Milken Institute School of Public Health Poster Presentations (Marvin Center & Video)

Poster Number

66

Document Type

Poster

Status

Graduate Student - Masters

Abstract Category

Epidemiology and Biostatistics

Keywords

HIV, Shigella, Giardia, Enteric disease, surveillance

Publication Date

Spring 2018

Abstract

Background: Shigellosis and giardiasis are transmitted via food, water, and fecal-oral contact. CDC has recently reported increased shigellosis among men who have sex with men (MSM) and among people living with HIV (PLWH), particularly stage 3. Our goal was to characterize the incidence and risk factors associated with shigellosis and giardiasis among PLWH in Washington, DC, in an era of robust availability of antiretroviral treatment.

Methods: We conducted a retrospective analysis of HIV, shigellosis and giardiasis cases reported to the District of Columbia Department of Health from 2012 to 2016. We used LinkPlus to probabilistically match individuals with reported HIV and Shigella or Giardia. We conducted bivariate analysis on gender, race/ethnicity, and age for Shigella-HIV, Giardia-HIV and HIV alone. Among men, we conducted bivariate analysis for HIV transmission risk factors. Among those with Shigella-HIV or Giardia-HIV, we compared CD4 cell count, HIV stage, HIV viral load, and viral suppression (VS) using laboratory data within 8 weeks before or after the incident enteric infection. We compared the incidence of shigellosis and giardiasis in the general population versus among those living with HIV in 2016.

Results: During 2012-2016, 250 DC residents were reported with shigellosis (2.1 per 100,000 in 2016) and 412 with giardiasis (7.3 per 100,000 in 2016). The proportion with HIV coinfection was 20.4% for shigellosis and 10.6% for giardiasis. Incidence rate ratio (PLWH versus general population) was 25.8 for shigellosis and 9.6 for giardiasis. 40.9% of coinfection cases, versus 15.9% HIV alone, were ages 25-34 at the end of 2016 (p

Conclusion: PLWH in DC disproportionately acquired shigellosis and giardiasis in 2012-2016. Factors associated with shigellosis and giardiasis among PLWH include male gender, white race, being in the 25-34 age group, and MSM. Among the Shigella-HIV and Giardia-HIV cases, most did not have stage 3 HIV, but we found low viral suppression rates. Our data supports the need for obtaining a thorough sexual history, focused HIV prevention and antiretroviral adherence counseling, and provides information to target high risk groups in DC.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Presented at GW Annual Research Days 2018.

Available for download on Saturday, October 13, 2018

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Shigellosis and giardiasis among people living with HIV in Washington, DC, 2012-2016

Background: Shigellosis and giardiasis are transmitted via food, water, and fecal-oral contact. CDC has recently reported increased shigellosis among men who have sex with men (MSM) and among people living with HIV (PLWH), particularly stage 3. Our goal was to characterize the incidence and risk factors associated with shigellosis and giardiasis among PLWH in Washington, DC, in an era of robust availability of antiretroviral treatment.

Methods: We conducted a retrospective analysis of HIV, shigellosis and giardiasis cases reported to the District of Columbia Department of Health from 2012 to 2016. We used LinkPlus to probabilistically match individuals with reported HIV and Shigella or Giardia. We conducted bivariate analysis on gender, race/ethnicity, and age for Shigella-HIV, Giardia-HIV and HIV alone. Among men, we conducted bivariate analysis for HIV transmission risk factors. Among those with Shigella-HIV or Giardia-HIV, we compared CD4 cell count, HIV stage, HIV viral load, and viral suppression (VS) using laboratory data within 8 weeks before or after the incident enteric infection. We compared the incidence of shigellosis and giardiasis in the general population versus among those living with HIV in 2016.

Results: During 2012-2016, 250 DC residents were reported with shigellosis (2.1 per 100,000 in 2016) and 412 with giardiasis (7.3 per 100,000 in 2016). The proportion with HIV coinfection was 20.4% for shigellosis and 10.6% for giardiasis. Incidence rate ratio (PLWH versus general population) was 25.8 for shigellosis and 9.6 for giardiasis. 40.9% of coinfection cases, versus 15.9% HIV alone, were ages 25-34 at the end of 2016 (p

Conclusion: PLWH in DC disproportionately acquired shigellosis and giardiasis in 2012-2016. Factors associated with shigellosis and giardiasis among PLWH include male gender, white race, being in the 25-34 age group, and MSM. Among the Shigella-HIV and Giardia-HIV cases, most did not have stage 3 HIV, but we found low viral suppression rates. Our data supports the need for obtaining a thorough sexual history, focused HIV prevention and antiretroviral adherence counseling, and provides information to target high risk groups in DC.