Predictors of serofast state after treatment for early syphilis in HIV-infected patients
© 2020 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association..
OBJECTIVES: Non-treponemal serological tests are used to monitor treatment response during syphilis infection. Syphilis- and HIV-coinfected patients may experience incomplete resolution in non-treponemal titres, which is referred to as the serofast state. The goal of this study was to evaluate risk factors for serofast state in HIV-infected patients.
METHODS: From November 2015 to June 2018, 1530 HIV-positive patients were tested for syphilis using a Treponema pallidum particle agglutination (TPPA) assay. Among TPPA-positive patients, medical records were reviewed for early syphilis infection. Serofast state was defined as a less than four-fold decrease in non-treponemal antibody titres during a 6-month follow-up period in the absence of symptoms of syphilis. Baseline characteristics were tested as predictive factors of serological response.
RESULTS: In all, 515 patients (33.7%) tested positive in TPPA assays, and in 163 patients at least one previous syphilis infection was documented. A total of 61 out of 163 patients (37.4%) were in a serofast state. A history of previous syphilis infection (61 vs. 43%; P = 0.04) was more common in serofast patients than in patients with serological cure after 6 months. Non-treponemal titres ≥ 1:32 before therapy (47 vs. 25%; P = 0.005) and adjunctive corticosteroids to prevent the Jarisch-Herxheimer reaction (35% vs 15%; P = 0.006) were associated with serological cure after 6 months, but corticosteroid therapy had no influence at 12 months. The intensity of syphilis treatment did not affect serological cure.
CONCLUSION: Corticosteroids for prevention of the Jarisch-Herxheimer reaction were associated with earlier serological cure. Although serological response is the accredited surrogate method to monitor syphilis treatment, the biological significance of the serofast state remains unclear.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
|---|---|
| Enthalten in: |
HIV medicine - 22(2021), 3 vom: 19. März, Seite 165-171 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Paul, G [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Corticosteroid |
|---|
| Anmerkungen: |
Date Completed 14.03.2022 Date Revised 14.03.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/hiv.12985 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM316967874 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM316967874 | ||
| 003 | DE-627 | ||
| 005 | 20231225162231.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/hiv.12985 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1056.xml |
| 035 | |a (DE-627)NLM316967874 | ||
| 035 | |a (NLM)33128333 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Paul, G |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Predictors of serofast state after treatment for early syphilis in HIV-infected patients |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 14.03.2022 | ||
| 500 | |a Date Revised 14.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association. | ||
| 520 | |a OBJECTIVES: Non-treponemal serological tests are used to monitor treatment response during syphilis infection. Syphilis- and HIV-coinfected patients may experience incomplete resolution in non-treponemal titres, which is referred to as the serofast state. The goal of this study was to evaluate risk factors for serofast state in HIV-infected patients | ||
| 520 | |a METHODS: From November 2015 to June 2018, 1530 HIV-positive patients were tested for syphilis using a Treponema pallidum particle agglutination (TPPA) assay. Among TPPA-positive patients, medical records were reviewed for early syphilis infection. Serofast state was defined as a less than four-fold decrease in non-treponemal antibody titres during a 6-month follow-up period in the absence of symptoms of syphilis. Baseline characteristics were tested as predictive factors of serological response | ||
| 520 | |a RESULTS: In all, 515 patients (33.7%) tested positive in TPPA assays, and in 163 patients at least one previous syphilis infection was documented. A total of 61 out of 163 patients (37.4%) were in a serofast state. A history of previous syphilis infection (61 vs. 43%; P = 0.04) was more common in serofast patients than in patients with serological cure after 6 months. Non-treponemal titres ≥ 1:32 before therapy (47 vs. 25%; P = 0.005) and adjunctive corticosteroids to prevent the Jarisch-Herxheimer reaction (35% vs 15%; P = 0.006) were associated with serological cure after 6 months, but corticosteroid therapy had no influence at 12 months. The intensity of syphilis treatment did not affect serological cure | ||
| 520 | |a CONCLUSION: Corticosteroids for prevention of the Jarisch-Herxheimer reaction were associated with earlier serological cure. Although serological response is the accredited surrogate method to monitor syphilis treatment, the biological significance of the serofast state remains unclear | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a HIV | |
| 650 | 4 | |a corticosteroid | |
| 650 | 4 | |a non-treponemal | |
| 650 | 4 | |a serofast | |
| 650 | 4 | |a syphilis | |
| 700 | 1 | |a Wesselmann, J |e verfasserin |4 aut | |
| 700 | 1 | |a Adzic, D |e verfasserin |4 aut | |
| 700 | 1 | |a Malin, J J |e verfasserin |4 aut | |
| 700 | 1 | |a Suarez, I |e verfasserin |4 aut | |
| 700 | 1 | |a Priesner, V |e verfasserin |4 aut | |
| 700 | 1 | |a Kümmerle, T |e verfasserin |4 aut | |
| 700 | 1 | |a Wyen, C |e verfasserin |4 aut | |
| 700 | 1 | |a Jung, N |e verfasserin |4 aut | |
| 700 | 1 | |a van Bremen, K |e verfasserin |4 aut | |
| 700 | 1 | |a Schlabe, S |e verfasserin |4 aut | |
| 700 | 1 | |a Wasmuth, J-C |e verfasserin |4 aut | |
| 700 | 1 | |a Boesecke, C |e verfasserin |4 aut | |
| 700 | 1 | |a Fätkenheuer, G |e verfasserin |4 aut | |
| 700 | 1 | |a Rockstroh, J |e verfasserin |4 aut | |
| 700 | 1 | |a Schwarze-Zander, C |e verfasserin |4 aut | |
| 700 | 1 | |a Lehmann, C |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t HIV medicine |d 1999 |g 22(2021), 3 vom: 19. März, Seite 165-171 |w (DE-627)NLM116282541 |x 1468-1293 |7 nnns |
| 773 | 1 | 8 | |g volume:22 |g year:2021 |g number:3 |g day:19 |g month:03 |g pages:165-171 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/hiv.12985 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 22 |j 2021 |e 3 |b 19 |c 03 |h 165-171 | ||