From the Institute of Preventive Medicine, Department of Disease Control.
Bangrak STIs Center, Bureau of AIDS TB and STIs, Department of Disease Control, Ministry of Public Health, Nonthaburi.
Sex Transm Dis. 2020 May;47(5):283-289. doi: 10.1097/OLQ.0000000000001154.
Together with clinical correlation, nontreponemal titers are used to monitor treatment outcomes. Syphilis patients with HIV and without HIV coinfection were found to have different serological responses after treatment. This study aims to determine time to serological cure for treatment of syphilis and factors associated with it in patients with and without HIV.
A descriptive study of syphilis patients who visited Bangrak STIs Center between January 1, 2007, and December 31, 2016. Univariate analysis was done to determine factors associated with serological outcomes. Survival curve analysis and multivariate Cox regression analysis were applied to compare time to serological cure between patients with various characteristics.
Of 497 syphilis patients, 62.1% had serological cure, 2.2% had nonresponse, 4.6% had treatment failure or reinfection, 9.9% had serofast status, and 21.2% were undetermined because of loss to follow-up. The time to serological cure was 110 days (95% confidence interval [CI], 59-163 days) and 102 days (95% CI, 94-110 days) among patients with HIV and without HIV, respectively (P = 0.162). Time to serological cure was significantly faster in early syphilis and baseline titer ≥1:32. After adjustment with the Cox regression model, patients with early syphilis were associated with serological cure with a hazard ratio of 1.75 (95% CI, 1.32-2.32). Time to serological cure among early syphilis patients was significantly longer in HIV-positive than HIV-negative patients (P = 0.002), whereas no difference was observed in late syphilis (P = 0.104).
Early syphilis was associated with faster time to serological cure. HIV patients with early syphilis took longer time to reach serological cure than did HIV-negative patients, whereas no such a difference was observed in late syphilis.
非梅毒螺旋体抗体滴度与临床相关性相结合，用于监测治疗效果。研究发现，梅毒合并 HIV 感染和不合并 HIV 感染的患者在治疗后具有不同的血清学反应。本研究旨在确定梅毒治疗后血清学治愈的时间以及与 HIV 相关的因素。
对 2007 年 1 月 1 日至 2016 年 12 月 31 日期间在邦拉基性传播感染中心就诊的梅毒患者进行描述性研究。采用单因素分析确定与血清学结果相关的因素。采用生存曲线分析和多变量 Cox 回归分析比较不同特征患者的血清学治愈时间。
在 497 例梅毒患者中，62.1%血清学治愈，2.2%无反应，4.6%治疗失败或再感染，9.9%血清固定，21.2%因失访而无法确定。HIV 阳性和 HIV 阴性患者的血清学治愈时间分别为 110 天（95%置信区间，59-163 天）和 102 天（95%置信区间，94-110 天）（P=0.162）。早期梅毒和基线滴度≥1:32 患者的血清学治愈时间明显较快。在 Cox 回归模型调整后，早期梅毒患者与血清学治愈相关，风险比为 1.75（95%置信区间，1.32-2.32）。HIV 阳性早期梅毒患者的血清学治愈时间明显长于 HIV 阴性患者（P=0.002），而晚期梅毒患者则无差异（P=0.104）。
早期梅毒与更快的血清学治愈时间相关。HIV 阳性早期梅毒患者达到血清学治愈的时间比 HIV 阴性患者长，而晚期梅毒患者则无差异。
