Response to therapy following retreatment of serofast early syphilis patients with benzathine penicillin.
Open accessAbstract
Persistent nontreponemal titers after treatment are common among patients with early syphilis. We retreated 82 human immunodeficiency virus-negative early syphilis participants who were serofast at 6 months using benzathine penicillin. Only 27% exhibited serological response after retreatment and after an additional 6 months of follow-up.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Serologic titers might not decrease despite a negative CSF examination and a repeated 3-week therapy course.
“Serologic titers might not decrease, despite a negative CSF examination and a repeated 3-week therapy course (599).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [599]
The Discussion reports that 73% of patients remained serofast after retreatment, supporting the possibility that titers may not fall. But the Methods specify a single retreatment dose, and the brief report (p. 421) says the investigators did not perform CSF examinations at the 12-month visit; it mentions a three-week course only as recommended therapy, not as the course studied. The paper therefore does not establish the claim under the stated negative-CSF and three-week-treatment conditions. (LLM, conf=0.90)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines
Workowski, K., & Berman, S. M. (2007) · Clinical Infectious Diseases · doi:10.1086/511430 · Cited by 1,977 · see citing works
Sexually Transmitted Diseases 7982 Treatment Guidelines
Workowski, K., & Berman, S. M. (1982) · American Pharmacy · doi:10.1016/s0160-3450(16)31823-2 · Cited by 1,573 · see citing works
Rolfs, R. T., Joesoef, M. R., Hendershot, E. F., Rompalo, A. M., Augenbraun, M. H., Chiu, M., Bolan, G., Johnson, S. C., French, P., Steen, E., et al. (1997) · New England Journal of Medicine · doi:10.1056/nejm199707313370504 · Cited by 550 · see citing works
THE MODERN TREATMENT OF SYPHILIS
Moore, J. E. (1934) · The American Journal of the Medical Sciences · doi:10.1097/00000441-193405000-00020 · Cited by 181 · see citing works
Sena, A. C., Wolff, M., Martin, D. H., Behets, F., Van Damme, K., Leone, P., Langley, C., McNeil, L., & Hook, E. W. (2011) · Clinical Infectious Diseases · doi:10.1093/cid/cir671 · Cited by 132 · see citing works
Hook III, E. W., Behets, F., Van Damme, K., Ravelomanana, N., Leone, P., Sena, A. C., Martin, D., Langley, C., McNeil, L., & Wolff, M. (2010) · The Journal of Infectious Diseases · doi:10.1086/652239 · Cited by 121 · see citing works
Current Controversies in the Management of Adult Syphilis
Stoner, B. P. (2007) · Clinical Infectious Diseases · doi:10.1086/511426 · Cited by 67 · see citing works
The Modern Treatment of Syphilis (2nd ed.)
Brumfield, W. A. (1942) · American Journal of Public Health and the Nations Health · doi:10.2105/ajph.32.8.877-a · Cited by 15 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Sexually Transmitted Infections Treatment Guidelines, 2021
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7004a1 · Cited by 2,759 · see citing works
Sexually Transmitted Diseases Treatment Guidelines, 2010
Workowski, K., & BOLAN, G. A. (2011) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2011.04.006 · Cited by 2,074 · see citing works
The Modern Epidemic of Syphilis
