Comparisons of Serologic Response of Early Syphilis

Condition(s) targeted: Serologic Response of Syphilis; Early Syphilis; High Risk Behavior

Phase: N/A

Status: Completed

Sponsored by: National Taiwan University Hospital

Official(s) and/or principal investigator(s):
Chia-Jui Yang, MD, Principal Investigator, Affiliation: Far Eastern Memorial Hospital
Chien-Chin Hung, PHD, Principal Investigator, Affiliation: National Taiwan University Hospital

Syphilis and HIV are prone to occur concomitantly and the two diseases share several modes of acquisition and risk factors such as men who have sex with men (MSM), sexual workers, intravenous drug users, previous history of sexual transmitted diseases (STDs), and multiple partners. HIV infection rates of up to 50% have been reported among patients diagnosed with syphilis in several regions, with higher HIV infection rates among MSM. Besides, syphilis ulcers are proposed to enhance the transmission of HIV. In Taiwan, there is also an increasing prevalence of syphilis and HIV co-infection among MSM. Therefore, to treat syphilis is an important issue for public health. According to literature review, whether patients with HIV and syphilis co-infection had higher serologic failure rate remains controversial, especially in the era after highly active anti-retroviral therapy (HAART) was introduced since 1996. Ghanem et al recently demonstrated that the use of HAART may reduce syphilis failure rates among HIV-infected patients who have syphilis. In addition, the treatment guideline in 2006 suggested that the treatment of primary syphilis and secondary syphilis is single dose benzathine penicillin G regardless of HIV status; however, it goes on to suggest that "some specialists recommended additional treatments for HIV-infected patients", namely 3 doses, each a week apart. There is no reference and evidence of strength of the suggestion but only specialists' opinion. In the study, we aim to compare serologic response of syphilis to penicillin treatment between HIV-infected and HIV-uninfected patients and to compare serologic response of early syphilis (primary or secondary) to 1 dose and 3 doses of benzathine penicillin G among HIV-infected patients. A longitudinal follow-up of serologic response will be conducted after syphilis treatment.

Official title: Comparisons of Treatment Response to Standard Treatment With Penicillin Between HIV-infected and HIV-uninfected Patients With Syphilis

Study design: Observational Model: Cohort, Time Perspective: Prospective

Primary outcome: To compare serologic response of HIV-infected patients co-infected with early syphilis who received 1-dose or 3-doses benzathine penicillin G

Secondary outcome: To compare the serologic response among HIV-infected and uninfected patients after receiving benzathine penicillin G

Minimum age: 20 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- persons aged ≧20 year-old, who had documented syphilis infection (RPR titer≧ 1: 4 and

TPPA ≧1: 320) Exclusion Criteria:

- Nil

National Taiwan University Hospital, Taipei City 100, Taiwan

Far Eastern Memorial Hospital, Taipei 220, Taiwan

Starting date: January 2007
Last updated: September 12, 2013