Ocular Syphilis and Human Immunodeficiency Virus Coinfection Among Syphilis Patients in North Carolina, 2014-2016.
Journal
Sexually transmitted diseases
ISSN: 1537-4521
Titre abrégé: Sex Transm Dis
Pays: United States
ID NLM: 7705941
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
pubmed:
1
9
2018
medline:
26
2
2020
entrez:
1
9
2018
Statut:
ppublish
Résumé
Ocular syphilis (OS) has been associated with human immunodeficiency virus (HIV) coinfection previously. We compared demographic and clinical characteristics of syphilis patients with and without HIV to identify risk factors for developing OS. We reviewed all syphilis cases (early and late) reported to the North Carolina Division of Public Health during 2014 to 2016 and categorized HIV status (positive, negative, unknown) and OS status based on report of ocular symptoms with no other defined etiology. We estimated prevalence ratios (PR) and 95% confidence intervals (CI) for OS by HIV status. Among syphilis patients with HIV, we compared viral loads and CD4 cell counts by OS status. We compared symptom resolution by HIV status for a subset of OS patients. Among 7123 confirmed syphilis cases, 2846 (39.9%) were living with HIV, 109 (1.5%) had OS, and 59 (0.8%) had both. Ocular syphilis was more prevalent in syphilis patients with HIV compared to HIV-negative/unknown-status patients (PR, 1.8; 95% CI, 1.2-2.6). Compared with other patients with HIV, the prevalence of OS was higher in patients with viral loads greater than 200 copies/mL (1.7; 1.0-2.8) and in patients with a CD4 count of 200 cells/mL or less (PR, 2.3; 95% CI, 1.3-4.2). Among 11 patients with severe OS, 9 (81.8%) were HIV-positive. Among 39 interviewed OS patients, OS symptom resolution was similar for HIV-positive (70.0%) and HIV-negative/unknown-status (68.4%) patients. Syphilis patients with HIV were nearly twice as likely to report OS symptoms as were patients without documented HIV. Human immunodeficiency virus-related immunodeficiency possibly increases the risk of OS development in co-infected patients.
Sections du résumé
BACKGROUND
Ocular syphilis (OS) has been associated with human immunodeficiency virus (HIV) coinfection previously. We compared demographic and clinical characteristics of syphilis patients with and without HIV to identify risk factors for developing OS.
METHODS
We reviewed all syphilis cases (early and late) reported to the North Carolina Division of Public Health during 2014 to 2016 and categorized HIV status (positive, negative, unknown) and OS status based on report of ocular symptoms with no other defined etiology. We estimated prevalence ratios (PR) and 95% confidence intervals (CI) for OS by HIV status. Among syphilis patients with HIV, we compared viral loads and CD4 cell counts by OS status. We compared symptom resolution by HIV status for a subset of OS patients.
RESULTS
Among 7123 confirmed syphilis cases, 2846 (39.9%) were living with HIV, 109 (1.5%) had OS, and 59 (0.8%) had both. Ocular syphilis was more prevalent in syphilis patients with HIV compared to HIV-negative/unknown-status patients (PR, 1.8; 95% CI, 1.2-2.6). Compared with other patients with HIV, the prevalence of OS was higher in patients with viral loads greater than 200 copies/mL (1.7; 1.0-2.8) and in patients with a CD4 count of 200 cells/mL or less (PR, 2.3; 95% CI, 1.3-4.2). Among 11 patients with severe OS, 9 (81.8%) were HIV-positive. Among 39 interviewed OS patients, OS symptom resolution was similar for HIV-positive (70.0%) and HIV-negative/unknown-status (68.4%) patients.
CONCLUSIONS
Syphilis patients with HIV were nearly twice as likely to report OS symptoms as were patients without documented HIV. Human immunodeficiency virus-related immunodeficiency possibly increases the risk of OS development in co-infected patients.
Identifiants
pubmed: 30169474
doi: 10.1097/OLQ.0000000000000910
pmc: PMC6400053
mid: NIHMS1009700
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
80-85Subventions
Organisme : Intramural CDC HHS
ID : CC999999
Pays : United States
Références
Sex Transm Infect. 2005 Oct;81(5):380-5
pubmed: 16199736
Ophthalmology. 1990 Feb;97(2):196-203
pubmed: 2326008
Clin Infect Dis. 2007 May 1;44(9):1222-8
pubmed: 17407043
Invest Ophthalmol Vis Sci. 2016 Feb;57(2):404-11
pubmed: 26848879
J Infect Dis. 1998 Jan;177(1):224-7
pubmed: 9419194
Sex Transm Dis. 2006 Mar;33(3):143-8
pubmed: 16505739
Ophthalmology. 2000 Nov;107(11):2015-23
pubmed: 11054325
MMWR Morb Mortal Wkly Rep. 2015 Oct 16;64(40):1150-1
pubmed: 26469141
Am J Med. 2006 May;119(5):448.e21-5
pubmed: 16651059
Sex Transm Dis. 2010 Jan;37(1):41-3
pubmed: 20118676
Invest Ophthalmol Vis Sci. 2014 Jun 12;55(8):5394-400
pubmed: 24925878
Clin Infect Dis. 2017 Oct 30;65(10):1676-1682
pubmed: 29020152
Sex Transm Dis. 2007 Aug;34(8):553-6
pubmed: 17667532
MMWR Morb Mortal Wkly Rep. 2016 Nov 04;65(43):1185-1188
pubmed: 27811837
Arch Ophthalmol. 1997 Apr;115(4):469-73
pubmed: 9109754
Clin Infect Dis. 2000 Mar;30(3):479-85
pubmed: 10722431
AIDS. 2004 Oct 21;18(15):2075-9
pubmed: 15577629
Sex Transm Infect. 2011 Feb;87(1):4-8
pubmed: 20798396
J Ophthalmic Inflamm Infect. 2015 Dec;5(1):56
pubmed: 26297110
Am J Ophthalmol. 1998 Mar;125(3):306-11
pubmed: 9512147
Acta Derm Venereol Suppl (Stockh). 1955;35(Suppl 34):3-368; Annex I-LVI
pubmed: 13301322
Clin Infect Dis. 2010 Aug 15;51(4):468-71
pubmed: 20604717
Sex Transm Dis. 2016 Aug;43(8):524-7
pubmed: 27419819