Jarisch-Herxheimer reaction after penicillin therapy among patients with syphilis in the era of the hiv infection epidemic: incidence and risk factors.
The incidence of and risk factors for Jarisch-Herxheimer (JH) reaction were investigated prospectively among 240 human immunodeficiency virus (HIV)-infected and 115 HIV-uninfected patients with syphilis who received penicillin treatment. The overall rate of JH reaction was 31.5% (34.6% in HIV-infected patients and 25.2% in HIV-uninfected patients). In multivariate analysis, risk factors for JH reaction included high rapid plasma reagin (RPR) titers (per log(2) RPR increase, risk ratio [RR], 1.19; 95% confidence interval [CI], 1.04-1.37), early syphilis (RR, 8.59; 95% CI, 4.75-15.56), and prior penicillin treatment (RR, 0.39; 95% CI, 0.20-0.78).
Yang
Chia-Jui
CJ
Department of Internal Medicine, Far Eastern Memorial Hospital, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Lee
Nan-Yao
NY
Lin
Yu-Hui
YH
Lee
Hsin-Chun
HC
Ko
Wen-Chien
WC
Liao
Chun-Hsing
CH
Wu
Cheng-Hsin
CH
Hsieh
Chia-Ying
CY
Wu
Pei-Ying
PY
Liu
Wen-Chun
WC
Chang
Ya-Chu
YC
Hung
Chien-Ching
CC
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D005076:Exanthema / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000139:chemically induced* / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000008:administration & dosage*; D011446:Prospective Studies; D011935:Reagins / Q000097:blood; D012307:Risk Factors; D013587:Syphilis / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D014664:Vasodilation; D055815:Young Adult
D000900:Anti-Bacterial Agents; D010406:Penicillins; D011935:Reagins