Factors Associated with Serological Cure and the Serofast State of HIV-Negative Patients with Primary, Secondary, Latent, and Tertiary Syphilis

Some syphilis patients remain in a serologically active state after the recommended therapy. We currently know too little about the characteristics of this serological response. We conducted a cohort study using the clinical database from Zhongshan Hospital, Medical College of Xiamen. In total, 1,32...

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Published in:PloS one Vol. 8; no. 7; p. e70102
Main Authors: Tong, Man-Li, Lin, Li-Rong, Liu, Gui-Li, Zhang, Hui-Lin, Zeng, Yan-Li, Zheng, Wei-Hong, Liu, Li-Li, Yang, Tian-Ci
Format: Journal Article
Language:English
Published: United States Public Library of Science 23.07.2013
Public Library of Science (PLoS)
Subjects:
Adult
Analysis
Antibiotics
Azithromycin - therapeutic use
Bivariate analysis
Care and treatment
Cohort Studies
Disease
Doxycycline - therapeutic use
Female
Health risk assessment
HIV
HIV Infections - blood
HIV Infections - microbiology
HIV patients
Hospitals
Human immunodeficiency virus
Humans
Immunoglobulin M - blood
Immunoglobulins
Infections
Laboratories
Male
Mathematics
Medical schools
Medicine
Multivariate Analysis
Patients
Penicillin
Penicillin G - therapeutic use
Public health
Reagin
Reagins - blood
Sexually transmitted diseases
STD
Syphilis
Syphilis - blood
Syphilis - drug therapy
Syphilis - virology
Syphilis Serodiagnosis
Syphilis, Latent - blood
Syphilis, Latent - drug therapy
Syphilis, Latent - virology
Systematic review
Therapy
Treponema pallidum
Treponema pallidum - immunology
Young Adult
China
ISSN:1932-6203, 1932-6203
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Summary:Some syphilis patients remain in a serologically active state after the recommended therapy. We currently know too little about the characteristics of this serological response. We conducted a cohort study using the clinical database from Zhongshan Hospital, Medical College of Xiamen. In total, 1,327 HIV-negative patients with primary, secondary, latent, and tertiary syphilis were enrolled. Bivariate and multivariate analyses were utilised to identify factors associated with a serological cure and serofast state in syphilis patients one year after therapy. Chi-square tests were used to determine the differences in the serological cure rate across different therapy time points. One year after the recommended therapy, 870 patients achieved a serological cure, and 457 patients (34.4%) remained in the serofast state. The serological cure rate increased only within the first 6 months. The bivariate analysis indicated that male or younger patients had a higher likelihood of a serological cure than female or older patients. Having a baseline titre ≤ 1∶2 or ≥ 1∶64 was associated with an increased likelihood of a serological cure. The serological cure rate decreased for the different disease stages in the order of primary, secondary, latent, and tertiary syphilis. A distinction should be drawn between early and late syphilis. The multivariate analysis indicated that a serological cure was significantly associated with the disease phase, gender, age, and baseline rapid plasma reagin (RPR) titre. The serofast state is common in clinical work. After one year of the recommended therapy, quite a few syphilis patients remained RPR positive. The primary endpoint of the study indicated that disease phase, gender, age and baseline RPR titre were crucial factors associated with a serological cure.
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Competing Interests: The authors have declared that no competing interests exist.
Conceived and designed the experiments: TCY LLL MLT LRL GLL. Performed the experiments: MLT GLL HLZ YLZ WHZ. Analyzed the data: TCY LLL LRL. Contributed reagents/materials/analysis tools: MLT HLZ GLL YLZ. Wrote the paper: TCY LLL MLT.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0070102