Author:
Chan Phillip,Tang Tommy H. C.,Kwong Ruby T. S.,Chan Lawrence,Chan Helen S. Y.,Lam K. W.,Ting W. M.,Yung S. K.,Lam Emily C. T.,Chu M. Y.,Lam Wilson,Wu T. C.,Li Patrick,Lee M. P.
Abstract
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.
Publisher
Springer Science and Business Media LLC
Subject
Pharmacology (medical),Virology,Molecular Medicine
Cited by
1 articles.
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