FREQUENCY OF ASYMPTOMATIC HUMAN IMMUNODEFICIENCY VIRUS, SYPHILIS, HEPATITIS B AND HEPATITIS C IN CIRCUMCISED MALE PATIENTS DIAGNOSED WITH URETHRITIS

Year 2022, Volume: 12 Issue: 4, 532 - 536, 31.07.2022

Ender Siyez

https://doi.org/10.16899/jcm.1030661

Abstract

Aim: In this study, it was aimed to determine the frequency of asymptomatic Human Immunodeficiency Virus (HIV), Hepatitis B, Hepatitis C, and syphilis in circumcised patients diagnosed with urethritis transmitted by sexual intercourse because of unprotected sexual contact.
Material and Methods: We retrospectively investigated the serological results of HIV, Hepatitis B, Hepatitis C, and Syphilis diseases in 364 male patients diagnosed with urethritis, all of them were circumcised during childhood. The study included patients who applied to the urology outpatient clinic of secondary state hospital between January 2017 and December 2019 with symptoms or signs of urethritis. In the examination, only urethral discharge could be seen without symptoms. After the patients were examined, first void urine samples were taken. Also at the first examination, peripheral blood samples were tested for HIV, Hepatitis B, Hepatitis C, and syphilis antibodies.
Results: As a result of retrospective screening of the serological results of 364 male patients diagnosed with urethritis, Hepatitis B positivity was 1.09% with 4 cases, Hepatitis C positivity was found as 0.27% in 1 case and the Syphilis positivity rate was 1.92% with 7 cases in 364 patients. None of the patients had HIV positivity.
Conclusions: The fact that there was not any encounter of HIV-positive patients in patients diagnosed with urethritis because of unprotected sexual contact led to the thought that circumcision had a protective contribution in these patients with urethritis, who were all circumcised. Also, screening tests, especially syphilis, should be performed on all patients diagnosed with STI infection.

Keywords

Sexually transmitted disease, circumcision, hiv, syphilis, hepatitis b, hepatitis c

Supporting Institution

-

Project Number

-

KORUNMASIZ CİNSEL İLİŞKİ SONUCU ÜRETRİT TANISI ALAN SÜNNETLİ HASTALARDA ASEMPTOMATİK HIV, HEPATİT B, HEPATİT C VE SİFİLİZ GÖRÜLME SIKLIĞI

Abstract

Amaç: Bu çalışmanın amacı korunmasız cinsel ilişki sonucu üretrit tanısı alan sünnetli hastalarda asemptomatik HIV, Hepatit B, Hepatit C ve sifiliz görülme sıklığının incelenmesidir.
Yöntem: Çocukluk döneminde sünnet olan ve üretrit tanısı almış olan 364 hastada HIV, Hepatit B, Hepatit C ve sifiliz için seroloji sonuçları retrospektif olarak incelenmiştir. Çalışma grubu Ocak 2017-Aralık 2019 yılları arasında ikinci basamak devlet hastanesine üretrit semptomları ile başvuran hastalardan oluşmaktadır. Hastaların bir kısmında sadece muayene bulgusu olarak üretral akıntıları vardı. Muayene sonrasında idrar örnekleri ve bunu takiben de HIV, Hepatit B, Hepatit C ve sifiliz için periferik kan örnekleri alındı.
Bulgular: Üretrit tanısı alan 364 hastanın seroloji sonuçları retrospektif olarak incelendiğinde 4 hastada (%1.09) Hepatit B pozitif, 1 hastada (%0.27) Hepatit C pozitif ve 7 hastada (%1.92) Sifiliz pozitif olarak bulundu. Hiçbir hastada HIV pozitifliği bulunmadı.
Sonuç: Korunmasız cinsel ilişki sonrası üretrit tanısı alan hiçbir hastada HIV-pozitif olmamasında sünnetin koruyucu etkisinin olabileceği düşünülmektedir. Bununla birlikte cinsel temasla bulaşan infeksiyon tanısı alan hastalarda başta sifiliz olmak üzere diğer cinsel temasla geçen hastalıkların da taraması yapılması önerilmektedir.

