Brief report: syphilis incidence and effect on viral load, CD4, and CD4/CD8 ratio in a Thai cohort of predominantly men who have sex with men living with HIV
Journal of Acquired Immune Deficiency Syndromes Jan 19, 2021
Muccini C, Crowell TA, Pinyakorn S, et al. - Researchers aimed at determining the prevalence of syphilis and its incidence and changes in CD4 count and viremia in the RV254 cohort of persons living with HIV who started antiretroviral therapy during acute HIV infection (AHI) in Bangkok, Thailand. From 2009 to 2018, screening for syphilis was performed in 579 participants at enrollment, every 24–48 weeks thereafter and when clinically indicated; median age: 26 (interquartile range: 22–31) years; 564 (97.4%) men. Syphilis prevalence of 14.3% was recorded at enrollment; its incidence was 10.2 cases per 100 person-years. Participants with syphilis were more likely to be MSM, use methamphetamine, and have hepatitis C. Observations overall suggest a common occurrence of syphilis in the RV254 cohort and indicate that it induces a marginal but significant impact on HIV RNA and a temporary decline in CD4. Based on these observations, they emphasize implementing syphilis screening and behavioral risk reduction counseling for MSM with AHI in Thailand.
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