Coinfecção HIV/Sífilis em homens vivendo com HIV em centro de referência de assistência em AIDS em Belém

Abstract

Introduction: Coinfection between HIV and Treponema pallidum has a synergistic action, characterized by both the increased transmission of HIV and the atypical evolution of treponemal infection. Therefore it is necessary to demonstrate the rates and relationship of syphilis coinfection and HIV / Aids. Objectives: To analyze the prevalence and factors related to syphilis coinfection and HIV / aids in the city of Belém-PA, as well as to describe sociodemographic and behavioral characteristics and to identify the factors associated with human immunodeficiency virus (HIV) co-infection and acquired syphilis cases. Methods: Cross-sectional, prospective and descriptive qualitative study that consisted of the application of a questionnaire prepared by the researchers. We interviewed and followed 127 patients followed in a reference institution in Infectious Diseases and Sexually Transmitted Infections (STI) in 2018-2019 in the State of Pará. Results: The total number of patients interviewed (127) was properly distributed after analyzing the data and their variables. There was a predominance of patients between 30-34 years (24.4%) and 25-29 years (18.1%). When asked which race / color, 81 (63.8%) identified as brown. Approximately half of the patients, 63 (49.6%), when analyzed for exposure category, identified themselves as homosexuals, while the other half was divided between heterosexuals 41 (32.03%) and bisexuals. 23 (18.1%). Regarding the diagnosis and development of aids, 64 (50.4%) had developed Aids, which represents more than half of the number of patients analyzed. When asked about the highest level of education obtained so far 51 (40.2%) have completed high school. When analyzing the data on the distribution of the diagnosis and treatment of syphilis already performed, it was observed that 44 (34.6%) patients at some point in their life had already been treated for syphilis, the main scheme used was benzathine penicillin G, corresponding to 40 (90.9%) of the total. In addition, 18 (14.2%) patients reported having a current or past sexual partner with syphilis. Of the 127 patients who participated in the interview, when evaluated in the laboratory for the results of FTA-ABs, 23 (76.7%) patients were reactive. Finally, when evaluated for the immunological and virological state of the disease, in laboratory terms, considering CD4 + values and Viral Load, there was a significant proportion of CD4 +> 350 cells / mL and Undetectable viral load. Of the total, 94 (80.3%) had such lymphocyte count> 350 cells / mL. Regarding the Viral Load result, 97 (82.9%) presented undetectable viral load, ie, less than 50 copies / ml. Conclusion: The study demonstrates the high prevalence of syphilis and HIV / Aids coinfection among patients treated in the city of Belém, as well as identifies the unequal distribution of the disease, taking into account socio-demographic aspects such as age, race, exposure category and schooling. The results may support a possible reorganization of care and medical service regarding the development and progression of such diseases.