Author | Solomon, Marc M. | |
Author | Mayer, Kenneth H. | |
Author | Glidden, David V. | |
Author | Liu, Albert Y. | |
Author | McMahan, Vanessa M. | |
Author | Guanira, Juan V. | |
Author | Chariyalertsak, Suwat | |
Author | Fernandez, Telmo | |
Author | Grant, Robert M. | |
Access date | 2015-07-09T11:14:53Z | |
Available date | 2015-07-09T11:14:53Z | |
Document date | 2014 | |
Citation | SOLOMON, 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. | pt_BR |
ISSN | 1058-4838 | |
URI | https://www.arca.fiocruz.br/handle/icict/11180 | |
Description | The 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. | pt_BR |
Sponsorship | This 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). | pt_BR |
Language | eng | pt_BR |
Publisher | Oxford University Press | pt_BR |
Rights | restricted access | pt_BR |
Title | Syphilis predicts HIV incidence among men and transgender women who have sex with men in a preexposure prophylaxis trial | pt_BR |
Type | Article | pt_BR |
DOI | 10.1093/cid/ciu450 | |
Abstract | Background. 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. | pt_BR |
Affilliation | The Gladstone Institutes. San Francisco, CA, United States of America / University of California. San Francisco, CA, United States of America | pt_BR |
Affilliation | Beth Israel Deaconess Medical Center. Fenway Institute. Boston, MA, United States of America / Harvard Medical School. Boston, MA, United States of America | pt_BR |
Affilliation | University of California. San Francisco, CA, United States of America | pt_BR |
Affilliation | San Francisco Department of Public Health. San Francisco, CA, United States of America | pt_BR |
Affilliation | The Gladstone Institutes. San Francisco, CA, United States of America | pt_BR |
Affilliation | Investigaciones Medicas en Salud. Lima, Peru | pt_BR |
Affilliation | Chiang Mai University. Faculty of Medicine. Research Institute for Health Sciences. Department of Community Medicine. Thailand | pt_BR |
Affilliation | Fundacion Ecuatoriana Equidad. Guayaquil, Ecuador | pt_BR |
Affilliation | The Gladstone Institutes. San Francisco, CA, United States of America / University of California. San Francisco, CA, United States of America | pt_BR |
Subject | HIV | pt_BR |
Subject | Syphilis | pt_BR |
Subject | Pre-Exposure Prophylaxis | pt_BR |
Subject | Statistical Analysis | pt_BR |
DeCS | HIV | pt_BR |
DeCS | Sífilis | pt_BR |
DeCS | Profilaxia Pré-Exposição | pt_BR |
DeCS | Análise Estatística | pt_BR |
e-ISSN | 1537-6591 | |