Sero-Prevalence of Syphilis Among HIV Positive Serum Samples Obtained From National Public Health Laboratory, Teku, Kathmandu, Nepal

Abstract

Sexually transmitted infections (STIs) have been prioritized not only because of their high incidence, complications and sequalae but also due to the socioeconomic impact and their role in transmission of HIV. HIV/syphilis co-infection presents a serious health problem. This study was carried out at National Public Health Laboratory, Nepal from November 2008 to April 2009, aiming at finding the prevalence of syphilis among HIV sero-reactive individuals. The serum specimens from HIV suspected individuals attending NPHL were tested by two rapid tests and ELISA using the WHO algorithm. The HIV positive individuals were further screened for syphilis by RPR followed by TPHA testing for those turned reactive with RPR. Reactive upon testing by both methods was set criterion for active syphilis determination. Data obtained from laboratory processing and the questionnaire was analyzed using Winpepi version 3.8. Out of 1094 samples tested, 30.6% were confirmed as HIV positives. Of the 303 samples, further screened for syphilis by RPR and TPHA tests confirmed a true syphilis sero-prevalence rate of 14.2%; 51.1% being confirmed as false positives. Majority of the HIV infected were males (61.5%) which was statistically significant (p<0.05). Similarly, the syphilis co-infection was also higher among males (62.8%) but was statistically insignificant (p>0.05). The highest prevalence of HIV was found in age group 25–34 years (46.9%), followed by 35–44 years (28.9%) which was statistically significant (p<0.05). Similarly, the highest prevalence of syphilis co-infection was also observed in age groups 25–34 years (60.4%) followed by 35–44 years (25.6%) but was statistically insignificant (p>0.05). The notable rate of syphilis among HIV positives is a public health concern. It indicates the need of introducing STIs screening in HIV positive individuals at national level.

Key words: HIV, Syphilis, HIV/syphilis co-infection, RPR, TPHA