Antiretroviral therapy is associated with reduced serologic failure rates for syphilis among HIV-infected patients
Antiretroviral therapy is associated with reduced serologic failure rates for syphilis among HIV-infected patients
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DOI：
10.1086/589295
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发表时间：
2008-07-15
影响因子：
11.8
通讯作者：
Gebo, Kelly A.
中科院分区：
文献类型：
--
作者：
Ghanem, Khalil G.;Moore, Richard D.;Gebo, Kelly A.
背景梅毒和人类免疫缺陷病毒（HIV）经常在患者中共存，但免疫抑制对梅毒病程的影响尚不清楚。我们的目的是确定HIV介导的免疫抑制程度和高效抗逆转录病毒治疗的使用是否影响梅毒血清学应答。我们评估了1990年至2006年所有梅毒血清学检测结果阳性的HIV感染患者的前瞻性、观察性临床队列。我们将血清逆转定义为先前梅毒血清学检测结果阳性的患者反应性丧失。我们将血清学失败定义为治疗后270-365天快速血浆反应素滴度未下降4倍或治疗后≥ 30天滴度增加4倍。我们使用考克斯比例风险模型，对多个失效实例进行统计调整。180例受试者发生了231例梅毒。中位随访时间为5.3年。共记录了71次血清学失败。CD 4细胞计数
Background. Syphilis and human immunodeficiency virus (HIV) frequently coexist in patients, but the effects of immunosuppression on the course of syphilis are unknown. Our goal was to determine whether the degree of HIV-mediated immunosuppression and the use of highly active antiretroviral therapy impact syphilis serologic responses.Methods. We assessed all cases of syphilis with positive serologic test results from 1990 through 2006 in a prospective, observational clinical cohort of HIV-infected patients. We defined seroreversion as the loss of reactivity in a patient who previously had a serologic test result positive for syphilis. We defined serologic failure as the lack of a 4-fold decrease in rapid plasma reagin titers 270-365 days after therapy or a 4-fold increase in titers >= 30 days after therapy. We used Cox proportional hazards models with statistical adjustments for multiple failure instances.Results. One hundred eighty subjects experienced 231 cases of syphilis. The median follow-up time was 5.3 years. A total of 71 episodes of serologic failure were documented. A CD4 cell count of