The Effects of Syphilis Infection on CD4 Counts and HIV-1 RNA Viral Loads in Blood: A Cohort Study Among MSM with HIV Infection in Sanglah Hospital Bali-Indonesia

• Main Authors: I Ketut Agus Somia, Ketut Tuti Parwati Merati, Dewi Dian Sukmawati, Nittaya Phanuphak, IGAA Elis Indira, Made Yogi Oktavian Prasetia, Komang Agus Trisna Amijaya, AA Sagung Sawitri
• Format: Article
• Language: English
• Published: DiscoverSys 2016-09-01
• Series: Bali Medical Journal
• Subjects: msm, hiv, syphilis; hiv-1 rna, cd4 count
• Online Access: https://balimedicaljournal.org/index.php/bmj/article/view/283
• ISSN: 2089-1180; 2302-2914

<p><strong>Background: </strong>Men who have sex with men (MSM), particularly those with HIV infection, are at high risk for contracting syphilis. However, little is known about the effect of syphilis on HIV-1 RNA and CD4 count among HIV infected MSM. <strong>Methods:</strong> MSM were enrolled into the MSM-VCT study cohort at Sanglah Hospital in Bali between June 22^nd2011 to February 13^rd2012. All participants had anti-HIV test and VDRL test at baseline, with TPHA confirmation for reactive VDRL results. Plasma HIV-1 RNA levels and CD4 counts were measured at baseline and month 6 visits. T-test or non-parametric Mann-Whitney test were used to compare changes in CD4 counts and HIV-1 RNA levels between those with and without syphilis. To analyze difference of baseline and 6 month visit in each group, we used paired students t-test. <strong>Results:</strong> HIV positive MSM with syphilis co-infection had significantly higher mean baseline CD4 count than those without syphilis (P=0.017). No difference was seen for median baseline plasma HIV-1 RNA between HIV positive MSM with and without syphilis (P=0.885). Mean change in CD4 count from baseline to month 6 was similar between HIV positive MSM with syphilis (n=11) and without syphilis (n=20) (P=0.860). Similarly, no significant difference in median HIV-1 RNA change was identified between those with (n=8) and without syphilis (n=11) (P=1.000). <strong>Conclusions:</strong> HIV positive MSM with syphilis co-infection had higher CD4 cell counts. However, syphilis influences the changes of CD4 cell count and HIV-1 RNA 6 months after HIV diagnosis, but not statistically significance.</p>