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Time trends of syphilis and HSV-2 co-infection among men who have sex with men in the German HIV-1 seroconverter cohort from 1996–2007
  1. Nadine Spielmann1,
  2. Dieter Münstermann2,
  3. Hans-Jochen Hagedorn2,
  4. Matthias an der Heiden1,
  5. Claudia Houareau1,
  6. Barbara Gunsenheimer-Bartmeyer1,
  7. Claudia Kücherer3,
  8. Katrin Keeren3,
  9. Osamah Hamouda1,
  10. Ulrich Marcus1,
  11. the German HIV-1 Seroconverter Study Group
  1. 1Department of Infectious Disease Epidemiology, HIV/AIDS, STI Unit, Robert Koch Institute, Berlin, Germany
  2. 2Labor Krone, Bad Salzuflen, Germany
  3. 3Project HIV Variability and Molecular Epidemiology, Robert Koch Institute, Berlin, Germany
  1. Correspondence to Ulrich Marcus, Department of Infectious Disease Epidemiology, HIV/AIDS, STI Unit, Robert Koch Institute, Robert Koch Institute, DGZ-Ring 1, Berlin 13086, Germany; MarcusU{at}


Objectives 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.

Methods 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.

Results 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.

Discussion 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.

  • Syphilis
  • HSV-2
  • HIV transmission
  • STI co-factor
  • men who have sex with men (MSM)
  • HIV
  • homosexual
  • transmission

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  • Participating collaborators of the German HIV-1 Seroconverter Study Group Aachen: Drs Habets and Knechten; Augsburg: Dr Hammond (Klinikum Augsburg); Berlin: Drs Mayr, Schmidt, Speidel and Strohbach (Medizinisches Versorgungszentrum, Ärzteforum Seestraße), Dr Arastéh (Auguste-Viktoria-Krankenhaus/Vivantes), Drs Bieniek and Cordes, Dr Claus, Drs. Baumgarten, Carganico and Dupke, Drs Freiwald and Rausch, Drs Gölz, Klausen, Mol, and Schleehauf, Dr Hintsche, Drs Jessen and Jessen, Drs Köppe and Krauthausen, Dr Reuter; Bielefeld: Dr Pfaff (Krankenhaus MARA II); Bochum: Prof Dr Brockmeyer (St Joseph-Hospital); Bonn: Prof Dr Rockstroh (Universitätsklinik Bonn); Dortmund: Prof Dr Gehring and Dr Schmalöer and Dr Hower (Klinikum Dortmund, ID27 Ambulanz); Dresden: Prof Dr Spornraft-Ragaller (Universitätsklinikum Dresden); Duisburg: Dr Becker-Boost, Dr Kwirant; Düsseldorf: Prof Dr Häussinger and PD Dr Reuter (Universitätsklinik Düsseldorf); Frankfurt/Main: Prof Dr Helm (Universitätsklinik Johann-Wolfgang-Goethe-Universität); Frankfurt/Oder: Dr Markus; Halle/Saale: Dr Kreft (Universitätsklinik Martin-Luther-Universität); Hamburg: Prof Dr Plettenberg, Dr Stoehr, Dr Graefe and Dr Lorenzen (Institut für Infektionsmedizin, ifi, Allgemeines Krankenhaus St. Georg); Drs Adam, Schewe and Weitner, Dr Fenske, Dr. Hansen, Prof Dr Stellbrink (Infektionsmedizinisches Zentrum Hamburg, ICH); Hannover: Prof Dr Schmidt (Medizinische Hochschule Hannover), Drs Buck and Leugner; Koblenz: Prof Dr Eisenhauer and Dr Rieke (Krankenhaus Kemperhof); Köln: Dr Bihari, Dr Ferdinand, Prof Dr Fätkenheuer (Universitätsklinik Köln); Prof Dr Oette, Krankenhaus der Augustinerinnen, Köln; Leipzig: Dr Pfeil (Universitätsklinik Leipzig); Magdeburg: Prof Dr Malfertheiner and Dr Wolle (Universitätsklinik Otto-v-Guericke-Universität); Mainz: Prof Dr Galle (Klinikum der Joh-Gutenberg-Universität); München: Drs Jäger and Jägel-Guedes, Dr Malm, Dr Rieger, Städtisches Krankenhaus 12 München-Schwabing, Prof Dr Fröschl (Technische Universität München); Münster: Prof Dr Rahn (Universitätsklinik Münster); Norderstedt: Dr Soldan; Nürnberg: Dr Brockhaus (Klinikum Nürnberg); Osnabrück: Dr Mutz (Städtische Klinik Natruper Holz); Regensburg: Prof Dr Salzberger, Prof Dr Schölmerich and Dr Schneidewind (Universitätsklinik Regensburg); Remscheid: Dr Steege; Rostock: Dr Kreft, Prof Dr Ziegler and Prof Dr Reisinger (Universitätsklinik Rostock); Stuttgart: Drs Ißler, Schaffert, Schnaitmann and Trein, Drs Frietsch, Müller and Ulmer; Dr Wagner-Wiening (Landesgesundheitsamt Stuttgart); Ulm: Prof Dr Kern and Prof Dr Kreidler (Universitätsklinik Ulm); Viernheim: Dr van Treek; Wiesbaden: Dr Starke.

  • Funding Funding for the German HIV Seroconverter Cohort was granted by the German Federal Ministry of Health.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Charite University Clinic Berlin, 2005.

  • Provenance and peer review Not commissioned; externally peer reviewed.