Factors influencing syphilis treatment failure and/or re-infection in HIV co-infected patients： immunosuppression or behaviors  

作　　者：Jong Hun Kim George Psevdos Jr Jin Suh Victoria Sharp 

机构地区：[1]Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA, USA [2]Center for Comprehensive Care, St. Luke's-Roosevelt Hospital Center, New York, USA

出　　处：《Chinese Medical Journal》2011年第14期2123-2126,共4页中华医学杂志（英文版）

摘　　要：Background Recent studies have reported overall increasing rates of syphilis with a high rate of human immunodeficiency virus （HIV） co-infection. However, there is little information about factors influencing syphilis treatment failure and/or re-infection in HIV co-infected patients. We conducted a study to evaluate factors associated with syphilis treatment failure/re-infection in HIV co-infected patients.Methods We reviewed 3542 medical records of HIV-infected patients from January 2005 to December 2007 followed up at HIV Clinic in New York City. Patients were categorized by rapid plasma regain titer （RPR） into success/serofast （4-fold decrease in RPR by 12 months after treatment, RPR conversion to nonreactive, persistently stable reactive RPR with no 4-fold increase）, and failure/re-infection （failure to decrease 4 folds in RPR by 12 months after treatment, 4-fold increase in RPR from baseline）.Results Among a total of 156 patients who met the eligibility criteria, 122 （78.2％） were under success/serofast category,and 34 （21.8％） were under failure/re-infection category. HIV viral load, CD4 cell count, and use of highly active antiretroviral therapy （HAART） were not associated with syphilis treatment failure/re-infection. However, early syphilis stage （OR：11.036, 95％ CI： 2.499-48.740, P=0.002） and high （＞1∶64） RPR titers （OR： 715.921, 95％ CI： 422.175-23 113.396, P ＜0.001） were significantly associated.Conclusions No correlations were seen with depressed immune states with syphilis treatment failure and/or re-infection. However, association with early stage syphilis suggests that risky psychological sexual behaviors may be the most important leading factor, emphasizing needs for safe sex education.Background Recent studies have reported overall increasing rates of syphilis with a high rate of human immunodeficiency virus （HIV） co-infection. However, there is little information about factors influencing syphilis treatment failure and/or re-infection in HIV co-infected patients. We conducted a study to evaluate factors associated with syphilis treatment failure/re-infection in HIV co-infected patients.Methods We reviewed 3542 medical records of HIV-infected patients from January 2005 to December 2007 followed up at HIV Clinic in New York City. Patients were categorized by rapid plasma regain titer （RPR） into success/serofast （4-fold decrease in RPR by 12 months after treatment, RPR conversion to nonreactive, persistently stable reactive RPR with no 4-fold increase）, and failure/re-infection （failure to decrease 4 folds in RPR by 12 months after treatment, 4-fold increase in RPR from baseline）.Results Among a total of 156 patients who met the eligibility criteria, 122 （78.2％） were under success/serofast category,and 34 （21.8％） were under failure/re-infection category. HIV viral load, CD4 cell count, and use of highly active antiretroviral therapy （HAART） were not associated with syphilis treatment failure/re-infection. However, early syphilis stage （OR：11.036, 95％ CI： 2.499-48.740, P=0.002） and high （＞1∶64） RPR titers （OR： 715.921, 95％ CI： 422.175-23 113.396, P ＜0.001） were significantly associated.Conclusions No correlations were seen with depressed immune states with syphilis treatment failure and/or re-infection. However, association with early stage syphilis suggests that risky psychological sexual behaviors may be the most important leading factor, emphasizing needs for safe sex education.

关 键 词：human immunodeficiency virus syphilis treatment failure RE-INFECTION 

分 类 号：S858.31[农业科学—临床兽医学] N031[农业科学—兽医学]