scholarly journals Comparison of the serological response to treatment of early syphilis in HIV positive versus HIV negative individuals

2004 ◽  
Vol 80 (2) ◽  
pp. 152-153 ◽  
Author(s):  
M A Kingston
Keyword(s):  
Response To Treatment ◽  
Hiv Positive ◽  
Serological Response ◽  
Early Syphilis ◽  
Hiv Negative

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

2021 ◽  
pp. sextrans-2020-054887
Author(s):  
Silvia Achia Nieuwenburg ◽  
Ricardo Jamie Sprenger ◽  
Maarten Franciscus Schim van der Loeff ◽  
Henry John Christiaan de Vries
Keyword(s):  
Hiv Infection ◽  
Controlled Trial ◽  
Clinical Manifestations ◽  
Response To Treatment ◽  
Disease Stage ◽  
Hiv Positive ◽  
Sexual Risk Behaviour ◽  
Serological Response ◽  
History Of ◽  
Hiv Negative

ObjectivesHIV-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.MethodsThis 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.ResultsWe 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).ConclusionsIn 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.

scholarly journals Slow clinical improvement after treatment initiation in Leishmania/HIV coinfected patients

2012 ◽  
Vol 45 (2) ◽  
pp. 147-150 ◽  
Author(s):  
Guenael Freire de Souza ◽  
Fernando Biscione ◽  
Dirceu Bartolomeu Greco ◽  
Ana Rabello
Keyword(s):  
Hiv Infection ◽  
Clinical Response ◽  
Clinical Picture ◽  
Treatment Initiation ◽  
Early Recognition ◽  
Response To Treatment ◽  
Hiv Positive ◽  
Large Area ◽  
Belo Horizonte ◽  
Hiv Negative

INTRODUCTION: In Brazil there is a large area of overlap of visceral leishmaniasis (VL) and HIV infection, which favored a increased incidence of coinfection Leishmania/HIV. METHODS: This study evaluated 65 consecutive patients with VL and their clinical response to treatment in two health care settings in Belo Horizonte, Brazil. RESULTS: At baseline, the clinical picture was similar between both groups, although diarrhea and peripheral lymphadenomegaly were more frequent in HIV-infected subjects. HIV-positive patients had lower median blood lymphocyte counts (686/mm³ versus 948/mm³p = 0.004) and lower values of alanine aminotransferase (ALT) (48IU/L versus 75.6IU/L p = 0.016) than HIV-negative patients. HIV-positive status (hazard ratio = 0.423, p = 0.023) and anemia (HR = 0.205, p = 0.002) were independent negative predictors of complete clinical response following antileishmanial treatment initiation. CONCLUSIONS: This study reinforces that all patients with VL should be tested for HIV infection, regardless of their clinical picture. This practice would allow early recognition of coinfection with initiation of antiretroviral therapy and, possibly, reduction in treatment failure.

scholarly journals Neurocysticercosis and HIV Infection: what can we learn from the published literature?

2019 ◽  
Vol 77 (5) ◽  
pp. 357-365 ◽  
Author(s):  
Omar Herrera Vazquez ◽  
Matthew L. Romo ◽  
Agnès Fleury
Keyword(s):  
Hiv Infection ◽  
Immune Status ◽  
Taenia Solium ◽  
Response To Treatment ◽  
Hiv Positive ◽  
Historical Series ◽  
Immunodeficiency Virus ◽  
The Central Nervous System ◽  
Published Research ◽  
Hiv Negative

ABSTRACT Infections caused by the human immunodeficiency virus (HIV) and by the larvae of Taenia solium (i.e., cysticercosis) are still widespread in many developing countries. Both pathologies modify host immune status and it is possible that HIV infection may modulate the frequency and pathogeny of cysticercosis of the central nervous system (i.e., neurocysticercosis [NCC]). Objective: To describe published cases of NCC among HIV-positive patients and to evaluate whether the characteristics of NCC, including frequency, symptoms, radiological appearance, and response to treatment differed between HIV-positive and HIV-negative patients. Methods: Forty cases of NCC/HIV co-infected patients were identified in the literature. Clinical and radiological characteristics, as well as response to treatment, were compared with non-matching historical series of NCC patients without HIV infection. Results: Most of these patients had seizures and multiple vesicular parasites located in parenchyma. Clinical and radiological characteristics were similar between HIV-positive and HIV-negative patients with NCC, as well as between immunocompromised and non-immunocompromised HIV-positive patients. Conclusion: Our review did not reveal clear interactions between HIV and NCC. This may be partially due to the small number of cases and reliance on published research. A systematic, multi-institutional effort aiming to report all the cases of this dual pathology is needed to confirm this finding and to clarify the possible relationship between both pathogens.

scholarly journals Similar serological response to conventional therapy for syphilis among HIV-positive and HIV-negative women.

