Investigation of syphilis coinfection and performance of the Architect Syphilis Tp ELISA screening test in HIV positive patients
Background/aim:
Limited data on syphilis coinfection in human immunodeficiency virus (HIV) positive cases exist in Turkey. Our aim
is to investigate syphilis coinfection and to evaluate the compatibility of the screening Architect Syphilis Tp ELISA with the fluorescent
treponemal antibody absorption (FTA-abs) confirmation test in HIV positive cases.
Materials and methods:
Totally 519 HIV positive patients were included in the study. Enzyme linked fluorescent assay (ELFA) was
used as a screening test and positive samples were confirmed by line immunassay (LIA). In order to discriminate acute HIV infection
and false ELISA positivity, HIV-1 RNA PCR was performed in ELFA positive and LIA negative samples. Architect Syphilis TP ELISA
was used for the detection of total antibodies against
Treponema pallidum
in HIV positive patients. Positive results were confirmed by
the FTA-abs test.
Results:
Out of 519 HIV-1 positive patients, IgG and IgM positivity, and only IgG positivity was detected as 1.9% and 11.4% in all the
samples, respectively. A total of 79 (15.2%) sera were positive with Architect Syphilis Tp ELISA test and 69 (13.3%) were positive with
FTA-abs test. Statistically significant, almost perfect agreement was found between Architect Syphilis Tp ELISA and FTA-abs tests
(kappa = 0.921 and P < 0.001).
Conclusion:
Implementation of syphilis and HIV screening tests together among risk groups is considered to be appropriate.
___
- Bhattar S, Aggarwal P, Sahani SK, Bhalla P. Co-infections and
sero-prevalence of HIV, syphilis, hepatitis B and C infections
in sexually transmitted infections clinic attendees of tertiary
care hospital in North India. J Res Health Sci 2016; 16: 162-165.
- Niama RF, Loukabou Bongolo NC, Bayonne Kombo ES, Yengo
R, Mayengue PI, Mandingha Kosso EB, Louzolo I, Macosso
L, Dzeret G, Dzabatou Babeaux ASP et al. Syphilis and HIV
infections among pregnant women attending antenatal clinics
in Republic of Congo. Pan Afr Med J 2017; 28: 8.
- Badie Yavari Z, Esmaeeli S, Paydary K, Emamzadeh-Fard
S, Seyedalinaghi S, Rasoulinejad M. Prevalence survey of
infection with Treponema pallidum among HIV-positive
patients in Tehran. Asian Pac J Trop Biomed 2013; 3: 334-336.
- McCoy SI, Eron JJ, Kuruc JD, Strauss RP, Macdonald PD,
Fiscus SA, Barnhart J, Pilcher CD, Leone PA, Miller WC.
Sexually transmitted infections among patients with acute HIV
in North Carolina. Sex Transm Dis 2009; 36: 372-374.
- Aktaş G, Ağaçfidan A, Yılmaz G, Badur S. Seroprevalence
of HIV infection in patients with positive syphilis serology.
İstanbul Tıp Fakültesi Dergisi 2008; 4: 116-119.
- Funnyé A, Akhtar A. Syphilis and human immunodeficiency
virus co-infection. J Natl Med Assoc 2003; 95: 363-382.
- Centers for Disease Control and Prevention, Workowski
KA, Berman SM. Sexually transmitted diseases treatment
guidelines. MMWR Recomm Rep 2006; 55: 1-94.
- Centers for Disease Control and Prevention, Association
of Public Health Laboratories. Laboratory Testing for the
Diagnosis of HIV infection: Updated Recommendations.
Atlanta, GA, USA: CDC; 2014.
- Sharma S, Chaudhary J, Hans C. VDRL v/s TPHA for diagnosis
of syphilis among HIV sero-reactive patients in a tertiary care
hospital. Int J Curr Microbiol App Sci 2014; 3: 726-730.
- Augenbraun M, French A, Glesby M, Sanchez-Keeland L,
Young M, Greenblatt R, Sharma A. Hepatitis C virus infection
and biological false-positive syphilis tests. Sex Transm Infect
2010; 86: 97-98.
- Larsen SA, Steiner BM, Rudolph AH. Laboratory diagnosis
and interpretation of tests for syphilis. Clin Mcrobiol Rev 1995;
8: 1-21.
- Löwhagen GB. Syphilis: test procedures and therapeutic
strategies. Semin Dermatol 1990; 9: 152-159.
- Binnicker MJ, Jespersen DJ, Rollins LO. Treponema-specific
tests for serodiagnosis of syphilis: comparative evaluation of
seven assays. J Clin Microbiol 2011; 49: 1313-1317.
- Pennap GR, Osita SO, Adoga MP. Owuna G, Agwale S
.
Prevalence of
Treponema pallidum
infection among human
immunodeficiency virus seropositive persons and their
corresponding CD4 counts in a Nigerian Cohort. Br Microbiol
Res J 2011; 1: 49-54.
- Kalichman SC, Pellowski J, Turner C. Prevalence of sexually
transmitted co-infections in people living with HIV/AIDS:
systematic review with implications for using HIV treatments
for prevention. Sex Transm Infect 2011; 87: 183-190.
- Callegari FM, Pinto-Neto LF, