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Dermatology, Infectious Disease Collaboration May Optimize Detection of Sexually Transmitted Infections

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Over the study period, significant increases in the number of screening tests, as well as the ratio between the tests and hospital admissions, was observed.
Over the study period, significant increases in the number of screening tests, as well as the ratio between the tests and hospital admissions, was observed.

Collaboration between dermatology and infectious disease clinics may help improve the diagnosis of sexually transmitted diseases such as syphilis, HIV, hepatitis B (HBV), and hepatitis C (HCV) in at-risk populations, according to results of a study that examined a collaborative effort by 2 Italian clinics. Results were published in the Journal of the European Academy of Dermatology and Venereology.

The investigators sought to analyze the number of screening tests performed in the dermatology and infectious disease clinics and to compare results obtained following adoption of the shared protocol with findings from the prior period. A secondary objective of the study was to assess the linkage with care of people newly diagnosed with sexually transmitted diseases. Consecutive patients who were referred to the clinics between January 2010 and December 2016, with ≥1 serologic screening test performed for HIV, HBV, HCV, and syphilis, were enrolled in the study.

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Over the 7-year observation period, a total of 13,117 admissions for 9154 patients were gathered. Over the study period, significant increases in the number of screening tests, as well as the ratio between the tests and hospital admissions, was observed (P <.001 and P =.002, respectively).

Overall, 7.0% (644 of 9154) of individuals were diagnosed with ≥1 infection. Among the infections, the most common were syphilis in 41.9%, HBV in 25.7%, HCV in 21.4%, and HIV in 10.9%. Syphilis was reported primarily among Italians (72.5%) and men (75.7%), similar to HCV, whereas foreign-born individuals had mainly HBV infection (85.5%). Additionally, HIV was diagnosed more often among men (67.1%), with a similar proportion observed among Italians and foreign-born patients. Linkage to care was reported among 84.3% (543 of 644) of patients. 

The investigators concluded that accurate epidemiologic information about the distribution of sexually transmitted diseases is key for targeting screening, as well as for designing, implementing, and assessing intervention programs.

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Reference

Mandel VD, Tullio FD, Rugge W, et al. Optimization strategies for HIV, hepatitis and syphilis testing in infectious disease clinic and dermatology unit of Modena: seven-years results of collaboration experience [published online December 6, 2018]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.15390