Predictors of serological cure after penicillin therapy in HIV-negative patients with early syphilis in Shenzhen, China.

Zhenzhou Luo,Qiuhong Wu,Lishan Tian,Yi Ding,Li Zhang,Jun Yuan,Jinsong Mou,Zixin Wang

doi:10.1371/journal.pone.0245812

Abstract

BackgroundSyphilis is a common infectious disease worldwide. Serological monitoring is important for syphilis management. We currently know little about the characteristics of this seronegative response. The aim of this study was to explore the factors associated with serological cure after treatment of early syphilis.MethodsA retrospective cohort study was conducted and the data of patients with early syphilis in a clinic in Shenzhen from 2011 to 2019 were retrieved. Univariable and multiple Cox proportional hazard regression models were utilized to identify factors associated with a serological cure state among syphilis patients with early syphilis two years after treatment.ResultsA total of 346 (85.9%) syphilis patients achieved serological cure. The multivariate analysis results revealed that having a baseline TRUST titer >1:8 was associated with an increased probability of serological cure, compared with having a baseline TRUST titer ≤1:8 (HR = 1.43, 95% CI = 1.10–1.85, P<0.01); primary syphilis was positively associated with serological cure, compared with participants with latent early syphilis (HR = 1.72, 95% CI = 1.27–2.33, P<0.001).ConclusionsTwo years after treatment, a higher percentage of early syphilis patients achieved serological cure. The study indicated that the syphilis stage and baseline serum titer were crucial factors associated with serological cure.

Highlights

Syphilis is a sexually transmitted disease caused by Treponema pallidum, and is spread mainly through direct lesion contact [1]
The study indicated that the syphilis stage and baseline serum titer were crucial factors associated with serological cure
As immune differences and human immunodeficiency virus (HIV) drugs have some effects on the outcome of HIV-positive and HIV-negative syphilis patients, the aim of this study was to estimate the rates of serological cure after treatment with benzathine penicillin G (BPG) and identify the factors related to the serological response among HIV-negative patients with early syphilis

Summary

Introduction

Syphilis is a sexually transmitted disease caused by Treponema pallidum, and is spread mainly through direct lesion contact [1]. Treponema pallidum can be treated and inexpensively with antibiotics [2], syphilis remains a prevalent disease worldwide. More than 5 million new cases of syphilis are diagnosed every year in the world [3,4]. The average syphilis incidence showed significantly increasing trends from 2004 to 2013 and fast rates of growth with annual percentage changes of 16.3% [5]. In 2018, the syphilis incidence increased to 35.6 cases per 100,000 [6]. Syphilis is a common infectious disease worldwide. The aim of this study was to explore the factors associated with serological cure after treatment of early syphilis

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Conclusion