Clinical and immunological characteristics of HIV/syphilis co-infected patients following long-term antiretroviral treatment
ObjectiveThis study aims to analyze the efficacy of anti-syphilis treatment and the impact of syphilis events on HIV virology and immunology in HIV/syphilis co-infected patients on long-term antiretroviral therapy (ART) and to investigate the incidence and factors of syphilis recurrence/re-infection...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1327896/full |
| _version_ | 1797354972148400128 |
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| author | Yuanni Wu Lianfeng Lu Xiaojing Song Xiaosheng Liu Yang Yang Ling Chen Jia Tang Yang Han Wei Lv Wei Cao Taisheng Li Taisheng Li Taisheng Li |
| author_facet | Yuanni Wu Lianfeng Lu Xiaojing Song Xiaosheng Liu Yang Yang Ling Chen Jia Tang Yang Han Wei Lv Wei Cao Taisheng Li Taisheng Li Taisheng Li |
| author_sort | Yuanni Wu |
| collection | DOAJ |
| description | ObjectiveThis study aims to analyze the efficacy of anti-syphilis treatment and the impact of syphilis events on HIV virology and immunology in HIV/syphilis co-infected patients on long-term antiretroviral therapy (ART) and to investigate the incidence and factors of syphilis recurrence/re-infection/serofast state. The insights derived from this investigation can potentially guide strategies for preventing and managing syphilis and AIDS.MethodsA retrospective case–control study was conducted at the AIDS clinic of Peking Union Medical College Hospital from January 2003 to December 2022. The study involved 86 HIV/syphilis co-infected patients and 86 HIV mono-infected patients matched based on age, baseline CD4 + T cell counts, and viral load. We examined the clinical characteristics of HIV/syphilis co-infected patients, evaluated the efficacy of anti-syphilis treatment, and analyzed the dynamic changes in HIV virology and immunology. The Generalized Estimating Equations (GEE) model investigated the factors associated with HIV/syphilis co-infection and syphilis recurrence/reinfection/serofast state.ResultsSyphilis serofast state was observed in 11.6% (10/86) of HIV/syphilis co-infected patients after treatment, and 33.7% (29/86) had syphilis recurrence or re-infection. The overall effectiveness of syphilis treatment stood at 76.8% (63/82). Notably, the effectiveness of syphilis treatment displayed a significant correlation with baseline syphilis titers exceeding 1:128 (p = 0.003). Over the 10-year follow-up period on ART, the HLA-DR + CD8+/CD8 + % levels in the HIV/syphilis co-infected group were markedly higher than those in the HIV mono-infected group (p < 0.05). However, no significant differences were observed between the two groups regarding HIV viral load, CD4+ T cell counts, CD8+ T cell counts, CD4/CD8 ratio, and CD38 + CD8+/CD8 + % (p > 0.05). GEE analysis model revealed that elevated HLA-DR + CD8+/CD8 + % levels were associated with HIV/syphilis co-infection (OR = 1.026, 95% CI = 1.007–1.046; p = 0.007) and syphilis recurrence/reinfection/serofast state (OR = 1.036, 95% CI = 1.008–1.065; p = 0.012).ConclusionWhile HIV/syphilis co-infected patients typically receive adequate treatment, the incidence of syphilis recurrence and reinfection remain notably elevated. A heightened HLA-DR + CD8+/CD8+ % is a notable risk factor for HIV/syphilis co-infection and syphilis recurrence/reinfection/serofast state. Therefore, it is advisable to reinforce health education efforts and ensure regular follow-ups for people living with HIV undergoing ART to monitor syphilis infection or increased risk of syphilis infection. |
| first_indexed | 2024-03-08T13:57:32Z |
| format | Article |
| id | doaj.art-c893d4b96407435e848421d963404533 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-08T13:57:32Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-c893d4b96407435e848421d9634045332024-01-15T11:40:03ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-01-011110.3389/fpubh.2023.13278961327896Clinical and immunological characteristics of HIV/syphilis co-infected patients following long-term antiretroviral treatmentYuanni Wu0Lianfeng Lu1Xiaojing Song2Xiaosheng Liu3Yang Yang4Ling Chen5Jia Tang6Yang Han7Wei Lv8Wei Cao9Taisheng Li10Taisheng Li11Taisheng Li12Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, and Chinese Academy of Medical Sciences, Beijing, ChinaTsinghua-Peking Center for Life Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, and