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Muccini C, Gianotti N, Diotallevi S, Lolatto R, Spagnuolo V, Canetti D, Bagaglio S, Perez VG, Clemente T, Bottanelli M, Candela C, Nozza S, Castagna A. One Year of Long-Acting Cabotegravir and Rilpivirine in People With Human Immunodeficiency Virus and Long Exposure to Antiretroviral Therapy: Data From the SCohoLART Study. Open Forum Infect Dis 2024; 11:ofae326. [PMID: 38962526 PMCID: PMC11221778 DOI: 10.1093/ofid/ofae326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/28/2024] [Indexed: 07/05/2024] Open
Abstract
Background The aim of the study was to evaluate the 12-month cumulative probability of treatment discontinuation (TD) in people with human immunodeficiency virus (HIV; PWH) and a long exposure to antiretroviral therapy (ART) switching to long-acting cabotegravir and rilpivirine (CAB/RPV). Methods SCohoLART is a single-center, prospective, cohort study designed to collect both samples and clinical data from PWH with virological suppression who switched to bimonthly long-acting CAB/RPV. TD occurred at switch to another regimen for any reason including virological failure (VF); VF was defined as HIV RNA levels ≥50 copies/mL at 2 consecutive measurements or a single HIV RNA level ≥1000 copies/mL. Results were reported as median (interquartile range [IQR]) or frequency (percentage). Cumulative probabilities of TD were estimated using Kaplan-Meier curves. Results We evaluated 514 participants; 467 (90.9%) were male, and their median age (IQR) was 49 (40-56) years. At the time of switching, the median time from HIV diagnosis and the median duration of ART were 14.0 (IQR, 8.8-20.5) and 11.4 (7.9-17.4) years, respectively; before starting CAB/RPV, the median number of antiretroviral regimens was 3 (2-4). During a median study follow-up (IQR) of 13.1 (9.1-15.5) months, 52 PWH (10.1%) experienced TD, including 4 (0.8%) for VF. The 12-month cumulative probability of TD was 11% (95% confidence interval, 8%-14%). The main cause of TD was injection site reaction (15 participants [28.8%]). Conclusions The 1-year cumulative probability of TD with long-acting CAB/RPV was quite low in this cohort of people with a median exposure to ART of 10 years, in whom injection site reaction was the leading cause of TD. VFs were rare during study follow-up.
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Affiliation(s)
- Camilla Muccini
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nicola Gianotti
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Diotallevi
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Lolatto
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Vincenzo Spagnuolo
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Diana Canetti
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sabrina Bagaglio
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Victoria Gordo Perez
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | - Silvia Nozza
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Antonella Castagna
- Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
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Pasin C, Nuñez DG, Kusejko K, Hachfeld A, Buvelot H, Cavassini M, Damonti L, Fux C, de Tejada BM, Notter J, Trkola A, Günthard HF, Aebi-Popp K, Kouyos RD, Abela IA. Impact of hormonal therapy on HIV-1 immune markers in cis women and gender minorities. HIV Med 2024. [PMID: 38830635 DOI: 10.1111/hiv.13677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/17/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Although sex hormones are recognized to induce immune variations, the effect of hormonal therapy use on immunity is only poorly understood. Here, we quantified how hormonal therapy use affects HIV-1 immune markers in cis women (CW) and trans women and non-binary people (TNBP) with HIV. METHODS We considered CD4, CD8 and lymphocyte measurements from cis men (CM), CW and TNBP in the Swiss HIV Cohort Study. We modelled HIV-1 markers using linear mixed-effects models with an interaction between 'gender' (CW, TNBP) and 'hormonal therapy use' (yes/no). Models were adjusted on age, ethnicity, education level, time since start of antiretroviral therapy and use of intravenous drugs. We assessed the inflammatory effect of hormonal therapy use in 31 TNBP using serum proteomics measurements of 92 inflammation markers. RESULTS We included 54 083 measurements from 3092 CW and 83 TNBP, and 147 230 measurements from 8611 CM. Hormonal therapy use increased CD4 count and CD4:CD8 ratio in TNBP more than in CW (pinteraction = 0.02 and 0.007, respectively). TNBP with hormonal therapy use had significantly higher CD4 counts [median = 772 cells/μL, interquartile range (IQR): 520-1006] than without (617 cells/μL, 426-892). This was similar to the effect of CW versus CM on CD4 T cells. Hormonal therapy use did not affect serum protein concentrations in TNBP. CONCLUSION This study highlights the potential role of hormonal therapy use in modulating the immune system among other biological and social factors, especially in TNBP with HIV.
