Does Syphilis Increase the Risk of HIV-RNA Elevation >200 Copies/mL in HIV-Positive Patients Under Effective Antiretroviral Treatment? Data From the ICONA Cohort. (1st October 2021)

• Record Type: Journal Article
• Authors: Giacomelli, Andrea; Cozzi-Lepri, Alessandro; Cingolani, Antonella; Tavelli, Alessandro; Mazzotta, Valentina; Tesoro, Daniele; Bassetti, Matteo; Castagna, Antonella; Di Biagio, Antonio; Lichter, Miriam; Monforte, Antonella d'Arminio; Rusconi, Stefano
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 88:Number 2(2021)
• Publication Date: 2021-10-01
• Subjects: HIV -- PLWH -- syphilis -- viral rebound -- STDs -- TasP; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000002749
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Background: To assess the impact of syphilis infection on the risk of HIV-RNA elevation in people living with HIV (PLWH) with current HIV-RNA ⩽50 copies/mL. Setting: The Italian Cohort Naive Antiretrovirals. Methods: All PLWH (2009–2020) under antiretroviral treatment with at least 2 consecutive HIV-RNA values ⩽50 copies/mL before the date of syphilis diagnosis and at least 1 HIV-RNA determination after the syphilis event were enrolled. A control group of PLWH without syphilis was matched for mode of HIV transmission. Outcomes were defined using the first HIV-RNA measure in the time window ranging between −2 and +6 months of the diagnosis/index date. The primary outcome used a single value >200 copies/mL to define HIV-RNA elevation associated with risk of transmission. The association between syphilis infection and the protocol defined outcome was evaluated using logistic regression analysis. Results: Nine hundred twenty-six PLWH with a syphilis event were enrolled and matched with a random sample of 1370 PLWH without syphilis. Eighteen of the 926 (1.9%) with syphilis had ≥1 HIV-RNA >200 copies/mL in the window vs. 29/1370 (2.1%) of the not exposed ( P = 0.77). In the multivariable analysis adjusted for age, year of diagnosis/index date, and clinical site, syphilis infection was not associated with the risk of HIV-RNA >200 copies/mL (adjusted odds ratio 0.81; 95% confidence interval 0.43–1.52, P = 0.508). Conclusions: We did not find any evidence for an association between syphilis infection and viral elevation >200 copies/mL.