Serological response to syphilis treatment in HIV-positive and HIV-negative patients attending sexually transmitted diseases clinics.

Ghanem, K G; Erbelding, E J; Wiener, Z S; Rompalo, A M

doi:10.1136/sti.2006.021402

Cited by 177Syphilis Diagnosis and TreatmentVector-borne infectious diseasesReproductive tract infections research

Serological response to syphilis treatment in HIV-positive and HIV-negative patients attending sexually transmitted diseases clinics.

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Ghanem, K G, Erbelding, E J, Wiener, Z S, Rompalo, A M·2007·Sexually Transmitted Infections

DOI 10.1136/sti.2006.021402PMC PMC2598600

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Abstract

BACKGROUND: HIV-positive patients treated for syphilis may be at increased risk for serological failure. OBJECTIVE: To compare follow-up serologies and serological responses to treatment between HIV-positive and HIV-negative patients attending two sexually transmitted disease (STD) clinics. STUDY DESIGN: Existing records were reviewed from HIV-positive patients who were diagnosed and treated for syphilis at the public STD clinics in Baltimore, Maryland, USA, between 1992 and 2000. Results of their serological follow-up were compared with those of HIV-negative clinic patients at the time of syphilis treatment. Failure was defined as lack of a fourfold drop in rapid plasma reagin (RPR) titre by 400 days after treatment or a fourfold increased titre between 30 and 400 days. RESULTS: Of the 450 HIV-positive patients with syphilis, 288 (64%) did not have documented follow-up serologies and 129 (28.5%) met the inclusion criteria; 168 (17%) of 1000 known HIV-negative patients were similarly eligible. There were 22 failures in the HIV-positive group and 5 in the HIV-negative group (p<0.001). The median times to successful serological responses in both groups were 278 (95% confidence interval (CI) 209 to 350) and 126 (95% CI 108 to 157) days, respectively (p<0.001). A multivariate Cox's proportional hazards model showed an increased risk of serological failure among the HIV-positive patients (hazards ratio 6.0, 95% CI 1.5 to 23.9; p = 0.01). CONCLUSION: HIV-positive patients treated for syphilis may be at higher risk of serological failure. Despite recommendations for more frequent serological follow-up, most patients did not have documentation of serological response after standard treatment for syphilis.

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Nontreponemal test titers might decrease more slowly for persons previously treated for syphilis.
“In addition, nontreponemal test titers might decrease more slowly for persons previously treated for syphilis (594,595).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [594]
The Results (page unavailable) mention a history of syphilis infection, but do not compare titre declines by prior treatment history. The paper compares response times by HIV status and syphilis stage; searches for prior treatment and serological response found no passage addressing whether previously treated patients’ titres decline more slowly. (LLM, conf=0.76)
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Authors: Ghanem, K. G., Erbelding, E. J., Wiener, Z. S., & Rompalo, A. M.
Affiliations: Johns Hopkins University (US)
Corresponding author: Ghanem, K G
ORCID: Ghanem, K G
Rompalo, A M
Venue: Sexually Transmitted Infections
Publisher: BMJ
Published: 2006-08-30
Volume: 83
Issue: 2
Pages: 97-101
ISSN: 0007-134X (ISSN-L)
1368-4973
DOI: 10.1136/sti.2006.021402
PMC: PMC2598600
OpenAlex: W2025129013
Cited by: 177
References: 23
Citations by year: 2026: 6 · 2025: 9 · 2024: 2 · 2023: 13 · 2022: 7 · 2021: 12 · 2020: 13 · 2019: 10 · 2018: 8 · 2017: 5 · 2016: 10 · 2015: 13 · 2014: 11 · 2013: 6 · 2012: 6
FWCI: 5.08
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Sexually Transmitted Infections (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Funders: National Institutes of Health
National Institute of Allergy and Infectious Diseases (R01AI045724)
Topics: Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
Life Sciences › Immunology and Microbiology › Parasitology › Vector-borne infectious diseases
Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Keywords: syphilis, HIV infection, treatment response, serological follow-up, sexually transmitted infections, people living with HIV
MeSH terms: Adult, Female, Hematologic Diseases, HIV Seropositivity, Humans, Male, Middle Aged, Reagins, Syphilis, Proportional Hazards Models

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Serological response to syphilis treatment in HIV-positive and HIV-negative patients attending sexually transmitted diseases clinics.

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