An analysis of people with syphilis in British Columbia found that people with HIV were more likely to have eye involvement.
An analysis of a cohort of people diagnosed with syphilis in British Columbia found an association between HIV and ocular cases of the sexually transmitted infection (STI). Ocular syphilis, which can damage vision, was also associated with early manifestations of the STI.
Syphilis has resurfaced worldwide in recent years, including in the United States, particularly among HIV-positive men who have sex with men (MSM). Research has identified an association between ocular syphilis and new HIV infections.
Troy Grennan, MD, clinical assistant professor at the University of British Columbia, and his team published their findings in Clinical Infectious Diseases . They analyzed 6,716 cases of syphilis diagnosed in British Columbia between 2010 and 2018, focusing on the 66 (0.98%) cases of ocular syphilis. They compared the ocular syphilis cases with a control group of 244 people with non-ocular syphilis, by age group, sex, and date of diagnosis.
In 2010, 0.48% of all syphilis cases were ocular, a figure that increased to 0.83% in 2018.
The median age of individuals with ocular syphilis was 49.5 years. A total of 87.8% of the individuals were male, and 54.6% were men who have sex with men (MSM). A total of 48.5% of those with ocular syphilis had HIV, compared to 26.4% of the control subjects.
The most common eye-related diagnosis was panuveitis, or inflammation of the middle layers of the eye, which is seen in 42.5% of cases of ocular syphilis.
After adjusting the data to account for various differences among members of the study cohort, the researchers found that, compared with having a late, latent case of STI, having an early stage of syphilis, including primary or secondary syphilis, was associated with a 4.95-fold increased likelihood of having ocular syphilis, and having early latent syphilis was linked to a 4.29-fold increased likelihood of ocular syphilis.
Having HIV infection was associated with a 2.16 times greater likelihood of having ocular syphilis.
"Ocular syphilis increased during the study period, both in absolute numbers and as a proportion of all syphilis cases, a finding consistent with other jurisdictions," the study authors concluded. "These findings highlight the importance of ocular syphilis surveillance to avoid delays in diagnosis and treatment."
From: https://www.poz.com/article/people-hiv-syphilis-risk-ocular-syphilis
• By Benjamin Ryan