Investigating latent syphilis in HIV treatment-experienced Ethiopians and response to therapy.
Investigating latent syphilis in HIV treatment-experienced Ethiopians and response to therapy.
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DOI：
10.1371/journal.pone.0270878
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
我们调查了接受联合抗逆转录病毒治疗(CART)的HIV(PWH)患者潜伏梅毒感染的患病率、危险因素、治疗反应和神经梅毒。对PWH和潜伏梅毒进行了前瞻性随访研究。将患者随机分为两组，分别接受青霉素G(BPG)和多西环素(Doxy)治疗，治疗12个月和24个月后评价疗效。传统算法用于血清诊断，半定量快速血浆反应素(RPR)试验监测疾病活动性和治疗效果。在823名参与者中，64.8%为女性，平均年龄为41.7±10岁。31名(3.8%)的参与者(22名男性和9名女性)患有潜伏梅毒。危险因素有男性(AOR=3.14)、年龄增长(AOR=1.04/年)和购物车年限(AOR=1.01/月)。基线RPR滴度：≤1：4 19例(61.3%)，1：8~1：32 10例(32.2%)，>；1：32 2例(6.4%)。七项脑脊液分析均不支持神经梅毒的诊断。治疗12个月时，27例(87.1%)血清学反应良好，3例(9.7%)血清学无反应，1例(3.2%)治疗失败。最后四例患者使用替代药物重复梅毒治疗。就足够的血清学反应而言，两种疗法在第12个月时具有可比性，p=0.37。所有病例在第24个月治疗后均有反应。在PWH接收车中，潜伏梅毒在男性中的发生率高于女性，这表明应该对性行为和产前梅毒筛查的影响进行调查。潜伏期梅毒疾病活跃度降低。因此，常规脑脊液分析对无症状神经梅毒的诊断和潜伏梅毒的治疗成功几乎没有帮助。Doxy是BPG的替代品，CART改善了对潜伏梅毒治疗的血清学反应。
We investigated people with HIV (PWH) receiving combination antiretroviral therapy (cART) for latent syphilis infection prevalence, risk factors, treatment response, and neurosyphilis. A prospective follow-up study was conducted on PWH and latent syphilis. The cases were randomly assigned to receive either benzathine penicillin G (BPG) or doxycycline (DOXY), and the posttreatment response was evaluated after 12 and 24 months. The traditional algorithm was used for serodiagnosis, and a semi-quantitative rapid plasma reagin (RPR) test monitored disease activity and treatment effectiveness. Of the 823 participants, 64.8% were women, and the mean age was 41.7±10 years. Thirty-one (3.8%) of the participants (22 males and nine females) had latent syphilis. The risk factors were male sex (aOR = 3.14), increasing age (aOR = 1.04 per year), and cART duration (aOR = 1.01 per month). Baseline RPR titers were: ≤1:4 in 19 (61.3%), between 1:8 and 1:32 in 10 (32.2%), and >1:32 in 2 (6.4%). None of the seven cerebrospinal fluid analyses supported a neurosyphilis diagnosis. In the 12th month of treatment, 27 (87.1%) had adequate serological responses, three (9.7%) had serological nonresponse, and one (3.2%) had treatment failure. Syphilis treatment was repeated in the last four cases with the alternative drug. In terms of adequate serologic response, both therapies were comparable at the 12th month, p = 0.37. All cases responded to treatment in the 24th month. In PWH receiving cART, latent syphilis occurred more in men than women, suggesting an investigation of sexual practices and the impact of antenatal syphilis screening. Syphilis disease activity reduces in the latent stage. Therefore, the routine cerebrospinal fluid analysis contributes little to the diagnosis of asymptomatic neurosyphilis and the treatment success of latent syphilis. DOXY is an alternative to BPG, and cART improves serologic response to latent syphilis treatment.
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影响因子：
158.5
作者：
JOHNS, DR;TIERNEY, M;FELSENSTEIN, D
通讯作者：
FELSENSTEIN, D
影响因子：
3.8
作者：
Chanem, Khalil G.;Moore, Richard D.;Gebo, Kelly A.
通讯作者：
Gebo, Kelly A.
影响因子：
11.8
作者：
Ghanem, Khalil G.;Moore, Richard D.;Gebo, Kelly A.
通讯作者：
Gebo, Kelly A.
DOI：
10.1111/jdv.16946
发表时间：
2020-10-22
影响因子：
9.2
作者：
Janier, M.;Unemo, M.;Patel, R.
通讯作者：
Patel, R.
影响因子：
2.7
作者：
Farhi, David;Dupin, Nicolas
通讯作者：
Dupin, Nicolas