scholarly journals Effect of syphilis infection on HIV acquisition: a systematic review and meta-analysis

2020 ◽  
pp. sextrans-2020-054706
Author(s):  
Meng Yin Wu ◽  
Hui Zi Gong ◽  
Kui Ru Hu ◽  
He-yi Zheng ◽  
Xia Wan ◽  
...  

ObjectivesCo-infection of syphilis and HIV remains hard to manage and its morbidity shows a rising tendency. Syphilis has been associated with increased risk of HIV acquisition in high-risk groups, especially in men who have sex with men (MSM). This systematic review and meta-analysis estimates the effect of syphilis infection on subsequent HIV acquisition, and assesses its difference between MSM and other high-risk populations.MethodsFive electronic databases were searched for literature published to 21 September 2019 without language restrictions. Longitudinal studies that enrolled key populations to compare the incidence of HIV with and without syphilis exposure were included. We used a random-effects model to estimate the effect of syphilis infection on HIV acquisition among high-risk populations, which include MSM, sex workers, serodiscordant couples, people who inject drugs and attendees of STD clinics.ResultsA total of 17 cohorts and 5 case-control studies involving 65 232 participants were included. HIV incidence showed a two-time increase after syphilis exposure, compared with a control group (relative risk (RR) 2.67 (95% CI 2.05 to 3.47); p<0.05 for prevalence; RR 3.21 (95% CI 2.26 to 4.57); p=0.419 for incidence). No significant differences were observed between MSM and other high-risk groups in syphilis infection prevalence (RR 2.60 (95% CI 1.78 to 3.80); p<0.05 vs RR, 2.98 (95% CI 2.15 to 4.14); p<0.05; ratio of relative risk 0.76 (95% CI 0.49 to 1.17)).ConclusionsSyphilis infection increases the risk of HIV acquisition in high-risk populations. There is no evidence to suggest MSM are at greater risk than other high-risk populations. Prompt diagnosis, timely treatment, preventive interventions against syphilis infection would be a worthwhile investment for reducing HIV incidence. Strategies to combat stigma and discrimination targeted at MSM are pragmatically needed.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jiayu He ◽  
Ying Wang ◽  
Zhicheng Du ◽  
Jing Liao ◽  
Na He ◽  
...  

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Ethan Gough ◽  
Mirjam C Kempf ◽  
Laura Graham ◽  
Marvin Manzanero ◽  
Edward W Hook ◽  
...  

Public Health ◽  
2018 ◽  
Vol 161 ◽  
pp. 90-98 ◽  
Author(s):  
S. Nematollahi ◽  
E. Ayubi ◽  
A. Almasi-Hashiani ◽  
K. Mansori ◽  
Y. Moradi ◽  
...  

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
So‐Jung Shim ◽  
Mei Chan ◽  
Louisa Owens ◽  
Adam Jaffe ◽  
Bernadette Prentice ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sara Ashtari ◽  
Hadis Najafimehr ◽  
Mohamad Amin Pourhoseingholi ◽  
Kamran Rostami ◽  
Hamid Asadzadeh-Aghdaei ◽  
...  

AbstractThis systematic review and meta-analysis study was conducted to estimate the pooled prevalence of CD in low and high risk groups in this region. Following keywords were searched in the Medline, PubMed, Scopus, Web of Science and Cochrane database according to the MeSH terms; celiac disease, prevalence, high risk population and Asian-Pacific region. Prevalence studies published from January 1991 to March 2018 were selected. Prevalence of CD with 95% confidence interval (CI) was calculated using STATA software, version 14. The pooled sero-prevalence of CD among low risk group in Asia–Pacific region was 1.2% (95% CI 0.8–1.7%) in 96,099 individuals based on positive anti-tissue transglutaminase (anti-t-TG Ab) and/or anti-endomysial antibodies (EMA). The pooled prevalence of biopsy proven CD in Asia–Pacific among high and low risk groups was 4.3% (95% CI 3.3–5.5%) and 0.61% (95% CI 0.4–0.8%) in 10,719 and 70,344 subjects, respectively. In addition, the pooled sero-prevalence and prevalence of CD in general population was significantly higher in children compared with adults and it was significantly greater in female vs. male (P < 0.05). Our results suggest high risk individuals of CD are key group that should be specifically targeted for prevention and control measures, and screening may prove to have an optimal cost–benefit ratio.


