Consequences of HIV/Syphilis Co-Infection on HIV Viral Load and Immune Response to Antiretroviral Therapy
Lina Fan,* Aiping Yu,* Defa Zhang, Ziyu Wang, Ping Ma Department of Infectious Diseases, Tianjin Second People’s Hospital, Nankai University, Tianjin, 300192, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ping MaDepartment of Infecti...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2021-07-01
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| Series: | Infection and Drug Resistance |
| Subjects: | |
| Online Access: | https://www.dovepress.com/consequences-of-hivsyphilis-co-infection-on-hiv-viral-load-and-immune--peer-reviewed-fulltext-article-IDR |
| _version_ | 1819155630535999488 |
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| author | Fan L Yu A Zhang D Wang Z Ma P |
| author_facet | Fan L Yu A Zhang D Wang Z Ma P |
| author_sort | Fan L |
| collection | DOAJ |
| description | Lina Fan,* Aiping Yu,* Defa Zhang, Ziyu Wang, Ping Ma Department of Infectious Diseases, Tianjin Second People’s Hospital, Nankai University, Tianjin, 300192, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ping MaDepartment of Infectious Diseases, Tianjin Second People’s Hospital, Nankai University, No. 7, Sudi Road, Naikai District, Tianjin, 300192, People’s Republic of ChinaTel +86-22-27468019Email maping@tj.gov.cnIntroduction: Although syphilis is a frequent co-infection in patients with human immunodeficiency virus (HIV) infection, the influence of syphilis on immune response and virologic failure in HIV-infected patients following initiation of antiretroviral therapy (ART) is not well-defined.Methods: A retrospective study was conducted at Tianjin Second People’s Hospital to evaluate the prevalence of syphilis and immune status in 4171 ART-naïve patients. The study included patients who initiated ART between August 2009 and June 2019.Results: The prevalence of syphilis was 40.1% in all ART-naïve patients and 42.5% in ART-naïve men who have sex with men. HIV/syphilis co-infection was associated with higher virologic failure (odds ratio (95% confidence interval): 1.30 (1.04, 1.63)). Patients with HIV/syphilis co-infection had lower median CD4+ T cell counts and CD4/CD8 ratios at baseline. After initiation of ART, patients co-infected with HIV/syphilis had smaller increases in CD4+ T cell counts and CD4/CD8 ratios than patients infected only with HIV. The rate of recurrence of syphilis or reinfection was 9% (n = 128) during seven years of ART.Conclusion: HIV/syphilis co-infection had a negative impact on immune recovery and antiretroviral effectiveness. RPR titer and HIV viral load should be monitored in patients co-infected with HIV/syphilis, especially in patients with high RPR titers.Keywords: HIV/syphilis, co-infection, antiretroviral therapy, virologic failure, CD4 response |
| first_indexed | 2024-12-22T15:40:02Z |
| format | Article |
| id | doaj.art-5224f261d5c44f5683184a5703eb1a0c |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-12-22T15:40:02Z |
| publishDate | 2021-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-5224f261d5c44f5683184a5703eb1a0c2022-12-21T18:21:10ZengDove Medical PressInfection and Drug Resistance1178-69732021-07-01Volume 142851286267263Consequences of HIV/Syphilis Co-Infection on HIV Viral Load and Immune Response to Antiretroviral TherapyFan LYu AZhang DWang ZMa PLina Fan,* Aiping Yu,* Defa Zhang, Ziyu Wang, Ping Ma Department of Infectious Diseases, Tianjin Second People’s Hospital, Nankai University, Tianjin, 300192, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ping MaDepartment of Infectious Diseases, Tianjin Second People’s Hospital, Nankai University, No. 7, Sudi Road, Naikai District, Tianjin, 300192, People’s Republic of ChinaTel +86-22-27468019Email maping@tj.gov.cnIntroduction: Although syphilis is a frequent co-infection in patients with human immunodeficiency virus (HIV) infection, the influence of syphilis on immune response and virologic failure in HIV-infected patients following initiation of antiretroviral therapy (ART) is not well-defined.Methods: A retrospective study was conducted at Tianjin Second People’s Hospital to evaluate the prevalence of syphilis and immune status in 4171 ART-naïve patients. The study included patients who initiated ART between August 2009 and June 2019.Results: The prevalence of syphilis was 40.1% in all ART-naïve patients and 42.5% in ART-naïve men who have sex with men. HIV/syphilis co-infection was associated with higher virologic failure (odds ratio (95% confidence interval): 1.30 (1.04, 1.63)). Patients with HIV/syphilis co-infection had lower median CD4+ T cell counts and CD4/CD8 ratios at baseline. After initiation of ART, patients co-infected with HIV/syphilis had smaller increases in CD4+ T cell counts and CD4/CD8 ratios than patients infected only with HIV. The rate of recurrence of syphilis or reinfection was 9% (n = 128) during seven years of ART.Conclusion: HIV/syphilis co-infection had a negative impact on immune recovery and antiretroviral effectiveness. RPR titer and HIV viral load should be monitored in patients co-infected with HIV/syphilis, especially in patients with high RPR titers.Keywords: HIV/syphilis, co-infection, antiretroviral therapy, virologic failure, CD4 responsehttps://www.dovepress.com/consequences-of-hivsyphilis-co-infection-on-hiv-viral-load-and-immune--peer-reviewed-fulltext-article-IDRhiv/syphilisco-infectionanti-retroviral therapyvirologic failurecd4 response |
| spellingShingle | Fan L Yu A Zhang D Wang Z Ma P Consequences of HIV/Syphilis Co-Infection on HIV Viral Load and Immune Response to Antiretroviral Therapy Infection and Drug Resistance hiv/syphilis co-infection anti-retroviral therapy virologic failure cd4 response |
| title | Consequences of HIV/Syphilis Co-Infection on HIV Viral Load and Immune Response to Antiretroviral Therapy |
| title_full | Consequences of HIV/Syphilis Co-Infection on HIV Viral Load and Immune Response to Antiretroviral Therapy |
| title_fullStr | Consequences of HIV/Syphilis Co-Infection on HIV Viral Load and Immune Response to Antiretroviral Therapy |
| title_full_unstemmed | Consequences of HIV/Syphilis Co-Infection on HIV Viral Load and Immune Response to Antiretroviral Therapy |
| title_short | Consequences of HIV/Syphilis Co-Infection on HIV Viral Load and Immune Response to Antiretroviral Therapy |
| title_sort | consequences of hiv syphilis co infection on hiv viral load and immune response to antiretroviral therapy |
| topic | hiv/syphilis co-infection anti-retroviral therapy virologic failure cd4 response |
| url | https://www.dovepress.com/consequences-of-hivsyphilis-co-infection-on-hiv-viral-load-and-immune--peer-reviewed-fulltext-article-IDR |
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