Syphilis and HIV co-infection in an Israeli HIV clinic: incidence and outcome
Syphilis and HIV co-infection in an Israeli HIV clinic: incidence and outcome
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DOI：
10.1258/ijsa.2009.009011
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发表时间：
2010-04-01
影响因子：
1.4
通讯作者：
Sthoeger, Z.
中科院分区：
文献类型：
--
作者：
Agmon-Levin, N.;Elbirt, D.;Sthoeger, Z.
近年来，有报道称艾滋病毒感染者中再次出现梅毒。我们评估了以色列艾滋病中心异性恋移民的合并感染。对2000年至2005年间1060例hiv感染者梅毒血清学阳性记录进行评估，并对所有血清阳性患者进行进一步评估。我们发现150例HIV/梅毒合并感染患者（57%为男性，93%为非洲裔），其中135例发现有晚潜伏梅毒。51例患者行腰椎穿刺（LP）， 16例（31%）脑脊液异常与神经梅毒相符。脑脊液异常与既往未接受抗梅毒治疗相关，但与CD4计数、病毒载量或性病研究实验室滴度无关。所有患者根据病情分期推荐使用青霉素，81例患者完成治疗后12个月随访。81例治疗中有21例（26%）成功，33例（41%）出现“血清快速反应”，27例（33%）治疗失败。总之，在埃塞俄比亚异性恋hiv感染者中观察到高发病率的梅毒伴脑脊液反应性提示神经梅毒。因此，反复的血清学筛查和脑脊液评估似乎是指在这些患者。青霉素治疗导致大多数患者出现“血清快速反应”或治疗失败。此外，可能需要对合并感染的艾滋病毒/梅毒患者进行强化治疗，特别是那些严重免疫缺陷和长期梅毒感染的患者。
The re-emergence of syphilis among HIV-infected patients has been reported in recent years. We evaluated co-infection among heterosexual immigrants in an Israeli AIDS center. The records of 1060 HIV-infected patients were evaluated for positive syphilis serology between the years 2000 and 2005, and all seropositive patients were further evaluated. We found 150 HIV/syphilis co-infected patients (57% men, 93% of African origin), of who 135 were found to have late latent syphilis. Lumbar puncture (LP) was performed in 51 patients, 16 (31%) had abnormal cerebrospinal fluid (CSF) compatible with neurosyphilis. Abnormal CSF correlated with the absence of previous anti-syphilis treatment, but not with CD4 count, viral load or Venereal Disease Research Laboratory titres. Penicillin was recommended to all patients according to their disease stages and 81 patients completed 12 months post-treatment follow-up. Twenty-one of 81 (26%) treatments were successful, 33 (41%) showed 'serofast reaction' and 27 (33%) failed therapy. In conclusion, a high incidence of syphilis with CSF reactivity suggestive of neurosyphilis was observed in heterosexual Ethiopian HIV-infected patients. Thus, repeated serological screening and CSF evaluation seems to be indicated in these patients. Penicillin therapy resulted in `serofast reaction' or treatment failure for most patients. More, intensive treatment might be needed for HIV/syphilis in co-infected patients, especially those with severe immune-deficiency and prolonged syphilis infection.