1995 ◽  
Vol 71 (5) ◽  
pp. 275-279 ◽  
Author(s):  
J Goeman ◽  
M Kivuvu ◽  
N Nzila ◽  
F Behets ◽  
B Edidi ◽  
...  
Keyword(s):  
Conventional Therapy ◽  
Hiv Positive ◽  
Serological Response ◽  
Hiv Negative

scholarly journals Early syphilis: serological treatment response to doxycycline/tetracycline versus benzathine penicillin

2014 ◽  
Vol 8 (02) ◽  
pp. 228-232 ◽  
Author(s):  
Jun Li ◽  
He-Yi Zheng
Keyword(s):  
Success Rate ◽  
Serological Test ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Response To Treatment ◽  
Penicillin G ◽  
Serological Response ◽  
Benzathine Penicillin ◽  
College Hospital ◽  
Early Syphilis

Introduction: Benzathine penicillin G is the treatment of choice for syphilis, but doxycycline and tetracycline are effective second-line treatments. The objective of this study was to assess the serological response to treatment for early syphilis with benzathine penicillin compared with doxycycline or tetracycline. Methodology: We examined rapid plasma regain (RPR) serological test results of all first-time early syphilis patients in Peking Union Medical College Hospital between 2000 and 2011, comparing treatment with two doses of penicillin to 14-day course of oral doxycycline (100 mg twice daily) or oral tetracycline (500 mg 4 times a day). Results: Of the 641 early syphilis cases with available treatment outcome data, 606 (94.5%) received penicillin and 35 (5.5%) received doxycycline/tetracycline. More than half (52.1%) had secondary syphilis, 13.4% had primary syphilis, and 34.5% had early latent syphilis. A statistically similar serological treatment success rate (p = 0.157) was observed in penicillin-treated patients 91.4% (554/606), when compared with patients treated with doxycycline/tetracycline 82.9% (29/35). Conclusion: Doxycycline/tetracycline had a similar serological treatment success rate when compared to penicillin in the treatment of early syphilis.

A retrospective review of anal squamous cell carcinoma in HIV positive and HIV negative patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4153-4153 ◽  
Author(s):  
J. Grandhi ◽  
P. A. Philip ◽  
T. Washington ◽  
A. F. Shields ◽  
U. Vaishampayan ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Anal Cancer ◽  
Squamous Cell ◽  
Case Series ◽  
Response To Treatment ◽  
Hiv Positive ◽  
Stage At Diagnosis ◽  
Anal Squamous Cell Carcinoma ◽  
Hiv Negative

4153 Background: The incidence of invasive anal cancer is 120 times higher in the HIV infected patients than in the general population. The outcome of anal cancer in HIV infected patients has not been evaluated in prospective trials and the published literature is limited to small retrospective case series. The aim of this study is to describe the outcome, tolerability, event free survival, and overall survival in patients with squamous cell carcinoma of anal canal (SCCAC) with and without HIV infection treated at Karmanos Cancer Institute/Wayne State University from 1991 to 2005. Methods: We performed a retrospective chart review. Patients were identified using the SEER database. We collected data regarding HIV status, demographics (age, gender, race), stage at diagnosis, treatment, response to treatment, toxicity and survival. Results: Forty patients with SCCAC were identified, of which 13 were HIV positive and 27 were HIV negative. The HIV-positive and HIV-negative groups differed by mean age (44 vs. 55 years), male gender (100 vs. 37 percent), and African American race (92 vs. 59 percent). There were no differences in stage at diagnosis, type of chemotherapy received. HIV positive population received reduced chemotherapy (67 vs. 8 percent), and RT (22 vs. 7 percent) dosage. The major toxicities observed in HIV positive and negative patients were mucositis (23% vs. 29%), neutropenia (8% vs. 33%) and skin toxicity (46% vs. 55%) secondary to radiotherapy. Only 61 percent of HIV-positive patients were disease free vs. 60 percent of HIV-negative patients. Conclusions: We found that HIV positive patients received lower doses of chemo-radiotherapy. Patients with HIV tolerated the lower dose chemoradiotherapy and had a similar toxicity profile to the HIV negative patients. No major difference in the risk of recurrence between HIV positive and negative patients was observed. No significant financial relationships to disclose.

