Epidemiological Profile of HIV/AIDS in Minnesota
Co-infections: HIV and other infectious disease co-infections
Risk factors for HIV infection are common to other diseases, namely other STDs (such as chlamydia, gonorrhea and syphilis), hepatitis B and hepatitis C. Also, having an STD may make an individual more susceptible to HIV infection and vice versa. Although Minnesota is considered a low to medium incidence state for chlamydia, gonorrhea and syphilis, many people infected with these STDs are also at risk for acquiring HIV.
HIV and STD co-infection
In the state of Minnesota, laboratory-confirmed infections of chlamydia, gonorrhea, syphilis, and chancroid are monitored by MDH through a passive, combined physician and laboratory-based surveillance system. State law (Minnesota Rule 4605.7040) requires both physicians and laboratories to report all cases of these four bacterial STDs directly to MDH. In 2002, MDH added an active component to the surveillance system for chlamydia and gonorrhea infections, and in 2008 changed the case report form to include gender of sexual partners and country of origin to better describe STDs in Minnesota. In addition to the regular surveillance, additional behavioral information is collected on syphilis and gonorrhea cases. Other common sexually transmitted conditions caused by viral pathogens, such as herpes simplex virus (HSV) and human papillomavirus (HPV) are not reported to MDH. Factors that impact the completeness and accuracy of the available data on STDs include: level of screening, accuracy of diagnostic tests, and compliance with case reporting. Thus, any changes in STD rates may be due to one of these factors, or due to actual changes in STD occurrence.
In 2014, 19,897 chlamydia cases and 4,073 gonorrhea cases were reported to MDH. 64% of combined chlamydia and gonorrhea cases reported to the MDH were among females and 64% were among persons aged 15-24. Minnesota has also seen resurgence in syphilis cases reported to the MDH. In 2014, the number of early syphilis cases (that is, primary, secondary, and early latent stages) increased by 25% (from 332 cases in 2013 to 416 cases in 2014). Of the 416 cases, 34% reported being co-infected with HIV. Most of these cases had been diagnosed with HIV before being diagnosed with syphilis.
HIV and viral hepatitis co-infection
People with viral hepatitis also share risk factors for HIV including sexual transmission (in the case of hepatitis B) and sharing needles (in the case of hepatitis C). In 2014, there were an estimated 22,967 people living in Minnesota with hepatitis B, and 43,543 living with past or present hepatitis C. Surveillance data from 2014 indicate that around 11% of people living with HIV/AIDS are also living with hepatitis B or hepatitis C (4% with hepatitis B and 7% with hepatitis C). Nationally, it is estimated that one quarter of people living with HIV are also infected with hepatitis C. Hepatitis B or C co-infection may lead to treatment complications with HIV/AIDS and vice versa.
HIV and TB co-infection
Tuberculosis (TB) co-infection may also be a problem among persons with HIV/AIDS. TB infection after HIV diagnosis is considered to be an AIDS-defining condition. In 2014, 147 new cases of TB were reported in Minnesota, and there were 250 documented cases of people living with TB or receiving treatment for TB. At least 153 (2%) of persons living with HIV/AIDS in Minnesota indicated TB co-infection at some point (44% with disseminated TB and 56% with pulmonary TB).