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Research article
Adeodatus Richard Haule
Catholic University of Health and Allied Sciences
Corresponding Author
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Background: HIV-syphilis co-infection can enhance the rapid progression of early or late latent syphilis to neurosyphilis and can cause catastrophic neurological complications. In studies in Mwanza, syphilis affects ~8% of healthy outpatients and studies done in the 1990s have suggested that up to 23.5% of HIV-syphilis co-infected patients also have neurosyphilis.
Methodology: This was a cross sectional study in which adult HIV infected patients who were hospitalized or attending the outpatient Care and Treatment Clinic (CTC) were interviewed using a structured questionnaire and screened for syphilis using serum Treponema Pallidum Hemagglutination Assay (TPHA). Blood was also taken for CD4+ T cells and viral load. Those who were found to have syphilis underwent neurological examination for any neurologic deficit and were offered a lumbar puncture.
Results: The prevalence of syphilis in HIV infected patients was found to be 9.6%. The majority of patients were female (72.5%) and median age was 42 years [interquartile range, 32-50]. Most patients were on ART (99.4%). In the study population of 1748 participants, 9.6% were TPHA positive; the majority (89.2%) reported not knowing their syphilis status and not previously been treated. One hundred and forty-one participants with syphilis had neurological examinations performed. Four of these had abnormal findings that necessitated a lumbar puncture. Neurosyphilis was confirmed in one patient (0.7%).
Conclusion: The high prevalence of syphilis in HIV infected patients indicates that there is a need to increase efforts in targeting this population to reduce sexually transmitted infections. Screening for syphilis should be done for all HIV patients given the high prevalence of the infection and the risk that aggressive forms of neurosyphilis can occur despite recovery of CD4+ T cell counts in untreated syphilis.
Keywords
Human immunodeficiency virus, Syphilis, Neurosyphilis, Human immunodeficiency virus- Treponema pallidum co-infection
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View the published article at BMC Public Health.
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On 28 Nov, 2020
Editorial decision: Accept
On 25 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 15 Nov, 2020
Editor assigned
On 10 Feb, 2020
Submission checks complete
On 09 Feb, 2020
Editor invited
On 09 Feb, 2020
No comments provided
Editorial decision: Minor revision
On 20 Jan, 2020
Review #1 received
Received 16 Jan, 2020
Reviewer #2 agreed
On 07 Jan, 2020
Review #2 received
Received 07 Jan, 2020
Reviewers invited
Invitations sent on 05 Jan, 2020
Reviewer #1 agreed
On 05 Jan, 2020
Editor assigned
On 03 Jan, 2020
Editor invited
On 02 Jan, 2020
Submission checks complete
On 31 Dec, 2019
No comments provided
Editorial decision: Major revision
On 24 Nov, 2019
Review #2 received
Received 22 Nov, 2019
Reviewer #2 agreed
On 10 Nov, 2019
Review #1 received
Received 27 Sep, 2019
Reviewer #1 agreed
On 05 Sep, 2019
Reviewers invited
Invitations sent on 05 Sep, 2019
Editor assigned
On 22 Aug, 2019
Submission checks complete
On 19 Aug, 2019
Editor invited
On 19 Aug, 2019
First submitted
On 12 Aug, 2019
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PDF Downloads: ...
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Subject Areas
Epidemiology
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See the published version of this preprint at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Adeodatus Richard Haule
Catholic University of Health and Allied Sciences
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
Version 4
Posted 08 Dec, 2020
No community comments so far
Submission checks complete
On 28 Nov, 2020
Editorial decision: Accept
On 25 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 15 Nov, 2020
Editor assigned
On 10 Feb, 2020
Submission checks complete
On 09 Feb, 2020
Editor invited
On 09 Feb, 2020
No comments provided
Editorial decision: Minor revision
On 20 Jan, 2020
Review #1 received
Received 16 Jan, 2020
Reviewer #2 agreed
On 07 Jan, 2020
Review #2 received
Received 07 Jan, 2020
Reviewers invited
Invitations sent on 05 Jan, 2020
Reviewer #1 agreed
On 05 Jan, 2020
Editor assigned
On 03 Jan, 2020
Editor invited
On 02 Jan, 2020
Submission checks complete
On 31 Dec, 2019
No comments provided
Editorial decision: Major revision
On 24 Nov, 2019
Review #2 received
Received 22 Nov, 2019
Reviewer #2 agreed
On 10 Nov, 2019
Review #1 received
Received 27 Sep, 2019
Reviewer #1 agreed
On 05 Sep, 2019
Reviewers invited
Invitations sent on 05 Sep, 2019
Editor assigned
On 22 Aug, 2019
Submission checks complete
On 19 Aug, 2019
Editor invited
On 19 Aug, 2019
First submitted
On 12 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Epidemiology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background: HIV-syphilis co-infection can enhance the rapid progression of early or late latent syphilis to neurosyphilis and can cause catastrophic neurological complications. In studies in Mwanza, syphilis affects ~8% of healthy outpatients and studies done in the 1990s have suggested that up to 23.5% of HIV-syphilis co-infected patients also have neurosyphilis.
Methodology: This was a cross sectional study in which adult HIV infected patients who were hospitalized or attending the outpatient Care and Treatment Clinic (CTC) were interviewed using a structured questionnaire and screened for syphilis using serum Treponema Pallidum Hemagglutination Assay (TPHA). Blood was also taken for CD4+ T cells and viral load. Those who were found to have syphilis underwent neurological examination for any neurologic deficit and were offered a lumbar puncture.
Results: The prevalence of syphilis in HIV infected patients was found to be 9.6%. The majority of patients were female (72.5%) and median age was 42 years [interquartile range, 32-50]. Most patients were on ART (99.4%). In the study population of 1748 participants, 9.6% were TPHA positive; the majority (89.2%) reported not knowing their syphilis status and not previously been treated. One hundred and forty-one participants with syphilis had neurological examinations performed. Four of these had abnormal findings that necessitated a lumbar puncture. Neurosyphilis was confirmed in one patient (0.7%).
Conclusion: The high prevalence of syphilis in HIV infected patients indicates that there is a need to increase efforts in targeting this population to reduce sexually transmitted infections. Screening for syphilis should be done for all HIV patients given the high prevalence of the infection and the risk that aggressive forms of neurosyphilis can occur despite recovery of CD4+ T cell counts in untreated syphilis.
Figure 1
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