Source:
Wolters Kluwer Health- AIDS
Author:
Antonio, Marilia B.; Cuba, Gabriel T.; Vasconcelos, Ricardo P.; Alves, Ana Paula P.S.; da Silva, Bruna Oliveira; Avelino-Silva, Vivian Iida.
Abstract:
Background: Although doxycycline is widely used as an alternative to benzathine
penicillin for the treatment of early and late latent syphilis, data on serological response
following treatment with doxycycline among HIV-infected patients are limited.
Methods: In this study, we analysed serological response to syphilis treatment with
doxycycline among HIV-infected patients treated during a benzathine penicillin
shortage period and compared with treatment response among patients treated with
benzathine penicillin. Cases with neurosyphilis and those treated with suboptimal
doses or with concurrent medications in association with benzathine penicillin or
doxycycline were excluded.
Results: Fifty patients treated with doxycycline from September 2014 to December 2016
were compared with 115 patients treated with benzathine penicillin for early, late latent or
latent syphilis of unknown duration. Patients treated with doxycycline were slightly older
[(median 49 years old, 95%confidence interval (95%CI) 43–56] than those in the penicillin
group (median 44 years old, 95% CI 37–50; P¼0.007). Groups had no statistically
significant differences regarding sex, HIV suppression under treatment and syphilis stages.
Serological response to treatment, defined as a nonreagent Venereal Disease Research
Laboratory (VDRL) or at least a four-fold reduction in VDRL titres measured 6–12 months
after treatment, was seen in 72% (95% CI 58–84) of patients treated with doxycycline and
70% (95% CI 60–78) of patients treated with penicillin (P¼0.753).
Conclusion: We found no statistically significant differences in serological response to
treatment with doxycycline or benzathine penicillin among HIV-infected patients with
early, late latent or latent syphilis of unknown duration. Our findings suggest that
doxycycline is an acceptable treatment to HIV-infected patients with nontertiary stages
of syphilis.
Natural_experiment_of_syphilis_treatment_with.8
Link para download aqui