Syphilis and HIV infection in patients with hepatitis A: a preliminary study from one centre in Poland

In 2017, there was a significant increase in hepatitis A incidence in Poland and several dozen times more cases were reported in comparison to previous years [1]. For instance, in the reference centre for infectious diseases for the Greater Poland Voivodeship in the period from the beginning of February to the end of August 2017, more patients with hepatitis A were hospitalized than in the previous 10 years in total.
As hepatitis A virus (HAV) infections are transmitted through the faecal-oral route, hepatitis A can spread during intimate contacts and some specific sexual practices [2, 3]. For this reason, we hypothesized that it could be an indicator of risky sexual behaviours and diagnosis of hepatitis A may be an opportunity to test patients for other sexually transmitted infections (STI).
Persons hospitalized at the Department of Infectious Diseases in Poznan (Jozef Strus Multidisciplinary City Hospital) for symptomatic HAV infection from February to mid-August 2017 were included in the present analysis.
The objectives of this study were a simple demographic description of patients with hepatitis A and their screening for some STI that may be asymptomatic (syphilis, HIV infection, hepatitis B, hepatitis C). The study was approved by the local Bioethics Committee. All patients gave their informed consent. One hundred patients aged 20–64 (median: 29.5 years) with symptomatic hepatitis A have been screened for the above mentioned STI.
Testing for HAV (HAVAb-IgM), HBV (HBsAg Qualitative), HCV (anti-HCV) and HIV (HIV Ag/Ab Combo) infections was performed using the ARCHITECT system (Abbott Laboratories). Each positive result of the screening test for HIV infection was confirmed with the western blot technique.
RPR Carbon (Hydrex Diagnostics Sp. z o.o., Warszawa, Poland) and Immuntrep TPHA (Omega Diagnostics Ltd, Alva, Scotland) assays were used for screening and confirmation of syphilis, respectively. Syphilis was diagnosed in the following circumstances: the presence of symptoms or signs consistent with an early stage of disease (primary or secondary syphilis) and reactive RPR and TPHA tests, or a 4-fold increase from baseline in RPR titres with a reactive TPHA in patients who had syphilis in the past, or positive RPR (at least 1 : 8 titre in quantitative assessment) and TPHA in patients who have never been tested for syphilis before. The majority of patients were men (93%). A significant proportion of male study...


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