Factors associated with syphilis incidence in the HIV-infected in the era of highly active antiretrovirals

Shilaih, Mohaned; Marzel, Alex; Braun, Dominique L; Scherrer, Alexandra U.; Kovari, Helen; Young, Jim; Calmy, Alexandra; Darling, Katharine E A; Battegay, Manuel; Hoffmann, Matthias; Bernasconi, Enos; Thurnheer, Maria Christine; Günthard, Huldrych F.; Kouyos, Roger D.

doi:10.1097/md.0000000000005849

Cited by 43 publications

(42 citation statements)

References 44 publications

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“…The different effects of syphilis on γδ T cells may relate to the different host immune environments in AHI and CHI and the natural features of γδ T cells which respond in the early stages of infection. Moreover, younger age other than CD4 + T-cell, nadir CD4 + T-cell, or CD8 + T-cell counts may be one of the key factors that affect the phenotype and function of γδ T cells ( 65 ). Therefore, syphilis should be followed up, monitored, and treated in the MSM population and in patients with AHI.…”

Section: Discussionmentioning

confidence: 99%

Syphilis Infection Differentially Regulates the Phenotype and Function of γδ T Cells in HIV-1-Infected Patients Depends on the HIV-1 Disease Stage

et al. 2017

Front. Immunol.

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A rapidly escalating outbreak of syphilis infection has been affected men who have sex with men, particularly those with HIV-1 infection. γδ T cells are unconventional immune cells with two main subsets, Vδ1 T cells and Vδ2 T cells, which possess a combination of innate and adaptive immune features allowing them against HIV-1. However, whether syphilis infection affects the phenotype and function of γδ T cells in HIV-1-infected patients remains unclear, especially in acute HIV-1 infection (AHI). In this study, we enrolled 57 HIV-1-infected patients (24 with HIV-1 infection only and 33 coinfected with syphilis) from an acute HIV-1-infected cohort in Beijing (PRIMO). A comprehensive analysis of γδ T-cell phenotype and function was performed by flow cytometry. We found syphilis coinfection could reverse the imbalance of Vδ1/Vδ2 ratio in AHI. Syphilis infection results in decreased γδ T-cell activation in AHI, but increased γδ T-cell activation in chronic HIV-1 infection (CHI). Moreover, patients with CHI had larger numbers of IL-17-producing γδ T cells than those with AHI, regardless of syphilis status. Thus, syphilis affected the γδ T-cell immune response differently in patients depending on the stages of HIV-1 disease. In addition, the percentage of IL-17-producing γδ T cells was positively correlated with the percentage of neutrophils. These results suggest that the γδ T-cell/IL-17/neutrophil axis is involved in HIV-1 pathogenesis and disease progression. Taken together, our observations provide new insight into the roles of γδ T cells in immunopathogenesis of syphilis and HIV-1 coinfection, particularly during AHI, and our findings may be helpful for the prevention of syphilis and other sexually transmitted infections and highlight the great significance on the remedy of patients coinfected with HIV-1.

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Section: Discussionmentioning

confidence: 99%

Syphilis Infection Differentially Regulates the Phenotype and Function of γδ T Cells in HIV-1-Infected Patients Depends on the HIV-1 Disease Stage

et al. 2017

Front. Immunol.

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“…Syphilis morbidity ranges from the relatively minor symptoms of the primary stage of infection to the more consequential neurological and cardiovascular effects of the tertiary stage of the disease [10]. The infection is re-emerging as a public health hazard globally particularly, among HIV infected persons [11]. The effect of the infections on each other is well documented.…”

Section: Whomentioning

confidence: 99%

“…The effect of the infections on each other is well documented. HIV wanes the immune system and there is a strong correlation between a weaken immune system and a higher chance of developing syphilis [11]. Conversely, the genital ulcerations and inflammation caused by syphilis are implicated as co-factor making infected individuals more likely to acquire HIV if exposed to the virus through sexual contact [12].…”

Section: Whomentioning

confidence: 99%

Human Immunodeficiency Virus (HIV) and Treponema pallidum (Syphilis) Co-infection in Uyo, Nigeria

