final program.qxd - Parallels Plesk Panel

PP 3.36
Impact of syphilis infection on HIV viral load and CD4 cell counts in HIV-infected
patients
Palacios R., Jiménez-Oñate F., Aguilar M., Galindo M.J., Rivas P., Miralles P., Ríos M.J.,
Knöbel H., Ena J., Arranz J.A., de la Torre J., Márquez M., Santos J.
Hosp. Virgen de la Victoria, Málaga, Spain, Hosp. Carlos Haya, Málaga, Spain, Hosp.
Virgen del Rocío, Sevilla, Spain, Hosp. General, Valencia, Spain, Hosp. Gregorio
Marañón, Madrid, Spain, Hosp. Carlos III, Madrid, Spain, Hosp. Virgen Macarena, Sevilla,
Spain, Hosp. Xeral, Vigo, Spain, Hosp. del Mar, Barcelona, Spain, Hosp. Marina Baixa,
Villajoyosa, Spain, Hosp. Príncipe de Asturias, Alcalá de Henares, Spain, Hosp. Costa del
Sol, Marbella, Spain
Objectives
Although increases in HIV viral load (VL) and decreases in CD4 cell count have been
suggested in HIV-patients with syphilis infection, the interaction between syphilis and
these variables is not well defined. Our aim was to assess the effect of early syphilis on
HIV VL and CD4 cell count in HIV-infected patients, and to analyze factors associated with
changes in HIV VL and CD4.
Methods
multicenter study of a series of HIV patients diagnosed with early syphilis infection during
2004-2005. All patients had HIV VL and CD4 cell count measurements during the syphilis
infection, and, at least another determination before and/or after this event. Patients who
started or changed their HAART regimen during the analysis period were excluded.
Statistical program: SPSS ® 12.0.
Results
151 HIV patients with early syphilis were identified in 12 Spanish hospitals, 118 satisfied
the inclusion criteria for study entry. 95.7% were men, the mean age was 38.0 years,
83.8% were men who had sex with men; 59 (50.4%) were on antiretroviral therapy at
diagnosis of syphilis, and in 38 (32.5%) cases, diagnosis of HIV and syphilis infection were
coincident. CD4 cell counts were lower during syphilis than before infection (596 vs 502
cells/mL; p=0.0001), and than after syphilis treatment (509 vs 597 cells/mL; p=0.0001).
HIV VL increased in 28.0% patients during syphilis. The only factor associated with HIV
VL increase was not being on HAART (OR 3.19, CI 95% 1.02-10.01; p=0.04), and the only
factor associated with a CD4 decrease >100 cells/ L during syphilis was the prior CD4 cell
count.
POSTERS
Conclusions
syphilis infection was associated with decreases in CD4 cell count and increases in HIV
VL in almost one third of the patients. In this series more than two thirds of the syphilis
cases were diagnosed in prior known HIV-infected patients.
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