Publisher Copyright:
Copyright © 2016 Ahn JY et al; licensee International AIDS Society.

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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