scholarly journals Neurological findings in early syphilis: a comparison between HIV positive and negative patients

2013 ◽  
Vol 5 (4) ◽  
pp. 19 ◽  
Author(s):  
Alejandra González-Duarte ◽  
Zaira Medina López
Keyword(s):  
Venereal Disease ◽  
Age At Onset ◽  
Disease Onset ◽  
Clinical Findings ◽  
Hiv Positive ◽  
Ocular Involvement ◽  
Early Syphilis ◽  
Ocular Manifestations ◽  
Csf Pleocytosis ◽  
Hiv Negative

After a decade of steady decline, syphilis has reemerged within the past few years and it is seeping back into the HIV negative population. We describe herein 16 consecutive cases of neurosyphilis and compare its clinical characteristics. Of the 16 patients, 14 (87%) were men. Mean age at onset was 43 years old (range: 23-82). Twelve patients (75%) were HIV positive; stage was B2 in 2 patients, B3 and C2 in one patient each, and C3 in 8 patients. The clinical presentation was meningitis in 6 (40%), stroke in 3 (18%), ocular manifestations in 4 (27%), and psychiatric manifestations in 2 (13%) cases. Five additional patients had ocular involvement after a formal ophthalmologic examination. High venereal disease research laboratory test (VDRL) titers in serum and cerebrospinal fluid (CSF) were found. Patients in C3 stage of HIV had less CSF pleocytosis (&lt;5 cells/mm3) than patients in earlier stages (P=0.018). Disease onset was earlier in patients older than 50 years old with HIV (P=0.049). We found that meningitis, ocular manifestations and stroke were the most common clinical findings in early syphilis. Moreover, stroke included the carotid and cerebrobasilar vascular territories. CSF VDRL continues to be a crucial test in all idiopathic cases of meningitis, stroke and uveitis, regardless of the HIV status or CSF pleocytosis. Except for less pleocytosis, there were no important differences between HIV positive and HIV negative patients.

scholarly journals P65 Serological response between HIV-positive and negative cohorts treated for early syphilis

2012 ◽  
Vol 88 (Suppl 1) ◽  
pp. A31.3-A32
Author(s):  
R Dhairyawan ◽  
A Almeida ◽  
M Gunathilake ◽  
B Goh
Keyword(s):  
Hiv Positive ◽  
Serological Response ◽  
Early Syphilis

Management of syphilis in HIV-positive individuals

Sexual Health ◽  
2015 ◽  
Vol 12 (2) ◽  
pp. 135 ◽  
Author(s):  
Fiona V. Cresswell ◽  
Martin Fisher
Keyword(s):  
Antibiotic Treatment ◽  
Controlled Trial ◽  
Clinical Manifestations ◽  
Response To Treatment ◽  
Penicillin G ◽  
Neurological Involvement ◽  
Hiv Positive ◽  
Reference Laboratory ◽  
Serological Response ◽  
Randomised Controlled

Since the turn of the millennium a sustained outbreak of syphilis among men who have sex with men continues, approximately 20–50% of whom have concurrent HIV infection. In this paper we aim to explore the controversies that exist around the management of syphilis in HIV-positive individuals. Not only do HIV-positive people have different clinical manifestations of syphilis they have higher rates of asymptomatic neurological involvement, slower serological response to treatment and higher serological failure than HIV-negative individuals in most studies. Whether long-term clinical outcomes are different or affected by the antibiotic regimen selected remains to be established. The optimal antimicrobial regimen to treat syphilis in HIV is unknown due to a dearth of randomised controlled trial data. International guidelines state that the antibiotic management of syphilis is the same regardless of HIV status, with early syphilis treated with a single dose of benzathine penicillin G 2.4mU intrmuscularly. In practice, however, the majority of surveyed clinicians do treat HIV-positive people with more intensive antibiotics suggesting a lack of faith in guidelines. Factors which appear to affect the likelihood of developing neurological disease include CD4+ count of <350 cells/μL, absence of antiretroviral therapy, rapid plasma regain (RPR) or venereal diseases reference laboratory titre (VDRL) >1 : 32, late-latent disease or lack of response to standard antibiotic treatment. We recommend a low-threshold for offering antibiotic treatment effective against neurosyphilis in HIV-positive people with syphilis, especially if they exhibit any of the above factors.

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