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Effect of Highly Active Antiretroviral Therapy on Incidence of Early Syphilis in HIV-Infected Patients

Park, Wan Beom MD, PhD; Jang, Hee-Chang MD; Kim, Sung-Han MD; Kim, Hong Bin MD, PhD; Kim, Nam Joong MD, PhD; Oh, Myoung-don MD, PhD; Choe, Kang Won MD, PhD

Sexually Transmitted Diseases: March 2008 - Volume 35 - Issue 3 - p 304-306
doi: 10.1097/OLQ.0b013e31815b0148

Objectives: To evaluate the incidence of early syphilis based on time from initiation of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV)-infected patients.

Study Design: Five hundred thirty-nine HIV-positive patients undergoing HAART were followed up to 4 years to identify early (primary or secondary) syphilis. Incidence rate trends according to time from HAART initiation were evaluated by Poisson regression after adjustment for calendar year.

Results: With median follow-up of 2.9 years, 56 (10.4%) patients experienced early syphilis, 17 (3.2%) with primary syphilis, and 39 (7.2%) with secondary syphilis. The overall incidence rate of early syphilis for 4 years after the start of HAART was 4.57 per 100 person-years (95% confidence interval, 3.45–5.93). The incidence rate of early syphilis significantly increased in proportion to the years after the start of HAART (3.4–6.1 per 100 person-year, P for trend <0.001).

Conclusions: Early syphilis incidence in HIV-infected patients increased in proportion to HAART duration. The finding suggests that screening for syphilis in HIV-infected patients who initiate HAART should be encouraged with attention to the time passed since HAART initiation.

A study in a tertiary referral hospital in Republic of Korea found that early syphilis incidence in HIV patients increased with time after the start of HAART.

From the Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea

This study was supported by the Medical Research Collaborating Center of Seoul National University Hospital, which provided statistical consultation.

Presented at 45th annual meeting of Infectious Diseases Society of America, San Diego, 2007.

Correspondence: Kang Won Choe, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, 28 Yeongun-dong, Chongro-gu, Seoul, Republic of Korea 110–744. E-mail:

Received for publication June 19, 2007, and accepted September 9, 2007.

© Copyright 2008 American Sexually Transmitted Diseases Association