Chinese Academy of Medical Sciences, Beijing, ChinaTsinghua-Peking Center for Life Sciences, Beijing, ChinaState Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, ChinaObjectiveThis study aims to analyze the efficacy of anti-syphilis treatment and the impact of syphilis events on HIV virology and immunology in HIV/syphilis co-infected patients on long-term antiretroviral therapy (ART) and to investigate the incidence and factors of syphilis recurrence/re-infection/serofast state. The insights derived from this investigation can potentially guide strategies for preventing and managing syphilis and AIDS.MethodsA retrospective case–control study was conducted at the AIDS clinic of Peking Union Medical College Hospital from January 2003 to December 2022. The study involved 86 HIV/syphilis co-infected patients and 86 HIV mono-infected patients matched based on age, baseline CD4 + T cell counts, and viral load. We examined the clinical characteristics of HIV/syphilis co-infected patients, evaluated the efficacy of anti-syphilis treatment, and analyzed the dynamic changes in HIV virology and immunology. The Generalized Estimating Equations (GEE) model investigated the factors associated with HIV/syphilis co-infection and syphilis recurrence/reinfection/serofast state.ResultsSyphilis serofast state was observed in 11.6% (10/86) of HIV/syphilis co-infected patients after treatment, and 33.7% (29/86) had syphilis recurrence or re-infection. The overall effectiveness of syphilis treatment stood at 76.8% (63/82). Notably, the effectiveness of syphilis treatment displayed a significant correlation with baseline syphilis titers exceeding 1:128 (p = 0.003). Over the 10-year follow-up period on ART, the HLA-DR + CD8+/CD8 + % levels in the HIV/syphilis co-infected group were markedly higher than those in the HIV mono-infected group (p < 0.05). However, no significant differences were observed between the two groups regarding HIV viral load, CD4+ T cell counts, CD8+ T cell counts, CD4/CD8 ratio, and CD38 + CD8+/CD8 + % (p > 0.05). GEE analysis model revealed that elevated HLA-DR + CD8+/CD8 + % levels were associated with HIV/syphilis co-infection (OR = 1.026, 95% CI = 1.007–1.046; p = 0.007) and syphilis recurrence/reinfection/serofast state (OR = 1.036, 95% CI = 1.008–1.065; p = 0.012).ConclusionWhile HIV/syphilis co-infected patients typically receive adequate treatment, the incidence of syphilis recurrence and reinfection remain notably elevated. A heightened HLA-DR + CD8+/CD8+ % is a notable risk factor for HIV/syphilis co-infection and syphilis recurrence/reinfection/serofast state. Therefore, it is advisable to reinforce health education efforts and ensure regular follow-ups for people living with HIV undergoing ART to monitor syphilis infection or increased risk of syphilis infection.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1327896/fullHIVAIDSsyphilisantiretroviral treatmentsexually transmitted diseaseimmune recovery |
| spellingShingle | Yuanni Wu Lianfeng Lu Xiaojing Song Xiaosheng Liu Yang Yang Ling Chen Jia Tang Yang Han Wei Lv Wei Cao Taisheng Li Taisheng Li Taisheng Li Clinical and immunological characteristics of HIV/syphilis co-infected patients following long-term antiretroviral treatment Frontiers in Public Health HIV AIDS syphilis antiretroviral treatment sexually transmitted disease immune recovery |
| title | Clinical and immunological characteristics of HIV/syphilis co-infected patients following long-term antiretroviral treatment |
| title_full | Clinical and immunological characteristics of HIV/syphilis co-infected patients following long-term antiretroviral treatment |
| title_fullStr | Clinical and immunological characteristics of HIV/syphilis co-infected patients following long-term antiretroviral treatment |
| title_full_unstemmed | Clinical and immunological characteristics of HIV/syphilis co-infected patients following long-term antiretroviral treatment |
| title_short | Clinical and immunological characteristics of HIV/syphilis co-infected patients following long-term antiretroviral treatment |
| title_sort | clinical and immunological characteristics of hiv syphilis co infected patients following long term antiretroviral treatment |
| topic | HIV AIDS syphilis antiretroviral treatment sexually transmitted disease immune recovery |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1327896/full |
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