{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:43:58Z","timestamp":1790207038441,"version":"4.1.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T00:00:00Z","timestamp":1705276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008235","name":"Peking Union Medical College Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008235","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005150","name":"Chinese Academy of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005150","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to analyze the efficacy of anti-syphilis treatment and the impact of syphilis events on HIV virology and immunology in HIV\/syphilis co-infected patients on long-term antiretroviral therapy (ART) and to investigate the incidence and factors of syphilis recurrence\/re-infection\/serofast state. The insights derived from this investigation can potentially guide strategies for preventing and managing syphilis and AIDS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective case\u2013control study was conducted at the AIDS clinic of Peking Union Medical College Hospital from January 2003 to December 2022. The study involved 86 HIV\/syphilis co-infected patients and 86 HIV mono-infected patients matched based on age, baseline CD4\u2009+\u2009T cell counts, and viral load. We examined the clinical characteristics of HIV\/syphilis co-infected patients, evaluated the efficacy of anti-syphilis treatment, and analyzed the dynamic changes in HIV virology and immunology. The Generalized Estimating Equations (GEE) model investigated the factors associated with HIV\/syphilis co-infection and syphilis recurrence\/reinfection\/serofast state.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Syphilis serofast state was observed in 11.6% (10\/86) of HIV\/syphilis co-infected patients after treatment, and 33.7% (29\/86) had syphilis recurrence or re-infection. The overall effectiveness of syphilis treatment stood at 76.8% (63\/82). Notably, the effectiveness of syphilis treatment displayed a significant correlation with baseline syphilis titers exceeding 1:128 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Over the 10-year follow-up period on ART, the HLA-DR\u2009+\u2009CD8+\/CD8\u2009+\u2009% levels in the HIV\/syphilis co-infected group were markedly higher than those in the HIV mono-infected group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). However, no significant differences were observed between the two groups regarding HIV viral load, CD4+ T cell counts, CD8+ T cell counts, CD4\/CD8 ratio, and CD38\u2009+\u2009CD8+\/CD8\u2009+\u2009% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). GEE analysis model revealed that elevated HLA-DR\u2009+\u2009CD8+\/CD8\u2009+\u2009% levels were associated with HIV\/syphilis co-infection (OR\u2009=\u20091.026, 95% CI\u2009=\u20091.007\u20131.046;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007) and syphilis recurrence\/reinfection\/serofast state (OR\u2009=\u20091.036, 95% CI\u2009=\u20091.008\u20131.065;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While HIV\/syphilis co-infected patients typically receive adequate treatment, the incidence of syphilis recurrence and reinfection remain notably elevated. A heightened HLA-DR\u2009+\u2009CD8+\/CD8+ % is a notable risk factor for HIV\/syphilis co-infection and syphilis recurrence\/reinfection\/serofast state. Therefore, it is advisable to reinforce health education efforts and ensure regular follow-ups for people living with HIV undergoing ART to monitor syphilis infection or increased risk of syphilis infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2023.1327896","type":"journal-article","created":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T06:40:13Z","timestamp":1705300813000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":19,"title":["Clinical and immunological characteristics of HIV\/syphilis co-infected patients following long-term antiretroviral treatment"],"prefix":"10.3389","volume":"11","author":[{"given":"Yuanni","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianfeng","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojing","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaosheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taisheng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"4","DOI":"10.13419\/j.cnki.aids.2023.03.01","article-title":"Analysis 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