TY - JOUR
T1 - One dose versus three weekly doses of benzathine penicillin G for patients co-infected with Hiv and early syphilis
T2 - A multicenter, prospective observational study
AU - Yang, Chia Jui
AU - Lee, Nan Yao
AU - Chen, Tun Chieh
AU - Lin, Yu Hui
AU - Liang, Shiou Haur
AU - Lu, Po Liang
AU - Huang, Wen Chi
AU - Tang, Hung Jen
AU - Lee, Chen Hsiang
AU - Lin, Hsi Hsun
AU - Chen, Yen Hsu
AU - Ko, Wen Chien
AU - Hung, Chien Ching
N1 - Publisher Copyright:
© 2014 Yang et al.
PY - 2014/10/6
Y1 - 2014/10/6
N2 - Background:One dose of benzathine penicillin G (BPG) has been recommended for HIV-infected patients with early syphilis (primary, secondary, and early latent syphilis) in the sexually transmitted diseases treatment guidelines, but clinical data to support such a recommendation are limited.Methods: We prospectively observed the serological response to 1 or 3 weekly doses of BPG in HIV-infected adults who sought treatment of early syphilis at 8 hospitals around Taiwan. Rapid plasma reagin (RPR) titers were followed every 3-6 months after treatment. The serological response was defined as a 4-fold or greater decline in RPR titers at 12 months of treatment. The missing values were treated by following the last-observed-carried-forward principle. We hypothesized that 1 dose was non-inferior to 3 weekly doses of BPG with the non-inferiority margin for the difference of serological response set to 10%.Results: Between 2007 and 2012, 573 patients completed at least 12 months of follow-up: 295 (51.5%) receiving 1 dose of BPG (1-dose group) and 278 (48.5%) 3 doses (3-dose group). Overall, 198 patients (67.1%; 95% confidence interval [Cl], 61.472.5%) in the 1-dose group achieved serological response at 12 months, as did 208 patients (74.8%; 95% Cl, 69.3-79.8%) in the 3-dose group (one-sided 95% Cl of the difference, 15.1%). In the multivariate analysis, secondary syphilis (adjusted odds ratio [AOR], 1.90; 95% Cl 1.17-3.09), RPR titer ≥32 (AOR, 1.93; 95% Cl, 1.38-2.69), and 3 doses of BPG (AOR, 1.68; 95% Cl, 1.20-2.36) were independently associated with a serological response. The time to the first episode of treatment failure was 1184 (standard deviation [SD], 70.5) and 1436 (SD, 80.0) days for 1- and 3-dose group, respectively.Conclusions: Single-dose BPG resulted in a higher serological failure rate and shorter time to treatment failure than 3 weekly doses of BPG in the treatment of early syphilis in HIV-infected patients.
AB - Background:One dose of benzathine penicillin G (BPG) has been recommended for HIV-infected patients with early syphilis (primary, secondary, and early latent syphilis) in the sexually transmitted diseases treatment guidelines, but clinical data to support such a recommendation are limited.Methods: We prospectively observed the serological response to 1 or 3 weekly doses of BPG in HIV-infected adults who sought treatment of early syphilis at 8 hospitals around Taiwan. Rapid plasma reagin (RPR) titers were followed every 3-6 months after treatment. The serological response was defined as a 4-fold or greater decline in RPR titers at 12 months of treatment. The missing values were treated by following the last-observed-carried-forward principle. We hypothesized that 1 dose was non-inferior to 3 weekly doses of BPG with the non-inferiority margin for the difference of serological response set to 10%.Results: Between 2007 and 2012, 573 patients completed at least 12 months of follow-up: 295 (51.5%) receiving 1 dose of BPG (1-dose group) and 278 (48.5%) 3 doses (3-dose group). Overall, 198 patients (67.1%; 95% confidence interval [Cl], 61.472.5%) in the 1-dose group achieved serological response at 12 months, as did 208 patients (74.8%; 95% Cl, 69.3-79.8%) in the 3-dose group (one-sided 95% Cl of the difference, 15.1%). In the multivariate analysis, secondary syphilis (adjusted odds ratio [AOR], 1.90; 95% Cl 1.17-3.09), RPR titer ≥32 (AOR, 1.93; 95% Cl, 1.38-2.69), and 3 doses of BPG (AOR, 1.68; 95% Cl, 1.20-2.36) were independently associated with a serological response. The time to the first episode of treatment failure was 1184 (standard deviation [SD], 70.5) and 1436 (SD, 80.0) days for 1- and 3-dose group, respectively.Conclusions: Single-dose BPG resulted in a higher serological failure rate and shorter time to treatment failure than 3 weekly doses of BPG in the treatment of early syphilis in HIV-infected patients.
UR - https://www.scopus.com/pages/publications/84907704752
UR - https://www.scopus.com/pages/publications/84907704752#tab=citedBy
U2 - 10.1371/journal.pone.0109667
DO - 10.1371/journal.pone.0109667
M3 - Article
C2 - 25286091
AN - SCOPUS:84907704752
SN - 1932-6203
VL - 9
JO - PloS one
JF - PloS one
IS - 10
M1 - e109667
ER -