Ghanem, K. G., Ram, S., & Rice, P. A. (2020) · New England Journal of Medicine · doi:10.1056/nejmra1901593 · Cited by 532 · see citing works
Hook, E. W. (2017) · The Lancet · doi:10.1016/s0140-6736(16)32411-4 · Cited by 446 · see citing works
Clement, M. E., Okeke, N. L., & Hicks, C. B. (2014) · JAMA · doi:10.1001/jama.2014.13259 · Cited by 315 · see citing works
Seña, A. C., Zhang, X.-H., Li, T., Zheng, H.-P., Yang, B., Yang, L.-G., Salazar, J. C., Cohen, M. S., Moody, M. A., Radolf, J. D., et al. (2015) · BMC Infectious Diseases · doi:10.1186/s12879-015-1209-0 · Cited by 150 · see citing works
Cohen, S. E., Klausner, J. D., Engelman, J., & Philip, S. (2013) · Infectious Disease Clinics of North America · doi:10.1016/j.idc.2013.08.005 · Cited by 115 · see citing works
Syphilis: antibiotic treatment and resistance
Stamm, L. V. (2014) · Epidemiology and Infection · doi:10.1017/s0950268814002830 · Cited by 114 · see citing works
Forrestel, A. K., Kovarik, C., & Katz, K. A. (2019) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2019.02.074 · Cited by 90 · see citing works
Syphilis in Dermatology: Recognition and Management
Whiting, C., Schwartzman, G. H., & Khachemoune, A. (2023) · American Journal of Clinical Dermatology · doi:10.1007/s40257-022-00755-3 · Cited by 76 · see citing works
Chi, K.-H., Danavall, D. C., Taleo, F., Pillay, A., Ye, T., Nachamkin, E., Kool, J. L., Fegan, D. J., Asiedu, K. B., Vestergaard, L. S., et al. (2014) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.14-0459 · Cited by 68 · see citing works
Ramchandani, M. S., Cannon, C. A., & Marra, C. M. (2023) · Infectious Disease Clinics of North America · doi:10.1016/j.idc.2023.02.006 · Cited by 55 · see citing works
Chevalier, F., Bacon, O., Johnson, K. A., & Cohen, S. E. (2025) · JAMA · doi:10.1001/jama.2025.17362 · Cited by 62 · see citing works
Ghanem, K. G. (2015) · Clinical Infectious Diseases · doi:10.1093/cid/civ714 · Cited by 53 · see citing works
Adhikari, E. H. (2020) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000003788 · Cited by 51 · see citing works
Syphilis testing, typing, and treatment follow-up
Tipple, C., & Taylor, G. P. (2014) · Current Opinion in Infectious Diseases · doi:10.1097/qco.0000000000000124 · Cited by 46 · see citing works
Emerging trends and persistent challenges in the management of adult syphilis
Tuddenham, S., & Ghanem, K. G. (2015) · BMC Infectious Diseases · doi:10.1186/s12879-015-1028-3 · Cited by 45 · see citing works
Zhang, R.-L., Wang, Q.-Q., Zhang, J.-P., & Yang, L.-J. (2017) · PLoS ONE · doi:10.1371/journal.pone.0175477 · Cited by 39 · see citing works
Tsai, S., Sun, M. Y., Kuller, J. A., Rhee, E. H. J., & Dotters-Katz, S. (2019) · Obstetrical & Gynecological Survey · doi:10.1097/ogx.0000000000000713 · Cited by 36 · see citing works
Haule, A. R., Msemwa, B., Mgaya, E., Masikini, P. J., & Kalluvya, S. E. (2020) · BMC Public Health · doi:10.1186/s12889-020-09984-9 · Cited by 30 · see citing works
Tipple, C., Jones, R., McClure, M. O., & Taylor, G. P. (2015) · PLoS neglected tropical diseases · doi:10.1371/journal.pntd.0003492 · Cited by 28 · see citing works
Syphilis Diagnosis and Treatment: State of The Art
Trovato, E., Tognetti, L., Campoli, M., Cinotti, É., & Rubegni, P. (2021) · European Medical Journal · doi:10.33590/emj/20-00221 · Cited by 31 · see citing works
Tang, E. C., Segura, E. R., Clark, J. L., Sánchez, J., & Lama, J. R. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-008552 · Cited by 23 · see citing works
