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- Title
Effects of syphilis infection among HIV-1-positive individuals on suppressive antiretroviral therapy.
- Authors
Chan, Phillip; Tang, Tommy H. C.; Kwong, Ruby T. S.; Chan, Lawrence; Chan, Helen S. Y.; Lam, K. W.; Ting, W. M.; Yung, S. K.; Lam, Emily C. T.; Chu, M. Y.; Lam, Wilson; Wu, T. C.; Li, Patrick; Lee, M. P.
- Abstract
Introduction: Incident syphilis leads to changes in plasma HIV-1 RNA and CD4 + T-cell level in people with HIV (PWH) with viraemia. Its effect in PWH on suppressive antiretroviral therapy (ART) is less clear. Methods: PWH on suppressive ART (plasma HIV-1 RNA < 50copies/mL) followed at the Queen Elizabeth Hospital, Hong Kong, China were regularly screened for syphilis. Their plasma HIV-1 RNA, CD4 + and CD8 + T-cell, and total lymphocyte levels before syphilis, during syphilis, and after successful treatment were compared. Results: Between 2005 and 2020, 288 syphilis episodes from 180 individuals were identified; 287 episodes were related to male, with a median age of 41 at diagnosis; 221 (77%) were syphilis re-infection. The rates of plasma HIV-1 suppression were statistically unchanged across the time-points (97% pre-syphilis, 98% during syphilis, and 99% post-treatment). Total lymphocyte, CD4+ and CD8+ T-cell levels decreased during incident syphilis (p<0.01), and rebounded post-treatment (p<0.01). VDRL titre was associated with declines in CD4+ T-cell (p=0.045), CD8+ T-cell (p=0.004), and total lymphocyte levels (p=0.021). Pre-syphilis CD4/CD8 ratio was associated with increases in CD8+ T-cell (p=0.001) and total lymphocyte levels (p=0.046) during syphilis. Syphilis re-infection was associated with an increase in total lymphocyte level (p=0.037). In the multivariable analysis, only pre-syphilis CD4/CD8 ratio was independently associated with increases in CD8+ T-cell (p=0.014) and total lymphocyte levels (p=0.039) during syphilis. Conclusions: Among virally-suppressed PWH, total lymphocyte, CD4+, and CD8+ T-cell levels declined during incident syphilis but rebounded post-treatment. The status of plasma HIV suppression was unaffected by syphilis.
- Subjects
HIV-positive persons; SYPHILIS; MULTIVARIATE analysis; HIGHLY active antiretroviral therapy; TREATMENT effectiveness; CD4 lymphocyte count; DESCRIPTIVE statistics; T cells; HIV
- Publication
AIDS Research & Therapy, 2022, Vol 19, Issue 1, p1
- ISSN
1742-6405
- Publication type
Article
- DOI
10.1186/s12981-022-00493-w