Kukanok Sivaporn, Kiertiburanakul Sasisopin
Southeast Asian J Trop Med Public Health. 2014 Mar;45(2):435-41.
Data regarding syphilis screening in resource-limited settings is limited. We aimed to determine the prevalence and associated factors of positive syphilis serology in HIV-infected adult patients in an outpatient setting in Thailand. A cross sectional study was conducted among 178 HIV-infected patients. Ninety-eight patients (55%) were male; then median (interquartile range; IQR) age was 43 (36-49) years. The majority of the patients (84.3%) had a heterosexual risk. Three patients (1.7%) had a positive rapid plasma reagin (RPR) test (range, 1:2 to 1:16), 9 (5%) patients had a positive Treponema pallidum particle agglutination (TPPA) test, and 3 patients (1.7%) had positive results on both tests. On multivariate logistic regression analysis, a pruritic papular eruption [odds ratio (OR) 5.37; 95% confidence interval (CI): 1.09-26.38; p = 0.038], current CD4 cell count (OR 1.22, per 50 cells/mm3; 95% CI: 1.01-1.46; p = 0.035), and using abacavir in the current regimen (OR 59.19; 95% CI: 2.15-1,628.68; p = 0.016) were associated with positive syphilis serology. In conclusion, the prevalence of positive syphilis serology among Thai HIV-infected patients was low. Routine screening for syphilis in HIV-infected patients who are asymptomatic may need to be re-considered at the national level in this resource-limited setting.
关于资源有限环境下梅毒筛查的数据有限。我们旨在确定泰国门诊环境中感染艾滋病毒的成年患者梅毒血清学阳性的患病率及相关因素。对178例感染艾滋病毒的患者进行了一项横断面研究。98例患者（55%）为男性；中位（四分位间距；IQR）年龄为43（36 - 49）岁。大多数患者（84.3%）有异性传播风险。3例患者（1.7%）快速血浆反应素（RPR）试验呈阳性（滴度范围为1:2至1:16），9例患者（5%）梅毒螺旋体颗粒凝集试验（TPPA）呈阳性，3例患者（1.7%）两项试验结果均为阳性。多因素逻辑回归分析显示，瘙痒性丘疹皮疹[比值比（OR）5.37；95%置信区间（CI）：1.09 - 26.38；p = 0.038]、当前CD4细胞计数（OR 1.22，每50个细胞/mm³；95% CI：1.01 - 1.46；p = 0.035）以及当前治疗方案中使用阿巴卡韦（OR 59.19；95% CI：2.15 - 1628.68；p = 0.016）与梅毒血清学阳性相关。总之，泰国感染艾滋病毒患者中梅毒血清学阳性的患病率较低。在这种资源有限的环境下，可能需要在国家层面重新考虑对无症状的艾滋病毒感染患者进行梅毒常规筛查。
