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 Naïve Antiretrovirals (ICONA). 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 one 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 and 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.

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 / A. Giacomelli, A. Cozzi-Lepri, A. Cingolani, A. Tavelli, V. Mazzotta, D. Tesoro, M. Bassetti, A. Castagna, A. Di Biagio, M. Lichter, A.D. Monforte, S. Rusconi. - In: JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES. - ISSN 1525-4135. - Publish Ahead of Print:(2021). [Epub ahead of print] [10.1097/QAI.0000000000002749]

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

A. Giacomelli
Primo
;
D. Tesoro;A.D. Monforte
Penultimo
;
S. Rusconi
Ultimo
2021

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 Naïve Antiretrovirals (ICONA). 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 one 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 and 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.
HIV, PLWH, syphilis, viral rebound, STDs, TasP
Settore MED/17 - Malattie Infettive
15-giu-2021
Article (author)
File in questo prodotto:
File Dimensione Formato  
Does_syphilis_increase_the_risk_of_HIV_RNA.95862_JAIDS June 2021.pdf

embargo fino al 15/06/2022

Tipologia: Post-print, accepted manuscript ecc. (versione accettata dall'editore)
Dimensione 495.33 kB
Formato Adobe PDF
495.33 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/855930
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus ND
  • ???jsp.display-item.citation.isi??? 2
social impact