Keywords

Cinsel yolla bulaşan hastalıklar, sünnet, HIV, sifiliz, hepatit B, hepatit C.

Project Number

-

References

• 1. World Health Organization. (2018). Report on global sexually transmitted infection surveillance 2018.
• 2. UNAIDS DATA 2020 https://www.unaids.org/sites/default/files/media_asset/2020_aids -data-book_en.pdf (12 march 2021)
• 3. Newman, L., Rowley, J., Vander Hoorn, S. et al. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. PloS One 2015 10.12: e0143304. doi:10.1371/journal. pone.0143304
• 4. Uzun, B., Güngör, S., Demirci, M. Seroprevalence of transfusion transmissible infections among blood donors in the western part of Turkey: a six-year study. Transf Apher Sci 2013; 49(3): 511-515. doi: 10.1016/j.transci.2013.02.039
• 5. Angulo, J. C., García-Díez, M. Male genital representation in Paleolithic art: erection and circumcision before history. Urology 2009; 74(1), 10-14. doi: 10.1016/j.urology.2009.01.010
• 6. Türk E., Karaca F., Edirne Y. A clinical and epidemiological study on the age of circumcision in Turkey. Eurasian J Med 2013; 1(2): 27-30 doi:10.4328/AEMED15
• 7. Hutchinson, J. (1855). On the influence of circumcision in preventing syphilis. Med Times-Gazette, 32, 542-543.
• 8. Tobian, A. A., Kacker, S., Quinn, T. C. Male circumcision: a globally relevant but under-utilized method for the prevention of HIV and other sexually transmitted infections. Annu Rev Med 2014; 65: 293-306. doi:10.1146/annurev-med-092412-090539
• 9. Matoga, M., Hosseinipour, M. C., Jewett, S., Hoffman, I. F., Chasela, C. Effects of HIV voluntary medical male circumcision programs on sexually transmitted infections. Curr Opin Infect Dis 2021; 34(1): 50-55. doi:10.1097/QCO.0000000000000696
• 10. Wang, Z., Yang, L., Hao, C. et al. A randomized controlled trial evaluating efficacy of a brief setting-based and theory-based intervention promoting voluntary medical male circumcision among heterosexual male sexually transmitted disease patients in China. AIDS Behav 2019; 23(9): 2453-2466. doi:10.1007/s10461-019-02610-9
• 11. Auvert, B., Taljaard, D., Lagarde, E., Sobngwi-Tambekou, J., Sitta, R., Puren, A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial. PloS Med 2005; 2(11): e298. doi:10.1371/journal.pmed.0020298
• 12. Gray, R. H., Kigozi, G., Serwadda, D., Makumbi, F., Watya, S. et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet 2007; 369(9562): 657-666. doi:10.1016/S0140-6736(07)60313-4
• 13. Bailey, R. C., Moses, S., Parker, C. B. et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet 2007; 369(9562): 643-656. doi:10.1016/S0140-6736(07)60312-2
• 14. Sobngwi–Tambekou, J., Taljaard, D., Nieuwoudt, M., Lissouba, P., Puren, Auvert B. Male circumcision and Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis: observations after a randomized controlled trial for HIV prevention. Sexually Transmitted Infections 2009; 85(2): 116-120. doi:10.1136/sti.2008.032334
• 15. Hofstraat, S. H. I., Falla, A. M., Duffell, E. F. et al. Current prevalence of chronic hepatitis B and C virus infection in the general population, blood donors and pregnant women in the EU/EEA: a systematic review. Epidemiol Infect 2017; 145(14): 2873-2885. doi:10.1017/S0950268817001947
