Are Clinicians Aware Enough of Syphilis in HIV-Infected Populations? The Clinical and Laboratory Findings in A Training Hospital
Öz
Background: Our study aimed to reveal the seroprevalence of syphilis in HIV-positive patients in our center and to reveal the diagnostic performance of the reverse sequence algorithm Materials and Methods: The study data were obtained retrospectively. Statistical analyses were carried out using SPSS version 20.0. Screening for syphilis was performed by reverse sequence algorithm using chemiluminescent microparticle immunoassay CMIA , Rapid Plasma Reagin and T.pallidum hemagglutination tests. Results: A total of 91 HIV-positive patients were included in the study. Of these patients, 15 16.48% had never been tested for syphilis, and the rate of the patients who have a proper follow-up for syphilis was only 36.17%. Nineteen patients were diagnosed with syphilis; the overall syphilis rate was 20.88%. The mean time to the diagnosis of syphilis was 9.89±13.5 months, ranging from 0 to 48 months. Of the 76 patients screened for syphilis, 19 25% had CMIA positivity with concurrent RPR positivity. Concurrent TP-HA testing was performed in 54 71.05% of the 76 patients and 17 89.4% of 19 patients with CMIA positivity, and all of these patients with CMIA positivity revealed positive TP-HA results. Conclusions: Syphilis co-infection rate in HIV-positive patients in our hospital was high. However, there are still deficiencies in the screening of syphilis, and it has been shown that a specific screening algorithm is not adopted by the clinicians who follow-up HIV-positive patients. Besides, non-treponemal and treponemal tests in the reverse sequence algorithm revealed reliable results in the diagnosis of syphilis in HIV-infected patients.
Anahtar Kelimeler
HIV syphilis reverse sequence diagnostic algorithm chemiluminescent immunoassay RPR Treponema pallidum hemagglutination assay
Kaynakça
- 1. Platt L, Easterbrook P, Gower E, McDonald B, Sabin K, McGowan C, Yanny I, Razavi H, Vickerman P. Prevalence and burden of HCV co-infection in people living with HIV: a global systematic review and meta-analysis. Lancet Infect Dis. 2016;16:797-808
- 2. Khaw C, Richardson D, Matthews G, Read T. Looking at the positives: proactive management of STIs in people with HIV. AIDS Res Ther. 2018;15:28
- 3. Peeling RW, Mabey D, Kamb ML, Chen XS, Radolf JD, Benzaken AS. Syphilis. Nat Rev Dis Primers. 2017;3:17073
- 4. Levy SB, Gunta J, Edemekong P. Screening for Sexually Transmitted Diseases. Prim Care. 2019;46:157-173
- 5. Centers for Disease Control and Prevention (CDC). Syphilis Testing Algorithms Using Treponemal Tests for Initial Screening Four Laboratories, New York City, 2005-2006. MMWR Morb Mortal Wkly Rep. 2008;57;872-875
- 6. Centers for Disease Control and Prevention (CDC). Discordant results from reverse sequence syphilis screening- -five laboratories, United States, 2006-2010. MMWR Morb Mortal Wkly Rep. 2011;60:133-7
- 7. Hook EW 3rd. Syphilis. Lancet. 2017;389:1550-1557
- 8. Kalichman SC, Pellowski J, Turner C. Prevalence of sexually transmitted co-infections in people living with HIV/AIDS: systematic review with implications for using HIV treatments for prevention. Sex Transm Infect. 2011;87:183-90
- 9. Aydin ÖA, Karaosmanoğlu HK, Sayan M, İnce ER, Nazlıcan Ö. Seroprevalence and risk factors of syphilis among HIV/AIDS patients in Istanbul, Turkey. Cent Eur J Public Health. 2015;23:65-8
- 10. Avoundjian T, Stewart J, Peyton D, Lewis C, Johnson K, Glick SN, Golden MR, Khosropour CM. Integrating HIV testing into syphilis partner services in Mississippi to improve HIV case finding. Sex Transm Dis. 2019;46:240–245
- 11. Ong JJ, Fu H, Smith MK, Tucker JD. Expanding syphilis testing: a scoping review of syphilis testing interventions among key populations. Expert Rev Anti Infect Ther. 2018;16:423-432.
