Temporal Trends in Syphilis Incidence among Men with HIV in Busan, Korea, 2005–2022: A Retrospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Definition
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | All Patients (n = 499) | Patients with Incident Syphilis (n = 82) | Patients without Incident Syphilis (n = 417) | p-Value |
---|---|---|---|---|
Median age at baseline, years [IQR] | 41 [31–51] | 34 [24–43.3] | 42 [32–52] | <0.001 |
Ethnicity | 0.491 | |||
Korean | 486 (97.4) | 81 (98.8) | 405 (97.1) | |
Non-Korean | 13 (2.6) | 1 (1.2) | 12 (2.9) | |
Marriage | 0.002 | |||
Unmarried | 308 (61.7) | 64 (78.0) | 244 (58.5) | |
Married previously | 185 (37.1) | 18 (22.0) | 167 (40.1) | |
Unknown | 6 (1.2) | 0 (0) | 6 (1.4) | |
Sexual behavior | <0.001 | |||
Non-MSM | 191 (38.3) | 16 (19.5) | 175 (42.0) | |
MSM | 290 (58.1) | 65 (79.3) | 225 (54.0) | |
Unknown | 18 (3.6) | 1 (1.2) | 17 (4.1) | |
Median CD4 cell counts, /µL [IQR] | 262 [100–417] | 302 [150.5–380] | 261 [92–422] | 0.495 |
Anti-retroviral therapy | 0.393 | |||
Naïve | 426 (85.4) | 73 (89.0) | 353 (84.7) | |
Experienced | 73 (14.6) | 9 (11.0) | 64 (15.3) | |
Treponemal test positive at baseline | 172 (34.5) | 41 (50.0) | 131 (31.5) | 0.002 |
Incaceration, ever | 30 (6.0) | 8 (9.8) | 22 (5.3) | 0.128 |
Illicit drug use, ever | 32 (6.4) | 8 (9.8) | 24 (5.8) | 0.213 |
Injection drug use, ever | 14 (2.8) | 3 (3.7) | 11 (2.6) | 0.712 |
HBV surface antigen, positive | 29 (5.8) | 3 (3.7) | 26 (6.2) | 0.449 |
HCV antibody, positive | 16 (3.2) | 1 (1.2) | 15 (3.6) | 0.333 |
Calendar period of baseline visit | 0.289 | |||
2005–2007 | 98 (19.6) | 15 (18.3) | 83 (19.9) | |
2008–2010 | 96 (19.2) | 15 (18.3) | 81 (19.4) | |
2011–2013 | 100 (20.0) | 21(25.6) | 79 (18.9) | |
2014–2015 | 78 (15.6) | 16 (19.5) | 62 (14.9) | |
2016–2019 | 80 (16.0) | 12 (14.6) | 68 (16.3) | |
2020–2022 | 47 (9.4) | 3 (3.7) | 44 (10.6) | |
Median testing rates per year [IQR] | 2.2 [1.6–2.8] | 2.9 [1.7–4.28] | 2.2 [1.6–2.7] | 0.043 |
Median follow-up periods, years [IQR] | 5.08 [1.97–9.93] | 3.03 [1.01–6.9] | 5.76 [2.35–11.13] | <0.001 |
Variables | Incidences per 100 PY | Univariate Analysis | Multivariate Analysis | ||
---|---|---|---|---|---|
Crude HR (95% CI) | p-Value | Adjusted HR (95% CI) | p-Value | ||
Age at enrollment, years | |||||
>50 | 0.98 | Reference | |||
30–50 | 2.21 | 2.3 (1.08–4.92) | 0.032 | 2.35 (0.99–5.58) | 0.052 |
≤30 | 5.69 | 5.41 (2.5–11.71) | <0.001 | 6.27 (2.38–16.56) | <0.001 |
Ethnicity (non-Korean vs. Korean) | 6.14 vs. 2.53 | 1.62 (0.22–11.92) | 0.633 | ||
Marriage (unmarried vs. previously married) | 3.57 vs. 1.28 | 2.63 (1.56–4.44) | <0.001 | 1.07 (0.57–2.03) | 0.825 |
Sexual behavior (MSM vs. non-MSM) | 3.4 vs. 1.27 | 2.63 (1.52–4.55) | <0.001 | 2.36 (1.34–4.16) | 0.003 |
CD4 cell counts at baseline, /µL | |||||
≤200 | 1.97 | Reference | |||
201–500 | 3.06 | 1.52 (0.94–2.47) | 0.091 | 1.24 (0.76–2.03) | 0.398 |
>500 | 2.84 | 1.39 (0.74–2.61) | 0.301 | 0.99 (0.51–1.91) | 0.964 |
ART (experienced vs. naïve) | 2.54 vs. 2.55 | 0.94 (0.47–1.89) | 0.860 | ||
Treponemal test at baseline (positive vs. negative) | 3.85 vs. 1.9 | 1.96 (1.27–3.02) | 0.002 | 2.33 (1.48–3.67) | <0.001 |
Incarceration (ever vs. never) | 4.97 vs. 2.42 | 2.02 (0.97–4.19) | 0.059 | 2.62 (1.21–5.67) | 0.015 |
Illicit drug use (ever vs. never) | 3.11 vs. 2.50 | 1.26 (0.61–2.62) | 0.530 | ||
Injection drug use (ever vs. never) | 3.33 vs. 2.52 | 1.27 (0.40–4.02) | 0.684 | ||
HBV surface antigen (positive vs. negative) | 1.51 vs. 2.61 | 0.58 (0.18–1.83) | 0.351 | ||
HCV antibody (positive vs. negative) | 1.26 vs. 2.58 | 0.46 (0.06–3.29) | 0.437 |
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Lee, S.H.; Lee, J.E.; Lee, S.O.; Lee, S.; Ko, W.S.; Kim, H.-H.; Shin, K.-H.; Kang, J.S.; Son, H. Temporal Trends in Syphilis Incidence among Men with HIV in Busan, Korea, 2005–2022: A Retrospective Cohort Study. Viruses 2024, 16, 265. https://doi.org/10.3390/v16020265
Lee SH, Lee JE, Lee SO, Lee S, Ko WS, Kim H-H, Shin K-H, Kang JS, Son H. Temporal Trends in Syphilis Incidence among Men with HIV in Busan, Korea, 2005–2022: A Retrospective Cohort Study. Viruses. 2024; 16(2):265. https://doi.org/10.3390/v16020265
Chicago/Turabian StyleLee, Sun Hee, Jeong Eun Lee, Soon Ok Lee, Shinwon Lee, Woo Seog Ko, Hyung-Hoi Kim, Kyung-Hwa Shin, Jin Suk Kang, and Hyunjin Son. 2024. "Temporal Trends in Syphilis Incidence among Men with HIV in Busan, Korea, 2005–2022: A Retrospective Cohort Study" Viruses 16, no. 2: 265. https://doi.org/10.3390/v16020265