• 16. Lee, C. Y., Wu, P. H., Lu, M. W., Chen, T. C., Lu, P. L. High prevalence of unawareness of HCV infection status among both HCV-seronegative and seropositive people living with human immunodeficiency virus in Taiwan. PloS One 2021; 16(5): e0251158. doi: 10.1371/journal.pone.0251158
• 17. Nijmeijer, B. M., Koopsen, J., Schinkel, J., Prins, M., Geijtenbeek, T. B. Sexually transmitted hepatitis C virus infections: current trends, and recent advances in understanding the spread in men who have sex with men. J Int AIDS Soc 2019; 22: e25348. doi.org/10.1002/jia2.25348
• 18. European Centre for Disease Prevention and Control. Syphilis. In: ECDC. Annual epidemiological report for 2018. Stockholm: ECDC; 2020.
• 19. Korenromp, E. L., Zhang, W., Zhang, X., Ma, Y., Jia., Luo H., et al The Spectrum-STI Groups model: syphilis prevalence trends across high-risk and lower-risk populations in Yunnan, China. Sci Rep 2020; 10(1): 1-10. doi: 10.1038/s41598-020-62208-3
• 20. de Souza, R. L., dos Santos Madeira, L. D. P., Pereira, M. V. S. et al. Prevalence of syphilis in female sex workers in three countryside cities of the state of Pará, Brazilian Amazon. BMC Infect Dis 2020; 20(1): 1-8. doi:10.1186/s12879-020-4850-1
• 21. Kojima, N., Klausner, J. D. An update on the global epidemiology of syphilis. Curr Epidemiol Rep 2018; 5(1): 24-38. doi:10.1007/s40471-018-0138-z
• 22. Yemisen, M., Altuntas Aydın, O., Gunduz, A. et al. Epidemiological profile of naive HIV-1/AIDS patients in Istanbul: the largest case series from Turkey. Curr HIV Res 2014; 12(1): 60-64. hdl.handle.net/20.500.12645/24863
• 23. Pharris, A., Quinten, C., Noori, T., Amato-Gauci, A. J., van Sighem, A. Estimating HIV incidence and number of undiagnosed individuals living with HIV in the European Union/European Economic Area, 2015. Euro Surveil 2016; 21(48): 30417. doi:10.2807/1560-7917.ES.2016.21.48.30417
• 24. Price, L. B., Liu, C. M., Johnson, K. E. et al. The effects of circumcision on the penis microbiome. PloS One 2010; 5(1): e8422. doi: 10.1371/journal.pone.0008422
• 25. Ganor, Y., Zhou, Z., Tudor, D. et al. Within 1 h, HIV-1 uses viral synapses to enter efficiently the inner, but not outer, foreskin mucosa and engages Langerhans–T cell conjugates. Mucosal Immunol 2010; 3(5): 506-522. doi: 10.1038/mi.2010.32
• 26. Dinh, M. H., Fahrbach, K. M., Hope, T. J. The role of the foreskin in male circumcision: An evidence‐based review. Am J Reprod Immunol 2011; 65(3): 279-283. doi: 10.1111/j.1600-0897.2010.00934.x
• 27. Sullivan, P. S., Kilmarx, P. H., Peterman, T. A. et al. Male circumcision for prevention of HIV transmission: what the new data mean for HIV prevention in the United States. PloS Med 2007; 4(7): e223. doi: 10.1371/journal.pmed.0040223.
• 28. Prodger, J. L., Kaul, R. The biology of how circumcision reduces HIV susceptibility: broader implications for the prevention field. AIDS Res Ther 2017; 14(1): 1-5. doi: 10.1186/s12981-017-0167-6
• 29. Jayathunge, P. H., McBride, W. J., MacLaren, D., Kaldor, J., Vallely, A., Turville, S. Male circumcision and HIV transmission; what do we know? Open AIDS J 2014; 8: 31-44. doi: 10.2174 / 1874613601408010031
• 30. Koss, C. A., Dunne, E. F., Warner, L. A systematic review of epidemiologic studies assessing condom use and risk of syphilis. Sex Transm Dis 2009; 36(7): 401-405. doi: 10.1097/OLQ.0b013e3181a396eb