- 12. Blocker ME, Levine WC, St Louis ME. HIV prevalence in patients with syphilis, United States. Sex Transm Dis. 2000;27: 53-9
- 13. Dougan S, Evans BG, Elford J. Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men. Sex Transm Dis. 2007;34:783-90
- 14. Lee K, Park H, Roh EY, Shin S, Park KU, Park MH, Song EY. Characterization of sera with discordant results from reverse sequence screening for syphilis. Biomed Res Int. 2013;2013:269347
- 15. Özbek ÖA, Doğan Y. Evaluation of a Syphilis Testing Algorithm Using a Treponemal Test for Screening. Mikrobiyol Bul. 2011;45:93-103
- 16. Sönmez C. Sifiliz Evaluation of RPR, TPHA Test Results and Diagnostic Algorithms Used in Syphilis Diagnosis. Türk Mikrobiyol Cem Derg. 2018;48:72-77
Öz
Kaynakça
- 1. Platt L, Easterbrook P, Gower E, McDonald B, Sabin K, McGowan C, Yanny I, Razavi H, Vickerman P. Prevalence and burden of HCV co-infection in people living with HIV: a global systematic review and meta-analysis. Lancet Infect Dis. 2016;16:797-808
- 2. Khaw C, Richardson D, Matthews G, Read T. Looking at the positives: proactive management of STIs in people with HIV. AIDS Res Ther. 2018;15:28
- 3. Peeling RW, Mabey D, Kamb ML, Chen XS, Radolf JD, Benzaken AS. Syphilis. Nat Rev Dis Primers. 2017;3:17073
- 4. Levy SB, Gunta J, Edemekong P. Screening for Sexually Transmitted Diseases. Prim Care. 2019;46:157-173
- 5. Centers for Disease Control and Prevention (CDC). Syphilis Testing Algorithms Using Treponemal Tests for Initial Screening Four Laboratories, New York City, 2005-2006. MMWR Morb Mortal Wkly Rep. 2008;57;872-875
- 6. Centers for Disease Control and Prevention (CDC). Discordant results from reverse sequence syphilis screening- -five laboratories, United States, 2006-2010. MMWR Morb Mortal Wkly Rep. 2011;60:133-7
- 7. Hook EW 3rd. Syphilis. Lancet. 2017;389:1550-1557
- 8. Kalichman SC, Pellowski J, Turner C. Prevalence of sexually transmitted co-infections in people living with HIV/AIDS: systematic review with implications for using HIV treatments for prevention. Sex Transm Infect. 2011;87:183-90
- 9. Aydin ÖA, Karaosmanoğlu HK, Sayan M, İnce ER, Nazlıcan Ö. Seroprevalence and risk factors of syphilis among HIV/AIDS patients in Istanbul, Turkey. Cent Eur J Public Health. 2015;23:65-8
- 10. Avoundjian T, Stewart J, Peyton D, Lewis C, Johnson K, Glick SN, Golden MR, Khosropour CM. Integrating HIV testing into syphilis partner services in Mississippi to improve HIV case finding. Sex Transm Dis. 2019;46:240–245
- 11. Ong JJ, Fu H, Smith MK, Tucker JD. Expanding syphilis testing: a scoping review of syphilis testing interventions among key populations. Expert Rev Anti Infect Ther. 2018;16:423-432.
- 12. Blocker ME, Levine WC, St Louis ME. HIV prevalence in patients with syphilis, United States. Sex Transm Dis. 2000;27: 53-9
- 13. Dougan S, Evans BG, Elford J. Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men. Sex Transm Dis. 2007;34:783-90
- 14. Lee K, Park H, Roh EY, Shin S, Park KU, Park MH, Song EY. Characterization of sera with discordant results from reverse sequence screening for syphilis. Biomed Res Int. 2013;2013:269347
- 15. Özbek ÖA, Doğan Y. Evaluation of a Syphilis Testing Algorithm Using a Treponemal Test for Screening. Mikrobiyol Bul. 2011;45:93-103
- 16. Sönmez C. Sifiliz Evaluation of RPR, TPHA Test Results and Diagnostic Algorithms Used in Syphilis Diagnosis. Türk Mikrobiyol Cem Derg. 2018;48:72-77
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Research Article |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Temmuz 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 5 Sayı: 3 |