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IV drug use, HCV predict syphilis in women with HIV

ByJohn C. Schoen, MA

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Jodie Dionne-Odom

SEATTLE — A recent analysis found that IV drug use and hepatitis C virus infection were the best predictors of incident syphilis among women with HIV.

Jodie Dionne-Odom, MD, an infectious disease specialist at the University of Alabama at Birmingham, explained that there is usually more attention paid to syphilis in men because many cases occur in men who have sex with men. However, studies on women are important, she said, because 918 cases of congenital syphilis occurred in 2017 — twice the number reported 4 years earlier.

Dionne-Odom and colleagues conducted a retrospective study of approximately 4,500 women living with HIV who were enrolled in a large United States cohort between 2005 and 2016. They found that the rate of syphilis among women with HIV was 760 cases per 100,000 women compared with 2.3 cases per 100,000 women in the general population. IV drug use (adjusted OR = 2.3; 95% CI, 1.3-3.9) and HCV (aOR = 2.1; 95% CI, 1.3-3.7) were both strong predictors of syphilis infection in this group.

Dionne-Odom said the findings — along with recent CDC data — demonstrate that drug use is driving the syphilis epidemic in women.

“These predictors are important to understand so we can come up with interventions to try to reduce the problem,” she said.

Dionne-Odom told Infectious Disease News that the take-home message for clinicians is to screen routinely for syphilis in women with HIV because infection is usually asymptomatic.

“Screening is particularly important among pregnant women and women with drug use or hepatitis C coinfection,” she said. – by John Schoen and Erin Michael

References:

CDC. Sexually Transmitted Disease Surveillance 2017. https://www.cdc.gov/std/stats17/default.htm. Accessed March 5, 2019.

Dionne-Odom J, et al. Abstract 47. Presented at: Conference on Retroviruses and Opportunistic Infections; March 4-7, 2019; Seattle.

Kidd SE, et al. MMWR Morb Mortal Wkly Rep. 2019;doi:10.15585/mmwr.mm6806a4.

Disclosures: The authors report no relevant financial disclosures.