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Affiliation(s)
- Chloé Pasin
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
- Collegium Helveticum, Zurich, Switzerland
| | - David Garcia Nuñez
- Center for Gender Variance, Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
| | - Katharina Kusejko
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Anna Hachfeld
- Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland
| | - Hélène Buvelot
- Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Matthias Cavassini
- Division of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland
| | - Lauro Damonti
- Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland
- Ente Ospedaliero Cantonale, Division of Infectious Diseases, Regional Hospital Lugano, Lugano, Switzerland
| | - Christoph Fux
- Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Aarau, Switzerland
| | - Begoña Martinez de Tejada
- Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Julia Notter
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Alexandra Trkola
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Huldrych F Günthard
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Karoline Aebi-Popp
- Department of Infectious Diseases, University Hospital Bern, Bern, Switzerland
| | - Roger D Kouyos
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Irene A Abela
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
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Weir BW, Wirtz AL, Chemnasiri T, Baral SD, Decker M, Dun C, Hnin Mon SH, Ungsedhapand C, Dunne EF, Woodring J, Pattanasin S, Sukwicha W, Thigpen MC, Varangrat A, Warapornmongkholkul A, O'Connor S, Ngo JP, Qaragholi N, Sisel HI, Truong JM, Janyam S, Linjongrat D, Sriplienchan S, Sirivongrangson P, Rooney JF, Sullivan P, Chua-Intra B, Hickey AC, Beyrer C. High PrEP uptake, adherence, persistence and effectiveness outcomes among young Thai men and transgender women who sell sex in Bangkok and Pattaya, Thailand: findings from the open-label combination HIV prevention effectiveness (COPE) study. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 15:100217. [PMID: 37614346 PMCID: PMC10442968 DOI: 10.1016/j.lansea.2023.100217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/06/2023] [Accepted: 05/02/2023] [Indexed: 08/25/2023]
Abstract
Background Daily oral pre-exposure prophylaxis (PrEP) is effective in preventing HIV infection, but no study has evaluated combination prevention interventions with PrEP for transgender women (TGW) and men who have sex with men (MSM) who sell sex. Methods The Combination Prevention Effectiveness (COPE) study was a community-based, non-randomized implementation study in Bangkok and Pattaya, Thailand. Participants were HIV-negative MSM and TGW aged 18-26 years who reported exchanging sex with men in the prior 12 months and who met 2014 U.S. Public Health Service PrEP eligibility criteria. The intervention included quarterly HIV testing, semiannual testing for sexually transmitted infections, provision of condoms with lubricant, and the opportunity to initiate or end daily oral PrEP use at any time during study participation. Participants taking PrEP received monthly adherence counseling and short message service reminders. The primary outcome was HIV incidence rate ratio (IRR) on PrEP vs. not on PrEP. Secondary outcomes were PrEP initiation, PrEP use at 12 months, and PrEP adherence. Findings From October 2017 to August 2019, 846 participants were enrolled: 531 (62.8%) immediately initiated PrEP; 104 (12.3%) subsequently initiated PrEP, and 211 (24.9%) never initiated PrEP. Among those initiating PrEP within 30 days of enrollment; 85.9% were on PrEP at the 12-months. When taking PrEP, participants reported adherent PrEP use at 94.2% of quarterly assessments. Ten HIV seroconversions occurred without PrEP use (incidence rate [IR] = 3.42 per 100 person-years [PY]; 95% CI = 1.64-6.30), while zero cases occurred with PrEP use (IR = 0.0 per 100PY; 95% CI = 0.0-0.62), with IRR = 0.0 (95% CI = 0.0-0.22; p < 0.001). Interpretation Young Thai MSM and TGW who exchange sex can have high PrEP uptake, persistence and adherence, and low HIV incidence when offered in supportive community-based settings. Funding U.S. National Institute of Allergy and Infectious Diseases; Centers for Disease Control and Prevention.