Ren, R.-X., Wang, L.-N., Zheng, H.-Y., & Li, J. (2016) · International Journal of STD & AIDS · doi:10.1177/0956462415573677 · Cited by 23 · see citing works
Salado-Rasmussen, K., Hoffmann, S., Cowan, S. A., Jensen, J. S., Benfield, T., Gerstoft, J., & Katzenstein, T. L. (2014) · Acta Dermato Venereologica · doi:10.2340/00015555-2289 · Cited by 22 · see citing works
Pastuszczak, M., Sitko, M., Bociąga‐Jasik, M., Kucharz, J., & Wojas‐Pelc, A. (2018) · Medicine · doi:10.1097/md.0000000000013171 · Cited by 18 · see citing works
Spagnuolo, V., Poli, A., Galli, L., Nozza, S., Bossolasco, S., Cernuschi, M., Maillard, M., Hasson, H., Gianotti, N., Guffanti, M., et al. (2018) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofy324 · Cited by 18 · see citing works
Osias, E. A., Hung, P., Giacani, L., Stafylis, C., Konda, K. A., Vargas, S. K., Reyes-Díaz, M., Comulada, W. S., Haake, D. A., Haynes, A. M., et al. (2020) · BMC Infectious Diseases · doi:10.1186/s12879-020-05141-0 · Cited by 15 · see citing works
Wang, Z., Liu, X., & Li, J. (2018) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dky006 · Cited by 15 · see citing works
Zhang, X., Andrea, S., Yang, L., Xue, Y., Wang, L., Yang, B., Zheng, H., Chen, J. S., Radolf, J. D., & Seña, A. C. (2020) · Sexually Transmitted Diseases · doi:10.1097/olq.0000000000001321 · Cited by 14 · see citing works
Association of interleukin-10 promoter polymorphisms with serofast state after syphilis treatment
Pastuszczak, M., Jakieła, B., & Wojas‐Pelc, A. (2018) · Sexually Transmitted Infections · doi:10.1136/sextrans-2018-053753 · Cited by 14 · see citing works
Dionne‐Odom, J., Giacani, L., Tamhane, A. R., Workowski, K., Lieberman, N. A. P., Greninger, A. L., Perlowski, C., Newman, L. M., & Hook, E. W. (2023) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiad582 · Cited by 13 · see citing works
Tan, X., Zhang, J., Li, J., Yue, X., & Gong, X. (2020) · PLoS ONE · doi:10.1371/journal.pone.0241572 · Cited by 13 · see citing works
Could lengthening minocycline therapy better treat early syphilis?
Shao, L., Guo, R., Shi, W.-J., Liu, Y., Feng, B., Han, L., & Liu, Q. (2016) · Medicine · doi:10.1097/md.0000000000005773 · Cited by 13 · see citing works
Clinical management of early syphilis
Holman, K. M., & Hook, E. W. (2013) · Expert Review of Anti-infective Therapy · doi:10.1586/14787210.2013.814865 · Cited by 12 · see citing works
Predictors of serofast state after treatment for early syphilis in HIV‐infected patients
Paul, G., Wesselmann, J. T., Adzic, D., Malin, J. J., Suárez, I., Priesner, V., Kümmerle, T., Wyen, C., Jung, N., van Bremen, K., et al. (2020) · HIV Medicine · doi:10.1111/hiv.12985 · Cited by 11 · see citing works
[Translated article] AEDV Expert Consensus for the Management of Syphilis
de Vega, L. F., García, J. M. D. L. T., Farfante, J. M. S., & Ceballos-Rodríguez, M. C. (2024) · Actas Dermo-Sifiliográficas · doi:10.1016/j.ad.2024.08.006 · Cited by 10 · see citing works
The Utility of Biomarkers in the Clinical Management of Syphilis: A Systematic Review
Lorenz, Z. W., Nijhar, S., Caufield-Noll, C. P., Ghanem, K. G., & Hamill, M. M. (2023) · Sexually Transmitted Diseases · doi:10.1097/olq.0000000000001813 · Cited by 10 · see citing works
Is repeated retreatment necessary for HIV‑negative serofast early syphilis patients?
