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

  • I Ketut Agus Somia Tropical and Infectious Disease Division, Department of Internal Medicine, Udayana University- Sanglah Hospital Bali-Indonesia.
  • Ketut Tuti Parwati Merati Tropical and Infectious Disease Division, Department of Internal Medicine, Udayana University- Sanglah Hospital Bali-Indonesia.
  • Dewi Dian Sukmawati Tropical and Infectious Disease Division, Department of Internal Medicine, Udayana University- Sanglah Hospital Bali-Indonesia.
  • Nittaya Phanuphak The Thai Red Cross AIDS Research Centre
  • IGAA Elis Indira Department of Dermatology and Venerology, Udayana University - Sanglah Hospital Bali-Indonesia
  • Made Yogi Oktavian Prasetia Nusa Indah VCT Clinic, Sanglah Hospital Bali-Indonesia
  • Komang Agus Trisna Amijaya Nusa Indah VCT Clinic, Sanglah Hospital Bali-Indonesia
  • AA Sagung Sawitri Department of Public Health, Udayana University Bali-Indonesia

Abstract

Background: 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. Methods: MSM were enrolled into the MSM-VCT study cohort at Sanglah Hospital in Bali between June 22 nd 2011 to February 13 rd 2012. 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. Results: 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). Conclusions: 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.

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Author Biographies

I Ketut Agus Somia, Tropical and Infectious Disease Division, Department of Internal Medicine, Udayana University- Sanglah Hospital Bali-Indonesia.
Nusa Indah VCT Clinic, Sanglah Hospital Bali-Indonesia
Ketut Tuti Parwati Merati, Tropical and Infectious Disease Division, Department of Internal Medicine, Udayana University- Sanglah Hospital Bali-Indonesia.
Nusa Indah VCT Clinic, Sanglah Hospital Bali-Indonesia
Dewi Dian Sukmawati, Tropical and Infectious Disease Division, Department of Internal Medicine, Udayana University- Sanglah Hospital Bali-Indonesia.
Nusa Indah VCT Clinic, Sanglah Hospital Bali-Indonesia
Nittaya Phanuphak, The Thai Red Cross AIDS Research Centre
The Thai Red Cross AIDS Research Centre
IGAA Elis Indira, Department of Dermatology and Venerology, Udayana University - Sanglah Hospital Bali-Indonesia
Department of Dermatology and Venerology, Udayana University - Sanglah Hospital Bali-Indonesia
Made Yogi Oktavian Prasetia, Nusa Indah VCT Clinic, Sanglah Hospital Bali-Indonesia
Nusa Indah VCT Clinic, Sanglah Hospital Bali-Indonesia
Komang Agus Trisna Amijaya, Nusa Indah VCT Clinic, Sanglah Hospital Bali-Indonesia
Nusa Indah VCT Clinic, Sanglah Hospital Bali-Indonesia
AA Sagung Sawitri, Department of Public Health, Udayana University Bali-Indonesia
Department of Public Health, Udayana University Bali-Indonesia
How to Cite
SOMIA, I Ketut Agus et al. 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. BALI MEDICAL JOURNAL, [S.l.], v. 5, n. 3, oct. 2016. ISSN 2302-2914. Available at: <https://ojs.unud.ac.id/index.php/bmj/article/view/23944>. Date accessed: 10 july 2020.
Section
Articles

Keywords

MSM, HIV, Syphilis; HIV-1 RNA, CD4 count