Risk factors and time-trends of cytomegalovirus (CMV), syphilis, toxoplasmosis and viral hepatitis infection and seroprevalence in human immunodeficiency virus (HIV) infected patients

Ann Acad Med Singap. 2013 Dec;42(12):667-73.


Introduction: Chronic bacterial, viral and parasitic infections contribute to the morbidity and mortality associated with human immunodeficiency virus (HIV) infection. This study investigated risk factors and time-trends of the seroprevalence of cytomegalovirus (CMV), toxoplasmosis and hepatitis A total antibody; and co-infection with syphilis, hepatitis B and hepatitis C among newly diagnosed HIV individuals in Singapore.

Materials and methods: This was a cross-sectional study. A random sample of 50% of HIV infected patients who visited the Communicable Disease Centre (CDC), Singapore for first-time care from January 2006 to December 2011 were analysed.

Results: Among the 793 study subjects, 93.4% were male; 77.9% of them were of Chinese ethnicity; mean age at HIV diagnosis was 41.4 years; and the mean baseline CD4+ T-cell count was 222 cells/mm³. The prevalence of sero-reactivity for CMV was 96.8%; hepatitis A: 40.9%; and toxoplasmosis: 23.7%. Co-infection with syphilis was identified in 12.3%; hepatitis B: 8.1%; and hepatitis C: 2%. Among those co-infected with hepatitis C, 73.3% of them were intravenous drug user (IVDU). Syphilis co-infection was significantly more common among men who have sex with men (MSM) (multivariate OR: 2.53, 95% CI, 1.31 to 4.90, P = 0.006).

Conclusion: This study described the baseline rates of HIV co-infection with syphilis, hepatitis B and C in Singapore, and sero-reactivity to CMV, toxoplasmosis and hepatitis A. The increased rates compared to the general population may have important consequences for disease progression, response to antiretroviral treatment and long-term general health.

MeSH terms

  • Adult
  • Coinfection / epidemiology
  • Cross-Sectional Studies
  • Cytomegalovirus / isolation & purification
  • Cytomegalovirus Infections / blood
  • Cytomegalovirus Infections / epidemiology*
  • Female
  • HIV Infections / epidemiology*
  • Hepacivirus / isolation & purification
  • Hepatitis, Viral, Human / blood
  • Hepatitis, Viral, Human / epidemiology*
  • Humans
  • Male
  • Odds Ratio
  • Risk Factors
  • Seroepidemiologic Studies
  • Singapore / epidemiology
  • Syphilis / blood
  • Syphilis / epidemiology*
  • Time Factors
  • Toxoplasmosis / blood
  • Toxoplasmosis / epidemiology*