Clinical outcomes of syphilis in HIV-negative and HIV-positive MSM: occurrence of repeat syphilis episodes and non-treponemal serology responses.

Autor:	Nieuwenburg SA; Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands., Sprenger RJ; Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands., Schim van der Loeff MF; Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands.; Department of Internal Medicine, Amsterdam UMC, location Academic Medical Centre, Amsterdam, The Netherlands.; Amsterdam institute for Infection and Immunity (AII), Amsterdam UMC, Amsterdam, The Netherlands., de Vries HJC; Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands hdvries@ggd.amsterdam.nl.; Amsterdam institute for Infection and Immunity (AII), Amsterdam UMC, Amsterdam, The Netherlands.; Department of Dermatology, Amsterdam UMC location Academic Medical Centre, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Sexually transmitted infections [Sex Transm Infect] 2022 Mar; Vol. 98 (2), pp. 95-100. Date of Electronic Publication: 2021 Feb 19.
DOI:	10.1136/sextrans-2020-054887
Abstrakt:	Objectives: HIV-positive men who have sex with men (MSM) may be at a higher risk of repeat syphilis, have different clinical manifestations and have a different serological response to treatment compared with HIV-negative MSM. The objective of this study was to assess whether HIV-negative and HIV-positive MSM with infectious syphilis (primary, secondary or early latent) differed in history of previous syphilis episodes, disease stage and non-treponemal titre of initial and repeat episodes, and the titre response 6 and 12 months after treatment. Furthermore, determinants associated with an inadequate titre response after treatment were explored. Methods: This retrospective analysis used data of five longitudinal studies (four cohorts; one randomised controlled trial) conducted at the STI clinic in Amsterdam, the Netherlands. Participants were tested for syphilis and completed questionnaires on sexual risk behaviour every 3-6 months. We included data of participants with ≥1 syphilis diagnosis in 2014-2019. Pearson's χ² test was used to compare HIV-negative and HIV-positive MSM in occurrence of previous syphilis episodes, disease stage of initial and repeat syphilis episode and non-treponemal titre treatment responses. Results: We included 355 participants with total 459 syphilis episodes. HIV-positive MSM were more likely to have a history of previous syphilis episodes compared with HIV-negative MSM (68/90 (75.6%) vs 96/265 (36.2%); p<0.001). Moreover, HIV-positive MSM with repeat syphilis were less often diagnosed with primary syphilis (7/73 (9.6%) vs 36/126 (28.6%)) and more often diagnosed with secondary syphilis (16/73 (21.9%) vs 17/126 (13.5%)) and early latent syphilis (50/73 (68.5%) vs 73/126 (57.9%)) (p=0.005). While not significantly different at 12 months, HIV-negative MSM were more likely to have an adequate titre response after 6 months compared with HIV-positive MSM (138/143 (96.5%) vs 66/74 (89.2%); p=0.032). Conclusions: In repeat syphilis, HIV infection is associated with advanced syphilis stages and with higher non-treponemal titres. HIV infection affects the serological outcome after treatment, as an adequate titre response was observed earlier in HIV-negative MSM. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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