Impact of Syphilis Infection on HIV Viral Load and CD4 Cell Counts in HIV-Infected Patients

Palacios, Rosario; Jiménez-Oñate, Francisco; Aguilar, Manuela; Galindo, Marı́a José; Rivas, Pedro; Ocampo, Antonio; Berenguer, Juan; Arranz, J. A.; Rios, María; Knobel, Hernando; Moreno, Francisco; Ena, Javier; Santos, Jesús

doi:10.1097/qai.0b013e31802ea4c6

Cited by 114 publications

(99 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…T. pallidum coinfection may have a deleterious impact on the immunologic and virologic status in HIV-infected persons, which may improve with syphilis treatment, although these data are conflicting (101)(102)(103)(104).…”

Section: Hiv and Syphilismentioning

confidence: 94%

Syphilis: using modern approaches to understand an old disease

Lukehart²

2011

J. Clin. Invest.

194

168

View full text Add to dashboard Cite

Syphilis is a fascinating and perplexing infection, with protean clinical manifestations and both diagnostic and management ambiguities. Treponema pallidum subsp. pallidum, the agent of syphilis, is challenging to study in part because it cannot be cultured or genetically manipulated. Here, we review recent progress in the application of modern molecular techniques to understanding the biological basis of this multistage disease and to the development of new tools for diagnosis, for predicting efficacy of treatment with alternative antibiotics, and for studying the transmission of infection through population networks.

show abstract

Section: Hiv and Syphilismentioning

confidence: 94%

Syphilis: using modern approaches to understand an old disease

Lukehart²

2011

J. Clin. Invest.

194

168

View full text Add to dashboard Cite

show abstract

“…48 However, it is unknown whether these changes are different from those in patients without HIV infection in whom a decrease in CD4 T-cell percentage has also been found during syphilis or whether these transient changes affect the overall course of the HIV disease. Similarly, syphilis has been found to increase HIV viral load, 21,22,45,46 but whether these increases are associated with development of resistance or accelerated disease progression is unclear. 49 Although the implications of these transient changes in the long-term course of the HIV infection are unknown, clinicians should be aware that syphilis and other asymptomatic STDs might account for otherwise unexplained decreases in CD4 T-cell counts or increases in plasma viral load of HIV-infected patients.…”

Section: Clinical Presentation and Natural History Of Diseasementioning

confidence: 99%

“…Infection with T pallidum has been shown to transiently decrease CD4 T-cell counts in HIV-infected patients 21,22,[45][46][47] and to induce lymphocyte and CD4 apoptosis. 48 However, it is unknown whether these changes are different from those in patients without HIV infection in whom a decrease in CD4 T-cell percentage has also been found during syphilis or whether these transient changes affect the overall course of the HIV disease.…”

Section: Clinical Presentation and Natural History Of Diseasementioning

confidence: 99%

Syphilis in the United States: An Update for Clinicians With an Emphasis on HIV Coinfection

Zetola

Engelman

Jensen

et al. 2007

Mayo Clinic Proceedings

112

View full text Add to dashboard Cite

Diagnosis and treatment of syphilis are challenging because of its variable clinical presentation and course and the lack of definitive tests of cure after treatment. This review of the most recent literature on the epidemiology, clinical manifestations, current diagnosis, and treatment of syphilis is focused toward clinicians who treat patients with this disease. Syphilis coinfection with human immunodeficiency virus is emphasized because it is increasingly common in the United States and affects the initial presentation, disease course, diagnosis, and treatment of syphilis. Of particular consequence is the effect of human immunodeficiency virus on the clinical diagnosis, prevalence, and course of neurosyphilis, one of the most serious consequences of syphilis infection. linicians from large metropolitan areas frequently face the challenge of diagnosing syphilis and treating patients with syphilis. In doing so, they are often faced with questions regarding interpretation of clinical findings and laboratory results and selection of appropriate therapy. Interpretation of the data available to answer these questions is often challenging given the paucity of large well-designed studies and the substantial variability that characterizes the clinical presentation of syphilis. Such a challenge is particularly found in the treatment of patients coinfected with syphilis and human immunodeficiency virus (HIV). To guide clinicians in this difficult task, we discuss the most recent literature on the epidemiology, clinical manifestations, diagnosis, and treatment of syphilis and the corresponding effects of HIV coinfection.

show abstract

“…En un estudio español de 1.161 pacientes con VIH, la seroprevalencia de sífilis era del 13% y un 4% más se diagnosticó de sífilis durante un período de seguimiento de 38 meses 31 . Un dato preocupante observado en diversos centros españoles 19,32 es que hasta un 70% de los casos de sífilis se diagnostica en pacientes con infección por el VIH conocida, muchos de ellos en TARGA, lo que refleja un fallo en las medidas de prevención de estos pacientes.…”

Section: Epidemiologíaunclassified

“…Además, las úlceras genitales pueden inducir un aumento de la carga viral y un descenso del recuento de linfocitos CD4 59 . Tres estudios recientes han evidenciado un incremento de la carga viral y un descenso de los linfocitos CD4 en pacientes con VIH y sífilis precoz 32,60,61 . En un estudio multicéntrico nacional 32 en el que se incluyó a 118 pacientes con infección por el VIH diagnosticados de sífilis precoz, la carga viral aumentó en un 27,6% de los pacientes, y destacó que 11 (25,0%) de los que estaban suprimidos antes del episodio de sífilis, presentaron carga viral detectable durante éste.…”

Section: Impacto De La Sífilis En La Situación Inmunovirológicaunclassified