title: The immunological response to syphilis differs by HIV status; a prospective observational cohort study.
abstract: It is not known if there is a difference in the immune response to syphilis between HIV-infected and uninfected individuals.
  
  
  
  We prospectively recruited all patients with a new diagnosis of syphilis and tested their plasma for IFNα, IFNγ, IL-1β, IL-12p40, IL-12p70, IP-10, MCP-1, MIP-1α, MIP-1β, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10 and IL-17A at baseline pre-treatment and 6 months following therapy.
  
  
  
  A total of 79 HIV-infected [44 primary/secondary syphilis (PSS) and 35 latent syphilis (LS)] and 12 HIV-uninfected (10 PSS and 2 LS) cases of syphilis and 30 HIV-infected controls were included in the study. At the baseline visit, compared to the control group, concentrations of IL-10 were significantly elevated in the HIV-infected and uninfected groups. The level of IL-10 was significantly higher in the HIV-infected compared to the HIV-uninfected PSS group (25.3 pg/mL (IQR, 4.56-41.76) vs 2.73 pg/mL (IQR, 1.55-9.02), P = 0.0192). In the HIV-infected PSS group (but not the HIV-infected LS or HIV-uninfected PSS groups) the IP-10, MIP-1b, IL-6 and IL-8 were raised compared to the controls. IL-10 levels decreased but did not return to control baseline values by 6 months in HIV infected PSS and LS and HIV uninfected PSS.
  
  
  
  PSS and LS in HIV-infected individuals is characterized by an increase in inflammatory and anti-inflammatory cytokines such as IL-10. The increase of IL-10 is greater in HIV-infected than uninfected individuals. Further work is required to ascertain if this is part of an immunological profile that correlates with adverse outcomes such as serofast syphilis and neurosyphilis, in HIV-infected individuals.
authors.affiliation: HIV/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium. ckenyon@itg.be.|Division of Infectious Diseases and HIV Medicine, University of Cape Town, Anzio Road, Observatory 7700, Cape Town, South Africa. ckenyon@itg.be.
authors.forename: Chris
authors.identifier: 0000-0002-2557-8998
authors.initials: C
authors.lastname: Kenyon
authors.affiliation: HIV/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Kara Krista
authors.initials: KK
authors.lastname: Osbak
authors.affiliation: HIV/STI Reference Laboratory, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Tania
authors.initials: T
authors.lastname: Crucitti
authors.affiliation: Immunology Unit, Institute of Tropical Medicine,, Antwerp, Belgium.|Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Kestens
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D013587:Syphilis / Q000097:blood / Q000276:immunology*; D015854:Up-Regulation
chemical_list: D016753:Interleukin-10
keywords: HIV; IL-10; Immunology; Syphilis; Treponema pallidum