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Affiliation(s)
- Brian W. Weir
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrea L. Wirtz
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tareerat Chemnasiri
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Stefan D. Baral
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michele Decker
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chen Dun
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sandra Hsu Hnin Mon
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chaiwat Ungsedhapand
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Eileen F. Dunne
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Joseph Woodring
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Sarika Pattanasin
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Wichuda Sukwicha
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Michael C. Thigpen
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Anchalee Varangrat
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Anchalee Warapornmongkholkul
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Siobhan O'Connor
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julie P. Ngo
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Noor Qaragholi
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Haley I. Sisel
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jasmine M. Truong
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Surang Janyam
- Service Workers in Group Foundation (SWING), Bangkok and Pattaya, Thailand
| | | | | | - Pachara Sirivongrangson
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | | | - Patrick Sullivan
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Boosbun Chua-Intra
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Andrew C. Hickey
- Division of HIV Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
- Division of HIV Prevention, Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand
| | - Chris Beyrer
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
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Begovac J, Romih Pintar V, Vrsaljko N, Močibob L, Bogdanić N, Zekan Š, Đaković Rode O. Incidence, risk factors, and clinical findings of syphilis among men living with HIV in Croatia during the COVID-19 pandemic. Sci Rep 2023; 13:11784. [PMID: 37479770 PMCID: PMC10361976 DOI: 10.1038/s41598-023-38807-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023] Open
Abstract
We conducted a nationwide longitudinal observational study to estimate the incidence of syphilis in a cohort of male persons living with HIV (MLWH) in Croatia in the pre-COVID-19 and COVID-19 years. Data were reviewed and extracted from the clinical database. We analyzed 1187 MLWH (≥ 18 years) in care in Croatia from 2018 to 2021 and used Poisson regression to calculate rates. We observed a 91.4% increase in incidence between 2019 and 2020; the overall rate was 6.0/100 person-years, and the annual rate ranged from 3.3/100 person-years in 2018 to 9.3/100 person-years in 2021. We found higher rates in men who have sex with men, MLWH with a baseline history of syphilis, MLWH with a more recent HIV diagnosis, and a lower rate in those who had clinical AIDS. The rate of syphilis serological testing was 3.5% lower in 2020 compared to 2019. Recurrent syphilis was more likely asymptomatic compared to the first episodes. In conclusion, during the COVID-19 epidemic years, there was a huge increase in syphilis. Results highlight the need for enhanced and novel prevention interventions.
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Affiliation(s)
- Josip Begovac
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia.
- School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Vanja Romih Pintar
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Nina Vrsaljko
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Loris Močibob
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Nikolina Bogdanić
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
| | - Šime Zekan
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Oktavija Đaković Rode
- University Hospital for Infectious Diseases "Dr. Fran Mihaljević", Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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5
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Blohm A, O'Donnell A, Simmons K, Fitzpatrick C, Williams D, Richardson D. Early syphilis and transient loss of HIV virological control in people living with HIV on antiretroviral therapy. J Eur Acad Dermatol Venereol 2023; 37:e441-e442. [PMID: 36178168 DOI: 10.1111/jdv.18627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/23/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Alice Blohm
- Sexual Health & HIV, University Hospitals Sussex NHS foundation Trust, Brighton, UK
| | - Alice O'Donnell
- Sexual Health & HIV, University Hospitals Sussex NHS foundation Trust, Brighton, UK
| | - Kiersten Simmons
- Sexual Health & HIV, University Hospitals Sussex NHS foundation Trust, Brighton, UK
| | - Colin Fitzpatrick
- Sexual Health & HIV, University Hospitals Sussex NHS foundation Trust, Brighton, UK
| | - Deborah Williams
- Sexual Health & HIV, University Hospitals Sussex NHS foundation Trust, Brighton, UK
| | - Daniel Richardson
