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Prevalence of asymptomatic sexually transmitted infections in HIV-positive men who have sex with men in Germany: results of a multicentre cross-sectional study

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Abstract

Purpose

Sexually transmitted infections (STIs) occur frequently in risk populations. Hereby, the role of screening-programmes remains controversial. Our study aimed to determine the prevalence of STI infections in HIV-positive men-who-have-sex-with-men (MSM).

Methods

We enrolled asymptomatic, HIV-MSM in a prospective cross-sectional study from February to August 2016 at seven German HIV-centres. All subjects were screened for Treponema-pallidum (TP) and hepatitis-B/C-infection. HIV RNA and screening for oral, rectal and urethral colonisation by Chlamydia-trachomatis (CT) and/or Neisseria-gonorrhoeae (NG) was performed. All subjects were asked to complete a sexual-risk-behaviour-questionnaire.

Results

In total, 296 subjects with a median age of 43.2 (36.2–49.5) years were enrolled; 99.3% were on ART for 5.5 (2.3–11.2) years. HIV RNA was < 50 copies/mL in 93.6%. Active syphilis infection was found in 5.0% of all patients, whereas 55.4% had history of infection. HCV seropositivity was found in 33 patients (13.2%) and positive HCV RNA was available in 39.4%. 66/294 (22.5%) showed negative anti-HBs-antibodies, indicating lack of immunity. Overall, 40/296 (13.5%) had positive CT/NG swabs (CT in 8.8%; 7.3% anorectal, 1.7% oropharyngeal, 1.0% urethral and NG in 6.8%; 4.5% anal, 2.0% oropharyngeal, 1.4% urethral). Time since HIV infection < 7 years (OR 2.6 (1.2–5.5); p = 0.012), the use of inhalative nitrites (“poppers”) (OR 2.8 (1.3–5.9; p = 0.008) and reporting unprotected intercourse with > 20 partners within the last 6 months [OR 3.0 (1.2–7.8); p = 0.003] were significantly associated in multivariate analysis.

Conclusion

We found high numbers of asymptomatic syphilis, hepatitis-C and CT/NG infections in HIV-MSM, remarkably in patients with shorter duration of HIV-infection with more sexual partners within last 6 months.

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Acknowledgements

We thank Marcus Kosch for providing assistance with sample processing and study Project management.

Funding

This study was funded by the University Hospital Klinikum rechts der Isar, Department of Medicine II, Ismaninger Str. 22, 81675 Munich, Germany.

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Authors and Affiliations

  1. Department of Medicine II, University Hospital Klinikum rechts der Isar, Ismaninger Str. 22, 81675, Munich, Germany

    Christoph D. Spinner & Cornelius Jordan

  2. Department of Medicine I, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany

    Christoph Boesecke

  3. Praxis am Ebertplatz, Ebertplatz 1, 50668, Cologne, Germany

    Christoph Wyen & Tim Kümmerle

  4. Infektiologikum Frankfurt, Stresemannallee 3, 60596, Frankfurt am Main, Germany

    Gaby Knecht

  5. Praxis Hohenstaufenring, Richard-Wagner-Str. 9-11, 50674, Cologne, Germany

    Stefan Scholten

  6. Department of Dermatology and Allergology, University Hospital Klinikum rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany

    Alexander Zink

  7. Zentrum für Infektiologie Prenzlauer Berg (ZIBP), Driesener Str. 11, 10439, Berlin, Germany

    Ivanka Krznaric

  8. Research and Clinical Care Center, Medizinisches Versorgungszentrum Karlsplatz, Karlsplatz 8, 80335, Munich, Germany

    Sebastian Noe

Authors
  1. Christoph D. Spinner
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  2. Christoph Boesecke
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  3. Cornelius Jordan
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  4. Christoph Wyen
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  5. Tim Kümmerle
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  6. Gaby Knecht
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  7. Stefan Scholten
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  8. Alexander Zink
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  9. Ivanka Krznaric
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  10. Sebastian Noe
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Contributions

CDS, CJ, SNO and CB provided, edited and supervised the manuscript. CDS, SNO, CW, TK, GK, SS, AZ, IK, CB screened and recruited patients. Data management was performed by CJ and CDS, SNO provided statistical analysis. All authors were involved in manuscript preparation and supervision and agreed with the final draft.

Corresponding author

Correspondence to Christoph D. Spinner.

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Conflict of interest

None.

Ethical approval

This study has been approved by Ethics committee at University Hospital Klinikum rechts der Isar (Approval no. 524/15), which operates according to the Declaration of Helsinki. Ethics committees at Landesärztekammer Berlin, Landesärztekammer Nordrhein and Bonn University Hospital have also been informed.

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Spinner, C.D., Boesecke, C., Jordan, C. et al. Prevalence of asymptomatic sexually transmitted infections in HIV-positive men who have sex with men in Germany: results of a multicentre cross-sectional study. Infection 46, 341–347 (2018). https://doi.org/10.1007/s15010-018-1124-6

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  • DOI: https://doi.org/10.1007/s15010-018-1124-6

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