De Francesco Davide, Winston Alan, Underwood Jonathan, Cresswell Fiona V, Anderson Jane, Post Frank A, Williams Ian, Mallon Patrick Wg, Sachikonye Memory, Babalis Daphne, Vera Jaime H, Bagkeris Emmanouil, Milinkovic Ana, Sabin Caroline A
1 Institute for Global Health, UCL, London, UK.
2 Division of Infectious Diseases, Imperial College London, London, UK.
Int J STD AIDS. 2019 Apr;30(5):440-446. doi: 10.1177/0956462418817612. Epub 2019 Jan 10.
We evaluated associations between history of syphilis infection and both cognitive function and depressive symptoms in people living with HIV (PLHIV) and comparable HIV-negative controls. Syphilis serological tests, cognitive function and depression were assessed in PLHIV and controls participating in the Pharmacokinetic and Clinical Observations in People Over Fifty study. Cognitive test scores were converted to demographically adjusted T-scores (mean = 50, SD = 10) and then averaged to obtain a global T-score. Severity of depressive symptoms was assessed via the Patient Health Questionnaire-9. Associations of syphilis with global T-scores and depression were assessed using median regression. The 623 PLHIV and 246 HIV-negative controls were predominantly male (89.3% and 66.5%) with median age (interquartile range [IQR]) of 57 (53-63) and 58 (53-63) years, respectively. PLHIV had lower global cognitive T-scores (median [IQR] 48.7 [45.1, 52.1] versus 50.5 [47.0, 53.9], p < 0.001), more severe depressive symptoms (median [IQR] 4 [1, 10] versus 1 [0, 3], p < 0.001) and were more likely to report history of syphilis infection (22.0% versus 8.1%) than controls. There was no significant association between history of syphilis and global cognitive function in either PLHIV (p = 0.69) or controls (p = 0.10). Participants with a history of syphilis had more severe depressive symptoms (median [IQR] 4 [1, 9] versus 2 [0, 8], p = 0.03); however, the association became non-significant (p = 0.62) after adjusting for HIV status and potential confounders. Despite the higher prevalence of syphilis infection in PLHIV, there was no evidence of an association between history of syphilis infection and impaired cognitive function nor depressive symptoms after accounting for potential confounders.
我们评估了梅毒感染史与艾滋病毒感染者（PLHIV）及可比的艾滋病毒阴性对照者的认知功能和抑郁症状之间的关联。在参与“五十岁以上人群的药代动力学和临床观察”研究的PLHIV和对照者中，评估了梅毒血清学检测、认知功能和抑郁情况。认知测试分数被转换为经人口统计学调整的T分数（均值 = 50，标准差 = 10），然后取平均值以获得总体T分数。通过患者健康问卷-9评估抑郁症状的严重程度。使用中位数回归评估梅毒与总体T分数及抑郁之间的关联。623名PLHIV和246名艾滋病毒阴性对照者主要为男性（分别占89.3%和66.5%），年龄中位数（四分位间距[IQR]）分别为57（53 - 63）岁和58（53 - 63）岁。PLHIV的总体认知T分数较低（中位数[IQR]为48.7[45.1, 52.1]，而对照者为50.5[47.0, 53.9]，p < 0.001），抑郁症状更严重（中位数[IQR]为4[1, 10]，而对照者为1[0, 3]，p < 0.001），且比对照者更有可能报告有梅毒感染史（22.0%对8.1%）。在PLHIV（p = 0.69）或对照者（p = 0.10）中，梅毒史与总体认知功能之间均无显著关联。有梅毒史的参与者抑郁症状更严重（中位数[IQR]为4[1, 9]，而无梅毒史者为2[0, 8]，p = 0.03）；然而，在调整艾滋病毒状态和潜在混杂因素后，该关联变得不显著（p = 0.62）。尽管PLHIV中梅毒感染的患病率较高，但在考虑潜在混杂因素后，没有证据表明梅毒感染史与认知功能受损或抑郁症状之间存在关联。