- Sexual Health & HIV, University Hospitals Sussex NHS foundation Trust, Brighton, UK.,Brighton & Sussex Medical School, Brighton, UK
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Chan P, Tang THC, Kwong RTS, Chan L, Chan HSY, Lam KW, Ting WM, Yung SK, Lam ECT, Chu MY, Lam W, Wu TC, Li P, Lee MP. Effects of syphilis infection among HIV-1-positive individuals on suppressive antiretroviral therapy. AIDS Res Ther 2022; 19:69. [PMID: 36587188 PMCID: PMC9805186 DOI: 10.1186/s12981-022-00493-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 12/19/2022] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Incident syphilis leads to changes in plasma HIV-1 RNA and CD4 + T-cell level in people with HIV (PWH) with viraemia. Its effect in PWH on suppressive antiretroviral therapy (ART) is less clear. METHODS PWH on suppressive ART (plasma HIV-1 RNA < 50copies/mL) followed at the Queen Elizabeth Hospital, Hong Kong, China were regularly screened for syphilis. Their plasma HIV-1 RNA, CD4 + and CD8 + T-cell, and total lymphocyte levels before syphilis, during syphilis, and after successful treatment were compared. RESULTS Between 2005 and 2020, 288 syphilis episodes from 180 individuals were identified; 287 episodes were related to male, with a median age of 41 at diagnosis; 221 (77%) were syphilis re-infection. The rates of plasma HIV-1 suppression were statistically unchanged across the time-points (97% pre-syphilis, 98% during syphilis, and 99% post-treatment). Total lymphocyte, CD4+ and CD8+ T-cell levels decreased during incident syphilis (p<0.01), and rebounded post-treatment (p<0.01). VDRL titre was associated with declines in CD4+ T-cell (p=0.045), CD8+ T-cell (p=0.004), and total lymphocyte levels (p=0.021). Pre-syphilis CD4/CD8 ratio was associated with increases in CD8+ T-cell (p=0.001) and total lymphocyte levels (p=0.046) during syphilis. Syphilis re-infection was associated with an increase in total lymphocyte level (p=0.037). In the multivariable analysis, only pre-syphilis CD4/CD8 ratio was independently associated with increases in CD8+ T-cell (p=0.014) and total lymphocyte levels (p=0.039) during syphilis. CONCLUSIONS Among virally-suppressed PWH, total lymphocyte, CD4+, and CD8+ T-cell levels declined during incident syphilis but rebounded post-treatment. The status of plasma HIV suppression was unaffected by syphilis.
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Affiliation(s)
- Phillip Chan
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China ,grid.513257.70000 0005 0375 6425Institute of HIV Research and Innovation, Bangkok, Thailand
| | - Tommy H. C. Tang
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Ruby T. S. Kwong
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Lawrence Chan
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Helen S. Y. Chan
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - K. W. Lam
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - W. M. Ting
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - S. K. Yung
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Emily C. T. Lam
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - M. Y. Chu
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Wilson Lam
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - T. C. Wu
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Patrick Li
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China ,grid.414329.90000 0004 1764 7097Hong Kong Sanatorium & Hospital, Hong Kong, China
| | - M. P. Lee
- grid.415499.40000 0004 1771 451XDepartment of Medicine, Queen Elizabeth Hospital, Hong Kong, China
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7
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Clinical features and incidence of visual improvement following systemic antibiotic treatment in patients with syphilitic uveitis. Sci Rep 2022; 12:12553. [PMID: 35869241 PMCID: PMC9307809 DOI: 10.1038/s41598-022-16780-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/15/2022] [Indexed: 11/15/2022] Open
Abstract
To describe the clinical features, longitudinal pattern, and incidence rate of improvement of visual acuity (VA) following antibiotic therapy in patients with syphilitic uveitis. A total of 36 patients were included in this retrospective study from 2009 to 2020. The longitudinal patterns of mean VA values during follow-up were analyzed using a linear mixed model. Most patients were men with HIV coinfection (81%) and presented with panuveitis (49%). The mean VA at baseline improved from 0.97 to 0.39 logMAR at 6 months and remained stable thereafter. The cumulative incidence of VA ≥ 20/25 achieved by 2 years was 70%. Receiving antibiotic therapy within four weeks of the onset of ocular symptoms (adjusted hazard ratio [aHR] 3.4, P = 0.012), absence of HIV coinfection (aHR 8.2, P < 0.001), absence of neurosyphilis (aHR 6.5, P = 0.037), better presenting VA (aHR 5.0, P = 0.003), and intermediate uveitis as opposed to panuveitis (aHR 11.5, P = 0.013) were predictive of achieving VA ≥ 20/25. Men with HIV coinfection represented the majority of our patients. Visual outcomes, in response to antibiotics, were favorable. Delayed treatment, poor presenting VA, presence of HIV coinfection, and concomitant neurosyphilis decreased the likelihood of VA restoration.
