You are here

  • Home
  • Archive
  • Volume 83, Issue 2
  • Serological response to syphilis treatment in HIV-positive and HIV-negative patients attending sexually transmitted diseases clinics

Article Text

Article menu
Download PDFPDF
Syphilis
Serological response to syphilis treatment in HIV-positive and HIV-negative patients attending sexually transmitted diseases clinics
  1. K G Ghanem,
  2. E J Erbelding,
  3. Z S Wiener,
  4. A M Rompalo
  1. Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to:
 K G Ghanem
 Division of Infectious Diseases, Bayview Medical Center, Johns Hopkins University, B3 North, 4940 Eastern Avenue, Baltimore, MD 21224, USA; kghanem{at}jhmi.edu

Abstract

Background: HIV-positive patients treated for syphilis may be at increased risk for serological failure.

Objective: To compare follow-up serologies and serological responses to treatment between HIV-positive and HIV-negative patients attending two sexually transmitted disease (STD) clinics.

Study design: Existing records were reviewed from HIV-positive patients who were diagnosed and treated for syphilis at the public STD clinics in Baltimore, Maryland, USA, between 1992 and 2000. Results of their serological follow-up were compared with those of HIV-negative clinic patients at the time of syphilis treatment. Failure was defined as lack of a fourfold drop in rapid plasma reagin (RPR) titre by 400 days after treatment or a fourfold increased titre between 30 and 400 days.

Results: Of the 450 HIV-positive patients with syphilis, 288 (64%) did not have documented follow-up serologies and 129 (28.5%) met the inclusion criteria; 168 (17%) of 1000 known HIV-negative patients were similarly eligible. There were 22 failures in the HIV-positive group and 5 in the HIV-negative group (p<0.001). The median times to successful serological responses in both groups were 278 (95% confidence interval (CI) 209 to 350) and 126 (95% CI 108 to 157) days, respectively (p<0.001). A multivariate Cox’s proportional hazards model showed an increased risk of serological failure among the HIV-positive patients (hazards ratio 6.0, 95% CI 1.5 to 23.9; p = 0.01).

Conclusion: HIV-positive patients treated for syphilis may be at higher risk of serological failure. Despite recommendations for more frequent serological follow-up, most patients did not have documentation of serological response after standard treatment for syphilis.

  • DIS, disease intervention specialist
  • RPR, rapid plasma reagin
  • STD, sexually transmitted disease

https://doi.org/10.1136/sti.2006.021402

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Published Online First 30 August 2006

    • Funding: This study was supported by grant NIH 5R01AI045724 (to AMR).

    • Competing interests: None.

    • This paper was presented in part as an oral presentation at the International Society for Sexually Transmitted Diseases Research (ISSTDR), July 2005, Amsterdam, The Netherlands.

    • Ethical approval: This study was approved by the institutional review boards of the Johns Hopkins Medical Institutions and the Baltimore City Health Department, Baltimore, Maryland, USA.

    • Contributors: KGG: study design, data collection, data analysis, drafting of manuscript; EJE: study design, data collection, drafting of manuscript; ZSW: data collection; AMR: study design, data analysis, drafting of manuscript.