Abstract | BACKGROUND: Treatment guidelines recommend the use of a single dose of benzathine penicillin G (BPG) for treating early syphilis in human immunodeficiency virus (HIV)-infected persons. However, data supporting this recommendation are limited. We examined the efficacy of single-dose BPG in the US Military HIV Natural History Study. METHODS: Subjects were included if they met serologic criteria for syphilis (ie, a positive nontreponemal test [NTr] confirmed by treponemal testing). Response to treatment was assessed at 13 months and was defined by a ≥4-fold decline in NTr titer. Multivariate Cox proportional hazard regression models were utilized to examine factors associated with treatment response. RESULTS: Three hundred fifty subjects (99% male) contributed 478 cases. Three hundred ninety-three cases were treated exclusively with BPG (141 with 1 dose of BPG). Treatment response was the same among those receiving 1 or >1 dose of BPG (92%). In a multivariate analysis, older age (hazard ratio [HR], 0.82 per 10-year increase; 95% confidence interval [CI], .73-.93) was associated with delayed response to treatment. Higher pretreatment titers (reference NTr titer <1:64; HR, 1.94 [95% CI, 1.58-2.39]) and CD4 counts (HR, 1.07 for every 100-cell increase [95% CI, 1.01-1.12]) were associated with a faster response to treatment. Response was not affected by the number of BPG doses received (reference, 1 dose of BPG; HR, 1.11 [95% CI, .89-1.4]). CONCLUSIONS: In this cohort, additional BPG doses did not affect treatment response. Our data support the current recommendations for the use of a single dose of BPG to treat HIV-infected persons with early syphilis.
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Authors | Anuradha Ganesan, Octavio Mesner, Jason F Okulicz, Thomas O'Bryan, Robert G Deiss, Tahaniyat Lalani, Timothy J Whitman, Amy C Weintrob, Grace Macalino, Brian K Agan, Infectious Disease Clinical Research Program HIV/STI Working Group |
Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
(Clin Infect Dis)
Vol. 60
Issue 4
Pg. 653-60
(Feb 15 2015)
ISSN: 1537-6591 [Electronic] United States |
PMID | 25389249
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected]. |
Chemical References |
- Antitreponemal Agents
- Penicillin G Benzathine
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Topics |
- Adult
- Age Factors
- Aged
- Antitreponemal Agents
(administration & dosage)
- CD4 Lymphocyte Count
- Cohort Studies
- Drug Administration Schedule
- Female
- Follow-Up Studies
- HIV Infections
(complications)
- Humans
- Injections, Intramuscular
- Male
- Middle Aged
- Multivariate Analysis
- Penicillin G Benzathine
(administration & dosage)
- Proportional Hazards Models
- Syphilis
(complications, diagnosis, drug therapy)
- Young Adult
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