Are Clinicians Aware Enough of Syphilis in HIV-Infected Populations? The Clinical and Laboratory Findings in A Training Hospital

Year 2019, Volume: 5 Issue: 3, 202 - 208, 01.07.2019

Ercan Yenilmez , Riza Aytac Cetinkaya

https://doi.org/10.5455/umj.20190717083737

Abstract

Background: Our study aimed to reveal the seroprevalence of syphilis in HIV-positive patients in our center and to reveal the diagnostic performance of the reverse sequence algorithm Materials and Methods: The study data were obtained retrospectively. Statistical analyses were carried out using SPSS version 20.0. Screening for syphilis was performed by reverse sequence algorithm using chemiluminescent microparticle immunoassay CMIA , Rapid Plasma Reagin and T.pallidum hemagglutination tests. Results: A total of 91 HIV-positive patients were included in the study. Of these patients, 15 16.48% had never been tested for syphilis, and the rate of the patients who have a proper follow-up for syphilis was only 36.17%. Nineteen patients were diagnosed with syphilis; the overall syphilis rate was 20.88%. The mean time to the diagnosis of syphilis was 9.89±13.5 months, ranging from 0 to 48 months. Of the 76 patients screened for syphilis, 19 25% had CMIA positivity with concurrent RPR positivity. Concurrent TP-HA testing was performed in 54 71.05% of the 76 patients and 17 89.4% of 19 patients with CMIA positivity, and all of these patients with CMIA positivity revealed positive TP-HA results. Conclusions: Syphilis co-infection rate in HIV-positive patients in our hospital was high. However, there are still deficiencies in the screening of syphilis, and it has been shown that a specific screening algorithm is not adopted by the clinicians who follow-up HIV-positive patients. Besides, non-treponemal and treponemal tests in the reverse sequence algorithm revealed reliable results in the diagnosis of syphilis in HIV-infected patients.

Keywords

HIV, syphilis, reverse sequence diagnostic algorithm, chemiluminescent immunoassay, RPR, Treponema pallidum hemagglutination assay

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