Buchacz Kate, Patel Pragna, Taylor Melanie, Kerndt Peter R, Byers Robert H, Holmberg Scott D, Klausner Jeffrey D
Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
AIDS. 2004 Oct 21;18(15):2075-9. doi: 10.1097/00002030-200410210-00012.
Syphilitic ulcers are known to facilitate the transmission of HIV infection, but the effect of syphilis infection on HIV viral loads and CD4 cell counts is poorly understood.
We abstracted medical records for HIV-infected male syphilis patients seen at three clinics in San Francisco and Los Angeles from January 2001 to April 2003. We compared plasma HIV-RNA levels and CD4 cell counts during syphilis infection with those before syphilis infection and after syphilis treatment, using the Wilcoxon signed rank test.
Fifty-two HIV-infected men with primary or secondary syphilis had HIV viral load and CD4 cell count data available for analysis; 30 (58%) were receiving antiretroviral therapy. Viral loads were higher during syphilis compared with pre-syphilis levels by a mean of 0.22 RNA log10 copies/ml (P = 0.02) and were lower by a mean of -0.10 RNA log10 copies/ml (P = 0.52) after syphilis treatment. CD4 cell counts were lower during syphilis infection than before by a mean of -62 cells/mm3 (P = 0.04), and were higher by a mean of 33 cells/mm3 (P = 0.23) after syphilis treatment. Increases in the HIV viral load and reductions in the CD4 cell count were most substantial in men with secondary syphilis and those not receiving antiretroviral therapy.
Syphilis infection was associated with significant increases in the HIV viral load and significant decreases in the CD4 cell count. The findings underscore the importance of preventing and promptly treating syphilis in HIV-infected individuals.
已知梅毒溃疡会促进艾滋病毒感染的传播，但梅毒感染对艾滋病毒病毒载量和 CD4 细胞计数的影响却知之甚少。
我们提取了 2001 年 1 月至 2003 年 4 月期间在旧金山和洛杉矶的三家诊所就诊的感染艾滋病毒的男性梅毒患者的病历。我们使用 Wilcoxon 符号秩检验比较了梅毒感染期间与梅毒感染前及梅毒治疗后的血浆艾滋病毒核糖核酸（HIV-RNA）水平和 CD4 细胞计数。
52 名患有一期或二期梅毒的感染艾滋病毒男性有可用于分析的艾滋病毒病毒载量和 CD4 细胞计数数据；30 名（58%）正在接受抗逆转录病毒治疗。与梅毒感染前相比，梅毒感染期间病毒载量平均高出 0.22 个 RNA log10 拷贝/毫升（P = 0.02），梅毒治疗后平均降低 -0.10 个 RNA log10 拷贝/毫升（P = 0.52）。梅毒感染期间 CD4 细胞计数比之前平均低 -62 个细胞/立方毫米（P = 0.04），梅毒治疗后平均高出 33 个细胞/立方毫米（P = 0.23）。艾滋病毒病毒载量的增加和 CD4 细胞计数的减少在患有二期梅毒的男性和未接受抗逆转录病毒治疗的男性中最为显著。
梅毒感染与艾滋病毒病毒载量显著增加和 CD4 细胞计数显著减少有关。这些发现强调了在感染艾滋病毒的个体中预防和及时治疗梅毒的重要性。
