Abstract | OBJECTIVES: HIV-positive men who have sex with men (MSM) may be at a higher risk of repeat syphilis, have different clinical manifestations and have a different serological response to treatment compared with HIV-negative MSM. The objective of this study was to assess whether HIV-negative and HIV-positive MSM with infectious syphilis (primary, secondary or early latent) differed in history of previous syphilis episodes, disease stage and non-treponemal titre of initial and repeat episodes, and the titre response 6 and 12 months after treatment. Furthermore, determinants associated with an inadequate titre response after treatment were explored. METHODS: This retrospective analysis used data of five longitudinal studies (four cohorts; one randomised controlled trial) conducted at the STI clinic in Amsterdam, the Netherlands. Participants were tested for syphilis and completed questionnaires on sexual risk behaviour every 3-6 months. We included data of participants with ≥1 syphilis diagnosis in 2014-2019. Pearson's χ² test was used to compare HIV-negative and HIV-positive MSM in occurrence of previous syphilis episodes, disease stage of initial and repeat syphilis episode and non-treponemal titre treatment responses. RESULTS: We included 355 participants with total 459 syphilis episodes. HIV-positive MSM were more likely to have a history of previous syphilis episodes compared with HIV-negative MSM (68/90 (75.6%) vs 96/265 (36.2%); p<0.001). Moreover, HIV-positive MSM with repeat syphilis were less often diagnosed with primary syphilis (7/73 (9.6%) vs 36/126 (28.6%)) and more often diagnosed with secondary syphilis (16/73 (21.9%) vs 17/126 (13.5%)) and early latent syphilis (50/73 (68.5%) vs 73/126 (57.9%)) (p=0.005). While not significantly different at 12 months, HIV-negative MSM were more likely to have an adequate titre response after 6 months compared with HIV-positive MSM (138/143 (96.5%) vs 66/74 (89.2%); p=0.032). CONCLUSIONS:
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Authors | Silvia Achia Nieuwenburg, Ricardo Jamie Sprenger, Maarten Franciscus Schim van der Loeff, Henry John Christiaan de Vries |
Journal | Sexually transmitted infections
(Sex Transm Infect)
Vol. 98
Issue 2
Pg. 95-100
(03 2022)
ISSN: 1472-3263 [Electronic] England |
PMID | 33608479
(Publication Type: Journal Article)
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Copyright | © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. |
Chemical References |
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Topics |
- Adult
- Antibodies, Bacterial
(blood, immunology)
- Data Analysis
- HIV Infections
(complications, epidemiology)
- Homosexuality, Male
(statistics & numerical data)
- Humans
- Longitudinal Studies
- Male
- Middle Aged
- Retrospective Studies
- Risk-Taking
- Serologic Tests
(statistics & numerical data)
- Sexual Behavior
- Syphilis
(epidemiology, immunology)
- Treponema
(immunology)
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