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

The study authors sought to evaluate the incidence of early syphilis based on time from initiation of highly active antiretroviral therapy (HAART) in HIV-infected patients.

HIV-positive patients undergoing HAART (539) were followed for up to four years to identify early (primary or secondary) syphilis. After adjusting for calendar year, Poisson regression was used to evaluate incidence rate trends according to time from HAART initiation.

With median follow-up of 2.9 years, 56 (10.4 percent) patients experienced early syphilis -- 17 (3.2 percent) with primary syphilis, and 39 (7.2 percent) with secondary syphilis. Four years after HAART initiation, the overall incidence rate of early syphilis was 4.57 per 100 person-years (95 percent confidence interval, 3.45-5.93). The incidence rate of early syphilis significantly increased in proportion to the years after the initiation of HAART (3.4-6.1 per 100 person-year, P for trend "Early syphilis incidence in HIV-infected patients increased in proportion to HAART duration," the authors concluded. "This 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."

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