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Observational Study
. 2021 Oct 1;88(2):132-137.
doi: 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

Andrea Giacomelli  1 , Alessandro Cozzi-Lepri  2 , Antonella Cingolani  3 , Alessandro Tavelli  4 , Valentina Mazzotta  5 , Daniele Tesoro  6 , Matteo Bassetti  7 , Antonella Castagna  8 , Antonio Di Biagio  7 , Miriam Lichter  9 , Antonella d'Arminio Monforte  6 , Stefano Rusconi  1   10 ; ICONA Foundation Study Group
Affiliations
Free article
Observational Study

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

Andrea Giacomelli et al. J Acquir Immune Defic Syndr. .
Free article

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 Naive Antiretrovirals.

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 1 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 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.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

References

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