Effect of syphilis infection on HIV acquisition: a systematic review and meta-analysis.
Effect of syphilis infection on HIV acquisition: a systematic review and meta-analysis.
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梅毒感染对艾滋病毒的影响：系统评价和荟萃分析。
DOI：
10.1136/sextrans-2020-054706
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发表时间：
2021-11
影响因子：
3.6
通讯作者：
Li J
中科院分区：
文献类型：
--
作者：
Wu MY;Gong HZ;Hu KR;Zheng HY;Wan X;Li J
梅毒和HIV合并感染仍难以控制，其发病率呈上升趋势。在高危人群中，特别是在男男性行为者（MSM）中，梅毒与艾滋病毒感染风险增加有关。本系统回顾和荟萃分析评估梅毒感染对随后HIV感染的影响，并评估其在MSM和其他高危人群之间的差异。检索了5个电子数据库中截至2019年9月21日发表的文献，无语言限制。纳入了纵向研究，这些研究招募了关键人群，以比较有和没有梅毒暴露的HIV发病率。我们使用随机效应模型来估计梅毒感染对高危人群中艾滋病毒感染的影响，其中包括男男性行为者、性工作者、血清不一致夫妇、注射毒品者和性病诊所就诊者。共纳入17个队列和5个病例对照研究，涉及65232例受试者。与对照组相比，梅毒暴露后HIV发病率增加了两倍（相对危险度（RR）2.67（95%CI 2.05至3.47）;患病率p<0.05; RR 3.21（95%CI 2.26至4.57）;发病率p=0.419）。MSM与其他高危人群梅毒感染率无显著性差异（RR 2.60（95%CI 1.78 ~ 3.80）; p<0.05 vs RR 2.98（95%CI 2.15 ~ 4.14）; p<0.05;相对危险度比0.76（95%CI 0.49 ~ 1.17））。梅毒感染增加了高危人群感染艾滋病毒的风险。没有证据表明MSM比其他高危人群面临更大的风险。及时诊断，及时治疗，预防梅毒感染是降低艾滋病发病率的一项值得投资的措施。实际上，需要制定战略，打击针对男男性行为者的污名化和歧视。
Co-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. Five 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. A 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)). Syphilis 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.
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DOI：
10.1097/qai.0b013e3181b48f33
发表时间：
2010-01-01
影响因子：
3.6
作者：
Jin, Fengyi;Prestage, Garrett P.;Grulich, Andrew E.
通讯作者：
Grulich, Andrew E.
DOI：
10.1038/nrmicro.2016.141
发表时间：
2016-12
期刊：
Nature reviews. Microbiology
影响因子：
--
作者：
通讯作者：
--
影响因子：
64.8
作者：
Deng, HK;Liu, R;Landau, NR
通讯作者：
Landau, NR
影响因子：
2.2
作者：
DerSimonian R;Laird N
通讯作者：
Laird N
影响因子：
6.4
作者：
Marra, Christina M.;Tantalo, Lauren C.;Lukehart, Sheila A.
通讯作者：
Lukehart, Sheila A.