Syphilis and human immunodeficiency virus (HIV)-1 coinfection: influence on CD4 T-cell count, HIV-1 viral load, and treatment response.
OBJECTIVE
To assess the effect of human immunodeficiency virus (HIV)-1 and syphilis coinfection on HIV-ribonucleic acid (RNA) viral load, CD4 cell count, and the response in rapid plasmin reagin (RPR) to treatment of the syphilis infection.


METHODS
Cases of syphilis diagnosed during 1 year in HIV-infected patients in Copenhagen were included. HIV-RNA, CD4 cell counts, and RPR-serology were measured before, during, and after syphilis.


RESULTS
Forty-one patients were included. CD4 cell count decreased significantly during infection in patients with primary and secondary stages of syphilis (mean 106 cells/mm, P = 0.03). Treatment of syphilis was associated with an increase in the CD4 cell count and a decrease in HIV-RNA in the overall group (mean 66 cells/mm and -0.261 RNA log10 copies/ml, P = 0.02 and 0.04). The serological response rates for 15 patients treated with penicillin and 25 treated with doxycycline were the same.


CONCLUSIONS
Syphilis was associated with a decrease in CD4 cell counts and an increase in HIV-RNA levels that both improved after treatment of syphilis.
Kofoed
Kristian
K
Clinical Research Unit, Hvidovre University Hospital, Copenhagen, Denmark. kristian.kofoed@hh.hosp.dk
Gerstoft
Jan
J
Mathiesen
Lars R
LR
Benfield
Thomas
T
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003718:Denmark / Q000453:epidemiology; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D012367:RNA, Viral / Q000097:blood; D011935:Reagins / Q000097:blood; D013587:Syphilis / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D016896:Treatment Outcome; D019562:Viral Load
D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents; D010406:Penicillins; D012367:RNA, Viral; D011935:Reagins; D004318:Doxycycline