Effects of syphilis infection among HIV-1-positive individuals on suppressive antiretroviral therapy

被引:5
作者
Chan, Phillip [1 ,2 ]
Tang, Tommy H. C. [1 ]
Kwong, Ruby T. S. [1 ]
Chan, Lawrence [1 ]
Chan, Helen S. Y. [1 ]
Lam, K. W. [1 ]
Ting, W. M. [1 ]
Yung, S. K. [1 ]
Lam, Emily C. T. [1 ]
Chu, M. Y. [1 ]
Lam, Wilson [1 ]
Wu, T. C. [1 ]
Li, Patrick [1 ,3 ]
Lee, M. P. [1 ]
机构
[1] Queen Elizabeth Hosp, Dept Med, Hong Kong, Peoples R China
[2] Inst HIV Res & Innovat, Bangkok, Thailand
[3] Hong Kong Sanat & Hosp, Hong Kong, Peoples R China
关键词
HIV; syphilis co-infection; CD4; decline; Lymphocyte depletion; Sexually transmitted infection; Viral suppression; CD4 CELL COUNT; VIRAL LOAD; CD4/CD8; RATIO; MEN;
D O I
10.1186/s12981-022-00493-w
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
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.
引用
收藏
页数:5
相关论文
共 17 条
[1]   Incidence of syphilis seroconversion among HIV-infected persons in Asia: results from the TREAT Asia HIV Observational Database [J].
Ahn, Jin Young ;
Boettiger, David ;
Kiertiburanakul, Sasisopin ;
Merati, Tuti Parwati ;
Huy, Bui Vu ;
Wong, Wing Wai ;
Ditangco, Rossana ;
Lee, Man Po ;
Oka, Shinichi ;
Durier, Nicolas ;
Choi, Jun Yong .
JOURNAL OF THE INTERNATIONAL AIDS SOCIETY, 2016, 19
[2]   Syphilis increases HIV viral load and decreases CD4 cell counts in HIV-infected patients with new syphilis infections [J].
Buchacz, K ;
Patel, P ;
Taylor, M ;
Kerndt, PR ;
Byers, RH ;
Holmberg, SD ;
Klausner, JD .
AIDS, 2004, 18 (15) :2075-2079
[3]   CD4/CD8 ratio normalization rates and low ratio as prognostic marker for non-AIDS defining events among long-term virologically suppressed people living with HIV [J].
Han, Win Min ;
Apornpong, Tanakorn ;
Kerr, Stephen J. ;
Hiransuthikul, Akarin ;
Gatechompol, Sivaporn ;
Do, Tanya ;
Ruxrungtham, Kiat ;
Avihingsanon, Anchalee .
AIDS RESEARCH AND THERAPY, 2018, 15
[4]   Effect of Early Syphilis Infection on Plasma Viral Load and CD4 Cell Count in Human Immunodeficiency Virus-Infected Men Results From the FHDH-ANRS CO4 Cohort [J].
Jarzebowski, Witold ;
Caumes, Eric ;
Dupin, Nicolas ;
Farhi, David ;
Lascaux, Anne-Sophie ;
Pihetty, Christophe ;
de Truchis, Pierre ;
Bouldouyre, Marie-Anne ;
Derradji, Ouda ;
Pacanowski, Jerome ;
Costagliola, Dominique ;
Grabar, Sophie .
ARCHIVES OF INTERNAL MEDICINE, 2012, 172 (16) :1237-1243
[5]   Detectable HIV-1 in semen in individuals with very low blood viral loads [J].
Kariuki, Samuel Mundia ;
Selhorst, Philippe ;
Norman, Jennifer ;
Cohen, Karen ;
Rebe, Kevin ;
Williamson, Carolyn ;
Dorfman, Jeffrey R. .
VIROLOGY JOURNAL, 2020, 17 (01)
[6]   Syphilis reinfection is associated with an attenuated immune profile in the same individual: a prospective observational cohort study [J].
Kenyon, Chris ;
Osbak, Kara Krista ;
Crucitti, Tania ;
Kestens, Luc .
BMC INFECTIOUS DISEASES, 2018, 18
[7]  
Lee Ma, 2007, Morbidity and Mortality Weekly Report, V56, P625
[8]   Imbalance in the game of T cells: What can the CD4/CD8 T-cell ratio tell us about HIV and health? [J].
McBride, Joseph A. ;
Striker, Rob .
PLOS PATHOGENS, 2017, 13 (11)
[9]   Effect of treating co-infections on HIV-1 viral load: a systematic review [J].
Modjarrad, Kayvon ;
Vermund, Sten H. .
LANCET INFECTIOUS DISEASES, 2010, 10 (07) :455-463
[10]   Brief Report: Syphilis Incidence and Effect on Viral Load, CD4, and CD4/CD8 Ratio in a Thai Cohort of Predominantly Men Who Have Sex With Men Living With HIV [J].
Muccini, Camilla ;
Crowell, Trevor A. ;
Pinyakorn, Suteeraporn ;
Kroon, Eugene ;
Sacdalan, Carlo ;
Ananworanich, Jintanat ;
Vasan, Sandhya ;
Phanuphak, Nittaya ;
Colby, Donn J. .
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 2021, 86 (02) :219-223