Universität zu Köln

Rowley, D., Swiecki, P., Firlag-Burkacka, E., Sabin, C., Kuemmerle, T., Surah, S., Sadlier, C., O'Dea, S., Horban, A., Faetkenheuer, G. and Mulcahy, F. (2015). Clinical and epidemiological characteristics of patients with early syphilis from three academic centres in Poland, Germany and Ireland: initial findings from the POETS study. Sex. Transm. Infect., 91 (6). S. 389 - 395. LONDON: BMJ PUBLISHING GROUP. ISSN 1472-3263

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Abstract

Objectives Syphilis recognition in HIV-positive patients has important implications. Initial data from this study, established in June 2012 to better understand the natural history of syphilis and treatment response, examine the characteristics of patients including sexual behaviour, rates of concurrent sexually transmitted infections (STI) and type of treatment given. Methods Patients were recruited from Ireland, Poland and Germany. Data gathered included demographics, method of syphilis acquisition, stage of syphilis infection, HIV status, nadir and current CD4 counts and HIV viral suppression rates. Data were then subanalysed into HIV-positive and HIV-negative groups. Results Of 175 patients recruited, 68% were HIV-positive and 86.3% were men who have sex with men. Most HIV-positive patients presented with secondary syphilis (55.7% vs 13.2%) (p=0.0001) while the majority of HIV-negative patients had primary syphilis noted at the time of recruitment (47.2% vs18.9%, p=0.0002). Approximately half of all patients had a HIV RNA viral load <40 copies/mL (55%). Previous syphilis infection occurred more frequently in HIV-positive than HIV-negative patients (p=0.0001). Concurrent STIs at the time of syphilis diagnosis were found in 26.8%, of whom 31 (25.4%) were HIV-positive (p=0.64). HIV-positive patients received doxycycline more frequently than their HIV-negative counterparts (33.6% vs 1.9%, p=0.0001) while HIV-negative patients were treated with long-acting penicillin in 88.7% of cases vs 58% of HIV-positive patients (p=0.0002). Conclusions A 40% rate of unsuppressed viraemia, high levels of STIs and varying treatment regimens represent a public health risk for Europe, suggesting the model of sexual healthcare delivery in HIV-positive patients requires further evaluation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rowley, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Swiecki, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Firlag-Burkacka, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabin, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuemmerle, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Surah, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sadlier, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED O'Dea, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Horban, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Faetkenheuer, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mulcahy, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-395887
DOI:	10.1136/sextrans-2014-051844
Journal or Publication Title:	Sex. Transm. Infect.
Volume:	91
Number:	6
Page Range:	S. 389 - 395
Date:	2015
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1472-3263
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language IMMUNODEFICIENCY-VIRUS-INFECTION; SEXUALLY-TRANSMITTED INFECTIONS; CD4 CELL COUNTS; HIV VIRAL LOAD; TREPONEMA-PALLIDUM; BENZATHINE PENICILLIN; MACROLIDE RESISTANCE; RISK BEHAVIOR; SAN-FRANCISCO; SEX Multiple languages Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39588