Syphilis predicts HIV incidence among men and transgender women who have sex with men in a preexposure prophylaxis trial

dc.creatorSolomon, Marc M.
dc.creatorMayer, Kenneth H.
dc.creatorGlidden, David V.
dc.creatorLiu, Albert Y.
dc.creatorMcMahan, Vanessa M.
dc.creatorGuanira, Juan V.
dc.creatorChariyalertsak, Suwat
dc.creatorFernandez, Telmo
dc.creatorGrant, Robert M.
dc.date2015-07-09T11:14:53Z
dc.date2015-07-09T11:14:53Z
dc.date2014
dc.date.accessioned2023-09-26T21:15:13Z
dc.date.available2023-09-26T21:15:13Z
dc.identifierSOLOMON, Marc M. et al. Syphilis predicts HIV incidence among men and transgender women who have sex with men in a preexposure prophylaxis trial. Clinical Infectious Diseases, v.59, n.7, p.1020–1026, 2014.
dc.identifier1058-4838
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/11180
dc.identifier10.1093/cid/ciu450
dc.identifier1537-6591
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8871552
dc.descriptionThe following are members of the iPrEx Study Team who contributed to this work: Linda-Gail Bekker, Susan Buchbinder, Martin Casapia, Suwat Chariyalertsak, Juan Guanira, Esper Kallas, Javier Lama, Kenneth Mayer, Orlando Montoya, Mauro Schechter, Valdiléa Veloso.
dc.descriptionThis work was supported by DAIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health (cooperative agreement UO1 AI64002 to R. M. G.) and by the Bill & Melinda Gates Foundation. Study drugs were donated by Gilead Sciences. Support for some specimen handling came from a grant from DAIDS (RO1 AI062333 to R. M. G.) and by the J. David Gladstone Institutes. Some infrastructure support at the University of California, San Francisco, was provided by a grant from the National Institutes of Health (UL1 RR024131).
dc.descriptionBackground. Syphilis infection may potentiate transmission of human immunodeficiency virus (HIV). We sought to determine the extent to which HIV acquisition was associated with syphilis infection within an HIV preexposure prophylaxis (PrEP) trial and whether emtricitabine/tenofovir (FTC/TDF) modified that association. Methods. The Preexposure Prophylaxis Initiative (iPrEx) study randomly assigned 2499 HIV-seronegative men and transgender women who have sex with men (MSM) to receive oral daily FTC/TDF or placebo. Syphilis prevalence at screening and incidence during follow-up were measured. Hazard ratios for the effect of incident syphilis on HIV acquisition were calculated. The effect of FTC/TDF on incident syphilis and HIV acquisition was assessed. Results. Of 2499 individuals, 360 (14.4%) had a positive rapid plasma reagin test at screening; 333 (92.5%) had a positive confirmatory test, which did not differ between the arms (FTC/TDF vs placebo, P = .81). The overall syphilis incidence during the trial was 7.3 cases per 100 person-years. There was no difference in syphilis incidence between the study arms (7.8 cases per 100 person-years for FTC/TDF vs 6.8 cases per 100 person-years for placebo, P = .304). HIV incidence varied by incident syphilis (2.8 cases per 100 person-years for no syphilis vs 8.0 cases per 100 personyears for incident syphilis), reflecting a hazard ratio of 2.6 (95% confidence interval, 1.6–4.4; P < .001). There was no evidence for interaction between randomization to the FTC/TDF arm and incident syphilis on HIV incidence. Conclusions. In HIV-seronegative MSM, syphilis infection was associated with HIV acquisition in this PrEP trial; a syphilis diagnosis should prompt providers to offer PrEP unless otherwise contraindicated.
dc.formatapplication/pdf
dc.languageeng
dc.publisherOxford University Press
dc.rightsrestricted access
dc.subjectHIV
dc.subjectSyphilis
dc.subjectPre-Exposure Prophylaxis
dc.subjectStatistical Analysis
dc.subjectHIV
dc.subjectSífilis
dc.subjectProfilaxia Pré-Exposição
dc.subjectAnálise Estatística
dc.titleSyphilis predicts HIV incidence among men and transgender women who have sex with men in a preexposure prophylaxis trial
dc.typeArticle


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