Liu, Y., Bian, Q., Zhang, S., Wang, J., Wang, Z., & Li, J. (2019) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2019.8180 · Cited by 10 · see citing works
Peripheral blood mononuclear cell microRNA profiles in syphilitic patients with serofast status
Jia, X., Wang, Z., Liu, X., Zheng, H., & Li, J. (2020) · Molecular Biology Reports · doi:10.1007/s11033-020-05421-7 · Cited by 9 · see citing works
Shukla, M. R., Pereira, L., Gaynor, A. M., Sun, Y., Edwards, D., Simmons, T., Andrews, C., Park, I. U., Hong, J., Cao, W., et al. (2023) · Journal of Clinical Microbiology · doi:10.1128/jcm.00168-23 · Cited by 9 · see citing works
Wu, M. Y., Chen, L., Liu, L. C., Liu, M., Li, Y. F., Zheng, H. Y., Leng, L., Zou, Y. J., Chen, W. J., & Li, J. (2024) · iScience · doi:10.1016/j.isci.2024.109399 · Cited by 7 · see citing works
Zheng, Y., Chen, H., Shen, X., Lin, Y., & Lin, L. (2021) · Clinica Chimica Acta · doi:10.1016/j.cca.2021.09.019 · Cited by 7 · see citing works
Hembert, R., Salle, R., Grange, P., Ollagnier, G., Benhaddou, N., Heller, U., Saule, J., Giudice, P. D., Fouéré, S., Bertolotti, A., et al. (2023) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.19761 · Cited by 6 · see citing works
The serological dilemma: rethinking syphilis treatment evaluation
Yao, J., Ling, P., Ding, X., Zhang, X., LIN, T. ‐., Xiao, Y., Liu, S., & Zhao, F. (2025) · Expert Review of Anti-infective Therapy · doi:10.1080/14787210.2025.2467646 · Cited by 6 · see citing works
Kojima, N., Siebert, J., Maecker, H. T., Rosenberg‐Hasson, Y., León, S. R., Vargas, S. K., Konda, K. A., Cáceres, C. F., & Klausner, J. D. (2020) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiaa127 · Cited by 6 · see citing works
Predictors of serofast state after treatment of patients with syphilis
Liu, X., Wang, Z., & Li, J. (2020) · Chinese Medical Journal · doi:10.1097/cm9.0000000000001175 · Cited by 5 · see citing works
Plasma Exosome-Derived microRNAs Profiles in Patients with Serofast Status: A Cross-Sectional Study
Liu, J., Zhang, R., Lian, T., Chen, Z., Zhang, R., & Wang, Q. (2023) · International Journal of General Medicine · doi:10.2147/ijgm.s404545 · Cited by 5 · see citing works
Documento de expertos de la AEDV para el manejo de la sífilis
de Vega, L. F., García, J. M. D. L. T., Farfante, J. M. S., & Ceballos-Rodríguez, M. C. (2024) · Actas Dermo-Sifiliográficas · doi:10.1016/j.ad.2024.03.033 · Cited by 5 · see citing works
Evaluation of serum cytokines to predict serofast in syphilis patients
Qiang, D., Wang, J., Ci, C., Tang, B., Ke, G., Chang, X., Bi-hua, J., & Shao, X. (2020) · Journal of Infection and Chemotherapy · doi:10.1016/j.jiac.2020.04.020 · Cited by 4 · see citing works
Current standards for syphilis treatment: comparing the russian and foreign guidelines (part II)
Krasnoselskikh, Т. V., & Sokolovskiy, E. V. (2015) · Vestnik dermatologii i venerologii · doi:10.25208/0042-4609-2015-91-2-23-40 · Cited by 4 · see citing works
Harjanto, R., Smith, D. E., Barratt, H., Kelly, M. L., Chan, D. J., Furner, V., Smith, M., Ronnachit, A., Post, J. J., & Rawlinson, W. D. (2020) · Sexual Health · doi:10.1071/sh20043 · Cited by 3 · see citing works
Changes of serofast status in HIV negative asymptomatic neurosyphilis patients after treatment
Liu, J., Zhao, T., Zhou, C., Yan, H., & Lun, W. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.938016 · Cited by 3 · see citing works
Casado, J. L., Vizcarra, P., Izuzquiza, I., Rodríguez-Domínguez, M., Romero‐Hernández, B., Moreno, A. H., & Vallejo, A. (2026) · Clinical Infectious Diseases · doi:10.1093/cid/ciag193 · Cited by 2 · see citing works
Henriques, B. L., Cortez, A. L., Nunes, N. N., Vidal, J. E., & Avelino‐Silva, V. I. (2022) · HIV Medicine · doi:10.1111/hiv.13306 · Cited by 2 · see citing works
Serological follow-up after syphilis diagnosis in Israel
