Investigation of Seroprevalence of Viral Hepatitis and Syphilis Co-infection in Individuals Living with HIV: A Single-Center Experience

INTRODUCTION: Individuals living with HIV (PLWH) exhibit a higher prevalence of viral hepatitis and syphilis compared to the general population. HIV infection and these co-infections mutually accelerate disease progression. This study aimed to evaluate the seroprevalence of viral hepatitis and syphilis, as well as immunization status against hepatitis, in PLWH.
METHODS: The study included 422 PLWH aged >18 years who visited our clinic from 2020 to 2024. Demographic data and the results of HBsAg, Anti-HBc IgG, Anti-HBs, Anti-HCV, Anti-HAV IgG, VDRL, RPR, TPHA, HBV-DNA, and HCV-RNA tests were retrospectively analyzed through the hospital data system. Tests for Treponema pallidum and Hepatitis A/B/C viruses were performed using the ELISA method.
RESULTS: Of the 422 PLWH included in the study, 381 (90.3%) were male, with a mean age of 39.69±12.75 years. When stratified by age, 58.2% of individuals were between 20 and 39 years old. HIV/syphilis co-infection was observed in 149 individuals (35.3%), while 19 individuals (4.5%) had HIV/HBV co-infection. Anti-HCV test results were positive in 7 patients; however, HCV-RNA tests were negative in all cases. The rate of HBV immunity following vaccination was 55.9%, while natural HBV immunity after previous infection was observed in 16.1% of patients. Immunity against HAV was detected in 79.8% (336) of individuals. Co-infected patients with viral hepatitis were statistically significantly older than those infected with HIV alone (p=0.01). A significant difference was found in the male gender among syphilis co-infected individuals (p=0.001). The prevalence of syphilis was significantly higher in individuals positive for Anti-HBc IgG (p=0.002). No significant difference was found between CD4<200 cells/mm³ and viral hepatitis or syphilis co-infection (p=0.125 and p=0.441).
DISCUSSION AND CONCLUSION: Since syphilis and HBV co-infections are more common in PLWH than in the general population, more effective communication regarding sexually transmitted disease (STD) prevention methods and more frequent screening are necessary in these individuals. Additionally, emphasis should be placed on vaccination programs to improve HBV and HAV vaccination rates in this population.