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High syphilis prevalence and incidence in people living with HIV and Preexposure Prophylaxis users: A retrospective review in the French Dat’AIDS cohort. PLoS One 2022; 17:e0268670. [PMID: 35587482 PMCID: PMC9119478 DOI: 10.1371/journal.pone.0268670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/03/2022] [Indexed: 12/03/2022] Open
Abstract
Background In the past years, we observed a sharp increase of Syphilis, especially among male who have sex with male (MSM), either HIV-infected, or on pre-exposure prophylaxis (PrEP). Our aim was to assess syphilis prevalence and incidence among people living with HIV (PLWH) and PrEP users. Methods PLWH were included from 2010 to 2020 and PrEP users from 2016 to 2020 from the Dat’AIDS French cohort. We calculated syphilis prevalence and incidences for first infections, re-infections, and iterative infections (> 2 times). T-Tests, Wilcoxon tests and Chi2 test were used for descriptive analysis and multivariate logistic regression models were used to estimate Odds ratios (OR) and 95% confidence intervals (95% CI) for factors associated with syphilis. Results Among the 8 583 PLWH, prevalence of subject with past or present syphilis was 19.9%. These subjects were more likely MSM or transgender and aged over 35 years, but prevalence was lower in AIDS subjects. Same pattern was seen for incident infection and re-infection. Incidence was 3.8 per 100 person-years for infection and 6.5 per 100 person-years for re-infection. Among 1 680 PrEP users, syphilis prevalence was 25.8%, with an estimated 7.2% frequency of active syphilis. Risk of syphilis infection was higher in male and increased with age. Incidence was 11.2 per 100 person-years for infection and 11.1 per 100 person-years for re-infection. Conclusion Syphilis prevalence and incidence were high, especially in older MSM with controlled HIV infection and PrEP users, enhancing the need to improve syphilis screening and behavioral risk reduction counseling among high-risk subjects.
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Tiecco G, Degli Antoni M, Storti S, Marchese V, Focà E, Torti C, Castelli F, Quiros-Roldan E. A 2021 Update on Syphilis: Taking Stock from Pathogenesis to Vaccines. Pathogens 2021; 10:1364. [PMID: 34832520 PMCID: PMC8620723 DOI: 10.3390/pathogens10111364] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 12/22/2022] Open
Abstract
In 2021 the scientific community's efforts have been focused on solving the back-breaking challenge of the COVID-19 pandemic, but sexually transmitted infections (STI) are still one of the most common global health problems. Syphilis is a systemic disease caused by the spirochaete Treponema pallidum (TP) and is one of the oldest known diseases. Its incidence has increased in the last few years and syphilis still remains a contemporary plague that continues to afflict millions of people worldwide. Despite research improvements, syphilis pathogenesis is not completely clear; clinical presentation is very heterogeneous and the diagnosis can sometimes be difficult. Furthermore, few therapeutic options are available, and a vaccine has not been found yet. In this review, we describe the most recent evidence concerning the clinical manifestation, diagnosis, treatment and vaccine prospectives for this disease.
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Affiliation(s)
- Giorgio Tiecco
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, ASST Spedali di Brescia, University of Brescia, 25123 Brescia, Italy; (G.T.); (M.D.A.); (S.S.); (V.M.); (E.F.); (F.C.)
| | - Melania Degli Antoni
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, ASST Spedali di Brescia, University of Brescia, 25123 Brescia, Italy; (G.T.); (M.D.A.); (S.S.); (V.M.); (E.F.); (F.C.)
| | - Samuele Storti
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, ASST Spedali di Brescia, University of Brescia, 25123 Brescia, Italy; (G.T.); (M.D.A.); (S.S.); (V.M.); (E.F.); (F.C.)
| | - Valentina Marchese
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, ASST Spedali di Brescia, University of Brescia, 25123 Brescia, Italy; (G.T.); (M.D.A.); (S.S.); (V.M.); (E.F.); (F.C.)
| | - Emanuele Focà
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, ASST Spedali di Brescia, University of Brescia, 25123 Brescia, Italy; (G.T.); (M.D.A.); (S.S.); (V.M.); (E.F.); (F.C.)
| | - Carlo Torti
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, “Magna Graecia” University of Catanzaro, 88100 Catanzaro, Italy;
| | - Francesco Castelli
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, ASST Spedali di Brescia, University of Brescia, 25123 Brescia, Italy; (G.T.); (M.D.A.); (S.S.); (V.M.); (E.F.); (F.C.)
| | - Eugenia Quiros-Roldan
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, ASST Spedali di Brescia, University of Brescia, 25123 Brescia, Italy; (G.T.); (M.D.A.); (S.S.); (V.M.); (E.F.); (F.C.)
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