AIDS ◽  
2012 ◽  
Vol 26 (17) ◽  
pp. 2211-2222 ◽  
Author(s):  
Catherine F. Houlihan ◽  
Natasha L. Larke ◽  
Deborah Watson-Jones ◽  
Karen K. Smith-McCune ◽  
Stephen Shiboski ◽  
...  

2020 ◽  
Author(s):  
Jiayu He ◽  
Ying Wang ◽  
Zhicheng Du ◽  
Jing Liao ◽  
Na He ◽  
...  

Abstract Background: Peer education has become a strategy for health promotion among high-risk groups for HIV infection worldwide. However, the extent to which peer education could have an impact on HIV prevention or the long-term effect of this impact is still unknown. This study thus quantifies the impact of peer education over time among high-risk HIV groups globally. Method: Following the PRISMA guidelines, a systematic review and meta-analysis was used to assess the effects and duration of peer education. A thorough literature search of PubMed, Web of Science, Embase and Cochrane Library was performed, and studies about peer education on high-risk HIV groups were reviewed. Pooled effects were calculated and the sources of heterogeneity were explored using meta-regression and subgroup analysis. Results: A total of 60 articles with 96484 subjects were identified, and peer education was associated with 36% decreased rates of HIV infection among overall high risk groups (OR: 0.64; 95%CI: 0.47-0.87). Peer education can promote HIV testing (OR=3.19; 95%CI:2.13,4.79) and condom use (OR=2.66, 95% CI: 2.11-3.36) while reduce equipment sharing (OR=0.50; 95%CI:0.33,0.75) and unprotected sex (OR=0.82; 95%CI: 0.72-0.94). Time trend analysis revealed that peer education had a consistent effect on behavior change for over 24 months and the different follow-up times were a source of heterogeneity. Conclusion: Our study shows that peer education is an effective tool with long-term impact for behavior change among high-risk HIV groups worldwide. Low and middle-income countries are encouraged to conduct large-scale peer education.


2020 ◽  
Vol 5 (10) ◽  
pp. e003438
Author(s):  
Anita Svadzian ◽  
Giorgia Sulis ◽  
Genevieve Gore ◽  
Madhukar Pai ◽  
Claudia M Denkinger

IntroductionAlthough universal drug susceptibility testing (DST) is a component of the End-TB Strategy, over 70% of drug-resistant tuberculosis (DR-TB) cases globally remain undetected. This detection gap reflects difficulties in DST scale-up and substantial heterogeneity in policies and implemented practices. We conducted a systematic review and meta-analysis to assess whether implementation of universal DST yields increased DR-TB detection compared with only selectively testing high-risk groups.MethodsPubMed, Embase, Global Health, Cochrane Library and Web of Science Core Collection were searched for publications reporting on the differential yield of universal versus selective DST implementation on the proportion of DR-TB, from January 2007 to June 2019. Random-effects meta-analyses were used to calculate respective pooled proportions of DR-TB cases detected; Higgins test and prediction intervals were used to assess between-study heterogeneity. We adapted an existing risk-of-bias assessment tool for prevalence studies.ResultsOf 18 736 unique citations, 101 studies were included in the qualitative synthesis. All studies used WHO-endorsed DST methods, and most (87.1%) involved both high-risk groups and the general population. We found only cross-sectional, observational, non-randomised studies that compared universal with selective DST strategies. Only four studies directly compared the testing approaches in the same study population, with the proportion of DR-TB cases detected ranging from 2.2% (95% CI: 1.4% to 3.2%) to 12.8% (95% CI: 11.4% to 14.3%) with selective testing, versus 4.4% (95% CI: 3.3% to 5.8%) to 9.8% (95% CI: 8.9% to 10.7%) with universal testing. Broad population studies were very heterogeneous. The vast majority (88/101; 87.1%) reported on the results of universal testing. However, while 37 (36.6%)/101 included all presumptive TB cases, an equal number of studies applied sputum-smear as a preselection criterion. A meaningful meta-analysis was not possible.ConclusionGiven the absence of randomised studies and the paucity of studies comparing strategies head to head, and selection bias in many studies that applied universal testing, our findings have limited generalisability. The lack of evidence reinforces the need for better data to inform policies.


2019 ◽  
Vol 26 (3) ◽  
pp. 37-48
Author(s):  
Amir Almasi Hashiani ◽  
◽  
Farzin Sadeghi ◽  
Erfan Ayubi ◽  
Shahab Rezaeian ◽  
...  

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