Abstract：
Incident syphilis leads to changes in plasma HIV-1 RNA and CD4 + T-cell level in people with HIV (PWH) with viraemia. Its effect in PWH on suppressive antiretroviral therapy (ART) is less clear.
PWH on suppressive ART (plasma HIV-1 RNA < 50copies/mL) followed at the Queen Elizabeth Hospital, Hong Kong, China were regularly screened for syphilis. Their plasma HIV-1 RNA, CD4 + and CD8 + T-cell, and total lymphocyte levels before syphilis, during syphilis, and after successful treatment were compared.
Between 2005 and 2020, 288 syphilis episodes from 180 individuals were identified; 287 episodes were related to male, with a median age of 41 at diagnosis; 221 (77%) were syphilis re-infection. The rates of plasma HIV-1 suppression were statistically unchanged across the time-points (97% pre-syphilis, 98% during syphilis, and 99% post-treatment). Total lymphocyte, CD4+ and CD8+ T-cell levels decreased during incident syphilis (p<0.01), and rebounded post-treatment (p<0.01). VDRL titre was associated with declines in CD4+ T-cell (p=0.045), CD8+ T-cell (p=0.004), and total lymphocyte levels (p=0.021). Pre-syphilis CD4/CD8 ratio was associated with increases in CD8+ T-cell (p=0.001) and total lymphocyte levels (p=0.046) during syphilis. Syphilis re-infection was associated with an increase in total lymphocyte level (p=0.037). In the multivariable analysis, only pre-syphilis CD4/CD8 ratio was independently associated with increases in CD8+ T-cell (p=0.014) and total lymphocyte levels (p=0.039) during syphilis.
Among virally-suppressed PWH, total lymphocyte, CD4+, and CD8+ T-cell levels declined during incident syphilis but rebounded post-treatment. The status of plasma HIV suppression was unaffected by syphilis.
PWH on suppressive ART (plasma HIV-1 RNA < 50copies/mL) followed at the Queen Elizabeth Hospital, Hong Kong, China were regularly screened for syphilis. Their plasma HIV-1 RNA, CD4 + and CD8 + T-cell, and total lymphocyte levels before syphilis, during syphilis, and after successful treatment were compared.
Between 2005 and 2020, 288 syphilis episodes from 180 individuals were identified; 287 episodes were related to male, with a median age of 41 at diagnosis; 221 (77%) were syphilis re-infection. The rates of plasma HIV-1 suppression were statistically unchanged across the time-points (97% pre-syphilis, 98% during syphilis, and 99% post-treatment). Total lymphocyte, CD4+ and CD8+ T-cell levels decreased during incident syphilis (p<0.01), and rebounded post-treatment (p<0.01). VDRL titre was associated with declines in CD4+ T-cell (p=0.045), CD8+ T-cell (p=0.004), and total lymphocyte levels (p=0.021). Pre-syphilis CD4/CD8 ratio was associated with increases in CD8+ T-cell (p=0.001) and total lymphocyte levels (p=0.046) during syphilis. Syphilis re-infection was associated with an increase in total lymphocyte level (p=0.037). In the multivariable analysis, only pre-syphilis CD4/CD8 ratio was independently associated with increases in CD8+ T-cell (p=0.014) and total lymphocyte levels (p=0.039) during syphilis.
Among virally-suppressed PWH, total lymphocyte, CD4+, and CD8+ T-cell levels declined during incident syphilis but rebounded post-treatment. The status of plasma HIV suppression was unaffected by syphilis.
摘要：
背景：急性梅毒导致HIV（PWH）病毒血症患者血浆HIV-1RNA和CD4+T细胞水平的变化。其在PWH中对抑制性抗逆转录病毒疗法（ART）的作用尚不清楚。
方法：在伊丽莎白女王医院对抑制性ART（血浆HIV-1RNA<50拷贝/mL）进行PWH随访，香港,中国定期进行梅毒筛查。他们的血浆HIV-1RNA，CD4+和CD8+T细胞，梅毒前的总淋巴细胞水平，梅毒期间,治疗成功后进行比较。
结果：在2005年至2020年之间，发现了180例梅毒发作；287例与男性有关，诊断时的中位年龄为41岁；221（77％）为梅毒再感染。血浆HIV-1抑制率在各个时间点之间在统计学上没有变化（97％的梅毒前，梅毒期间98%，和99％的后处理）。总淋巴细胞,发生梅毒时CD4+和CD8+T细胞水平下降（p<0.01），治疗后反弹(p<0.01)。VDRL滴度与CD4+T细胞下降相关（p=0.045），CD8+T细胞（p=0.004），和总淋巴细胞水平（p=0.021）。梅毒前CD4/CD8比率与梅毒期间CD8T细胞（p=0.001）和总淋巴细胞水平（p=0.046）的增加有关。梅毒再感染与总淋巴细胞水平升高相关(p=0.037)。在多变量分析中，仅梅毒前CD4/CD8比值与梅毒期间CD8+T细胞(p=0.014)和总淋巴细胞水平(p=0.039)的增加独立相关.
结论：在病毒抑制的PWH中，总淋巴细胞，CD4+,和CD8+T细胞水平在梅毒事件期间下降，但在治疗后反弹。血浆HIV抑制状态不受梅毒影响。
方法：在伊丽莎白女王医院对抑制性ART（血浆HIV-1RNA<50拷贝/mL）进行PWH随访，香港,中国定期进行梅毒筛查。他们的血浆HIV-1RNA，CD4+和CD8+T细胞，梅毒前的总淋巴细胞水平，梅毒期间,治疗成功后进行比较。
结果：在2005年至2020年之间，发现了180例梅毒发作；287例与男性有关，诊断时的中位年龄为41岁；221（77％）为梅毒再感染。血浆HIV-1抑制率在各个时间点之间在统计学上没有变化（97％的梅毒前，梅毒期间98%，和99％的后处理）。总淋巴细胞,发生梅毒时CD4+和CD8+T细胞水平下降（p<0.01），治疗后反弹(p<0.01)。VDRL滴度与CD4+T细胞下降相关（p=0.045），CD8+T细胞（p=0.004），和总淋巴细胞水平（p=0.021）。梅毒前CD4/CD8比率与梅毒期间CD8T细胞（p=0.001）和总淋巴细胞水平（p=0.046）的增加有关。梅毒再感染与总淋巴细胞水平升高相关(p=0.037)。在多变量分析中，仅梅毒前CD4/CD8比值与梅毒期间CD8+T细胞(p=0.014)和总淋巴细胞水平(p=0.039)的增加独立相关.
结论：在病毒抑制的PWH中，总淋巴细胞，CD4+,和CD8+T细胞水平在梅毒事件期间下降，但在治疗后反弹。血浆HIV抑制状态不受梅毒影响。