Cohen, G. G., Cohen, M. J., Dveyrin, Z., Mor, Z., Rorman, E. G., & Kaliner, E. (2024) · Epidemiology and Infection · doi:10.1017/s0950268824000566 · Cited by 2 · see citing works
Yan, R., Xu, Y., Tong, J., Chen, P., Huang, L., Wen, G.-C., Li, L., Zhang, C., Deng, Y., Cai, Y.-M., et al. (2025) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiaf193 · Cited by 2 · see citing works
Konda, K. A., Kojima, N., Vargas, S. K., Calvo, G., Reyes-Díaz, M., Giacani, L., Cáceres, C. F., & Klausner, J. D. (2021) · Clinical Infectious Diseases · doi:10.1093/cid/ciab877 · Cited by 2 · see citing works
Analysis of Factors Determining Serologic Response to Treatment of Early Syphilis in Adult Men
Czarny, J. H., Kadylak, D., Sokołowska‐Wojdyło, M., & Nowicki, R. J. (2025) · Infectious Disease Reports · doi:10.3390/idr17030041 · Cited by 1 · see citing works
Yılmaz, E., Özer, N. K., & Topal, E. (2026) · Clinical Infectious Diseases · doi:10.1093/cid/ciag643 · Cited by 1 · see citing works
Clement, M. E., Okeke, N. L., & Hicks, C. B. (2015)
(2021) · Clinical Infectious Diseases · doi:10.1093/cid/ciab291
Plasma Exosome-derived MicroRNAs profiles in patients with serofast syphilisPreprint
Liu, J., Zhang, R., Lian, T., Chen, Z., Zhang, R., & Wang, Q. (2022) · Research Square · doi:10.21203/rs.3.rs-2132314/v1
Lawrence, S. M. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-79525-8.00026-3
Sethi, S. K., Kanaujia, R., Sankaranantham, M., Sharma, N., Kaur, K., & Chaudhry, H. (2025) · Indian Journal of Sexually Transmitted Diseases and AIDS · doi:10.4103/ijstd.ijstd_66_24
Syphilis treatment outcomes in HIV-coinfected patients: a retrospective study
Krasnoselskikh, Т. V., Shved, O. V., Manasheva, E. B., Danilyuk, M. I., Chirskaya, M. A., Виноградова, Т. Н., & Sokolovskiy, E. V. (2026) · Vestnik dermatologii i venerologii · doi:10.25208/vdv16940
The Role of TH17 Cells and Treg Cells in the Pathogenesis of Serofast Syphilis
牛, 楚. (2026) · Medical Diagnosis · doi:10.12677/md.2026.162027
Sabranski, M., Schäfer, G., Fenske, S., Adam, A., Hansen, S., Schewe, K., Buhk, T., Hinrichs, M., & Hoffmann, C. (2026) · Infection · doi:10.1007/s15010-026-02950-4
- Authors
- Sena, A. C., Wolff, M., Behets, F., Van Damme, K., Martin, D. H., Leone, P., McNeil, L., & Hook, E. W.
- Affiliations
- Emmes (United States) (US)
- University of North Carolina at Chapel Hill (US)
- Louisiana State University (US)
- Family Health International 360 (US)
- University of Alabama at Birmingham (US)
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-11-01
- Volume
- 56
- Issue
- 3
- Pages
- 420-422
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- PMC
- PMC3590030
- OpenAlex
- W2151862494
- Cited by
- 69
- References
- 8
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 3 · 2021: 5 · 2020: 12 · 2019: 3 · 2018: 4 · 2017: 1 · 2016: 2 · 2015: 8 · 2014: 5 · 2013: 2
- FWCI
- 3.22
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Infectious Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- GlaxoSmithKline
- Louisiana State University
- U.S. Public Health Service (N01 A1 75329)
- University of North Carolina at Chapel Hill
- School of Medicine, Indiana University
- Abbott Diagnostics
- National Institute of Allergy and Infectious Diseases
- Topics
- Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Historical Medical Research and Treatments
- Life Sciences › Immunology and Microbiology › Parasitology › Vector-borne infectious diseases
- Keywords
- early syphilis, benzathine penicillin, retreatment, serological response, treatment response
- MeSH terms
- Adolescent, Adult, Anti-Bacterial Agents, Female, Humans, Male, Middle Aged, Penicillin G Benzathine, Syphilis, Syphilis Serodiagnosis, Time Factors, Treatment Outcome, Retreatment, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review