Okonko

Adiele

Awanye

et al. 2020

I-SRR

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Aim: HIV/AIDS remains a leading cause of death and disability in Sub Saharan Africa and this accounts for almost half of the world’s HIV related deaths. On the other hand, bacterial sexually transmitted diseases (STDs) such as syphilis contributes to the morbidity and mortality obtained in developing countries. Co-infection of syphilis and HIV may increase the risk of HIV transmission and adversely affect reproductive health. Prompt diagnosis and treatment of STDs in HIV positive individuals can help prevent spread to their partners. There is also very little information about incidence and prevalence of HIV/Syphilis co-infection and their determinants. The aim of this study is to evaluate the HIV/Syphilis co-infection among HIV-infected individuals in Uyo, Nigeria. Methods: A total of 176 individuals living with HIV participated in this study. The average age of the study participants was 39.1 years from a range of 6-67 years. Plasma samples obtained from the human subjects were analysed for presence of HIV and Syphilis antibodies using enzyme-Linked immunosorbent Assay. Results: Our findings showed that the overall prevalence of HIV/Syphilis co-infection in Uyo was 1.7%. Analysis of the results revealed that the variables—sex and educational background—significantly influenced the rate of syphilis sero-positivity among the population under study. While variables- age, marital status and occupational skills non-significantly influenced the rate of syphilis sero-positivity among the population under study. Conclusion: This study confirmed the co-infection of HIV and Syphilis in Uyo, Nigeria. Early screening of Syphilis and other STDs contributes to the control of infection and reduces the spread of HIV to partners. A number of primary preventive interventions for HIV and syphilis need to be adopted including use of condoms and medical male circumcision in order to improve sexual and reproductive health amongst individuals.

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“…Both HBV and syphilis co-infections were observed to occur at HIV RNA > 10,000 copies/ml RNA suggesting increased susceptibility during acute infection. Syphilis has been associated with high-risk sexual behaviour, increasingly prevalent in adolescence (58) and reported to be one of the more frequently occurring infection among in HIV infected people (54).…”

Section: Discussionmentioning

confidence: 99%

Laboratory Markers and Characteristics of New HIV Infections Among Adolescents in Zambia

Nanyangwe-Moyo

Moyo²,

Zheng

et al. 2020

Preprint

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Background We aimed to explore HIV RNA (ribonucleic acid) virologic levels greater than 1,000 copies/millilitre (ml), among HIV-positive adolescents aged 15–24 years, establish the spread of CD4 T- cell counts and inspect characteristics of adolescents presenting with new HIV infections, including co-infections with Hepatitis B virus and syphilis. Methods We analysed data from the Zambia Population-based HIV Impact Assessment 2016 survey. Two-stage stratified cluster probability sample design was used to select the target population. Our study truncated the population to focus on the age-group 15–24 whose biomarker tests and household information were complete. Our primary outcome measure was “New HIV-positive Infections among 15-24-year-olds” defined as HIV-positive biomarker samples presenting with HIV RNA ≥ 1,000 copies/ml without detectable ARVs. We tested associations between new HIV infections and clinical characteristics using negative binomial models adjusting for age, sex, education, marital-status, residence among several covariates. Results Overall, 2·3% ([166/7320], 95% CI: 1·9–2·6) adolescents aged 15–24 years were diagnosed with new HIV infections, with greater proportions among females (3·3% [139/4,165], 95% CI: 2·8–3·9) than males (0·86% [27/3,155], 95% CI: 0·6–1·2). Almost half (47·6%) of seroconversions had HIV RNA ≥ 50,000 copies/ml and an average CD4 + T-cell count of 479 cells/mm 3. HBV– positive adolescents (IRR 8·6, 95% CI: 2·9–24·9, P < 0·001, model 2) were at increased risk of new infections unlike those testing positive for syphilis antibodies (IRR 1·22, 95% CI: 0·2–8·3, P < 0·84). Adjusting for confounders revealed that being married or cohabiting, testing positive for HBV, being a rural resident and attaining higher than secondary education emerged as strongest correlates of new infections. Conclusion High baseline levels of viral load and low CD4 + T-cell count in recent HIV infections among adolescents indicate weak immune repertoire at first diagnosis, increasing the risk of contagion. As the epidemic continues to spread within the adolescent population, HIV-infection will become more complex and greater proportions of adolescents will likely be infected by regular partners. This suggests growing need for interventions targeted at stable partnerships and intensified public health campaigns specific for adolescents.

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Factors associated with syphilis incidence in the HIV-infected in the era of highly active antiretrovirals

Abstract: Supplemental Digital Content is available in the text

Cited by 43 publications

References 44 publications

Syphilis Infection Differentially Regulates the Phenotype and Function of γδ T Cells in HIV-1-Infected Patients Depends on the HIV-1 Disease Stage

Syphilis Infection Differentially Regulates the Phenotype and Function of γδ T Cells in HIV-1-Infected Patients Depends on the HIV-1 Disease Stage

Human Immunodeficiency Virus (HIV) and Treponema pallidum (Syphilis) Co-infection in Uyo, Nigeria

Laboratory Markers and Characteristics of New HIV Infections Among Adolescents in Zambia

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