CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

866

INCIDENT SYPHILIS INFECTIONS IN HIV-POSITIVE PATIENTS IN CARE Raynell Lang 1 , Ron Read 2 , Soheil Ramazani 3 , John Gill 2 1 Alberta Hlth Services, Calgary, Canada, 2 Univ of Calgary, Calgary, Canada, 3 Southern Alberta Clinic, Calgary, Canada

Background: Syphilis is a reemerging global infectious disease and in the province of Alberta rates of diagnosis have doubled between 2014-2015. The Southern Alberta Clinic (SAC) and Calgary STI Clinic identified a rising number of incident syphilis infections in patients successfully engaged in HIV care. The medical and demographic characteristics of those engaging in high-risk sexual behavior contracting syphilis were examined to enhance targeted preventative strategies. Methods: Syphilis serology has been undertaken routinely with bloodwork used for monitoring HIV care for ten years in SAC. All cases of incident Syphilis infections (initial and reinfection) in HIV positive patients between 2006 and 2016 were reviewed. Data was retrospectively collected through a comprehensive medical chart review combined with manual data abstraction from an EMR database in both the Calgary STI clinic and SAC. Data was pooled and statistical analysis was performed. Results: We identified were 231 cases involving 188 individuals over 10 years. Of the 231 cases, 170 (74%) were the patients first syphilis infection, whereas the remaining 61 (26%) cases were repeat infections. Since 2011(12), cases had doubled by 2014 (25) and more than tripled by 2015 (41). The vast majority of those acquiring syphilis were males (94%) of Caucasian race (72%). Of the males 76% are MSM, 21% heterosexual and 3% IDU. The average age of this population is 42 years with a range of 21-72 years. 52% of the population admitted to current or prior excessive alcohol use, 27% to smoking and 27% to recreational drug use. The average length of time between HIV infection and incident syphilis infection was 7.8 years with 31% of the population having been HIV positive for over 10 years. HIV viral loads were fully suppressed in 64% of the population prior to contracting syphilis. 80% of the individuals were on ART at the time of syphilis co-infection. There was no significant change in CD4 counts or HIV viral loads prior to and following syphilis infection . Conclusion: We identified a dramatic increase in incident syphilis infection in the gay male Caucasian population while receiving HIV care over last three years. HIV positive population demonstrates an emerging public health concern. As part of a quality assurance programwe have identified demographic features and disease trends that may be used for development of targeted preventive strategies.

Poster and Themed Discussion Abstracts

867 SCREENING FOR EXTRAGENITAL CT/GC AMONG HIV-INFECTED MSM: A COMPARISON OF 4 NAATS Jodie Dionne-Odom , Kristal Aaron, Mary Banasiewicz, Sarah Dougherty, Brice Daniels, James Raper, Edward Hook, Barbara Van Der Pol Univ of Alabama at Birmingham, Birmingham, AL, USA

Background: CDC recommends annual screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) using NAAT at sites of exposure in adults with HIV. NAAT is highly sensitive but testing is not FDA-approved at rectal and pharyngeal sites and several testing platforms have become available. Although HIV-infected MSM have high incidence rates of rectal and pharyngeal CT/GC, clinic screening rates are suboptimal. Methods: HIV-infected MSM who presented to clinic for routine care and reported receptive anal intercourse in the past 30 days were eligible to participate. Self-collected rectal swabs, urine, and provider-collected pharyngeal samples were run on at least two of four platforms and positivity rates for CT and GC were determined. Data for all visits were

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