Incidence and Predictors of Serological Treatment Response in Early and Late Syphilis Among People Living With HIV.

HIV antibiotic treatment early syphilis late syphilis serological response

Journal

Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045

Informations de publication

Date de publication:
Jan 2019
Historique:
received: 03 10 2018
revised: 17 11 2018
accepted: 28 11 2018
entrez: 12 1 2019
pubmed: 12 1 2019
medline: 12 1 2019
Statut: epublish

Résumé

Few studies have investigated predictors of serological response to syphilis treatment in people living with HIV (PLWH). This was a retrospective, longitudinal study on PLWH who were diagnosed with and treated for syphilis who had an assessable serological response between January 2004 and June 2016. Serological treatment response (TR) was defined as a ≥4-fold decline in rapid plasma reagin (RPR) titers or a reversion to nonreactive (if RPR ≤1:4 at diagnosis) 12 months after treatment for early syphilis and 24 months after treatment for late syphilis. Factors associated with a TR were assessed with multivariate Cox proportional hazard models for recurrent events. A total of 829 episodes of syphilis (686 early, 143 late) in 564 patients were recorded. TR was observed in 732 (88%) syphilis episodes. The proportion of TR differed between early and late syphilis (89% vs 83%, respectively; Higher RPR titers at diagnosis and a diagnosis of syphilis that was made in more recent years were associated with TR in early and late syphilis.

Sections du résumé

BACKGROUND BACKGROUND
Few studies have investigated predictors of serological response to syphilis treatment in people living with HIV (PLWH).
METHODS METHODS
This was a retrospective, longitudinal study on PLWH who were diagnosed with and treated for syphilis who had an assessable serological response between January 2004 and June 2016. Serological treatment response (TR) was defined as a ≥4-fold decline in rapid plasma reagin (RPR) titers or a reversion to nonreactive (if RPR ≤1:4 at diagnosis) 12 months after treatment for early syphilis and 24 months after treatment for late syphilis. Factors associated with a TR were assessed with multivariate Cox proportional hazard models for recurrent events.
RESULTS RESULTS
A total of 829 episodes of syphilis (686 early, 143 late) in 564 patients were recorded. TR was observed in 732 (88%) syphilis episodes. The proportion of TR differed between early and late syphilis (89% vs 83%, respectively;
CONCLUSIONS CONCLUSIONS
Higher RPR titers at diagnosis and a diagnosis of syphilis that was made in more recent years were associated with TR in early and late syphilis.

Identifiants

pubmed: 30631790
doi: 10.1093/ofid/ofy324
pii: ofy324
pmc: PMC6324658
doi:

Types de publication

Journal Article

Langues

eng

Pagination

ofy324

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Auteurs

Vincenzo Spagnuolo (V)

Vita-Salute San Raffaele University, Faculty of Medicine and Surgery, Milan, Italy.
IRCCS San Raffaele Scientific Institute, Clinic of Infectious Diseases, Milan, Italy.

Andrea Poli (A)

IRCCS San Raffaele Scientific Institute, Clinic of Infectious Diseases, Milan, Italy.

Laura Galli (L)

IRCCS San Raffaele Scientific Institute, Clinic of Infectious Diseases, Milan, Italy.

Silvia Nozza (S)

IRCCS San Raffaele Scientific Institute, Clinic of Infectious Diseases, Milan, Italy.

Simona Bossolasco (S)

IRCCS San Raffaele Scientific Institute, Clinic of Infectious Diseases, Milan, Italy.

Massimo Cernuschi (M)

IRCCS San Raffaele Scientific Institute, Clinic of Infectious Diseases, Milan, Italy.

Myriam Maillard (M)

IRCCS San Raffaele Scientific Institute, Clinic of Infectious Diseases, Milan, Italy.

Hamid Hasson (H)

IRCCS San Raffaele Scientific Institute, Clinic of Infectious Diseases, Milan, Italy.

Nicola Gianotti (N)

IRCCS San Raffaele Scientific Institute, Clinic of Infectious Diseases, Milan, Italy.

Monica Guffanti (M)

IRCCS San Raffaele Scientific Institute, Clinic of Infectious Diseases, Milan, Italy.

Adriano Lazzarin (A)

IRCCS San Raffaele Scientific Institute, Clinic of Infectious Diseases, Milan, Italy.

Antonella Castagna (A)

Vita-Salute San Raffaele University, Faculty of Medicine and Surgery, Milan, Italy.
IRCCS San Raffaele Scientific Institute, Clinic of Infectious Diseases, Milan, Italy.

Classifications MeSH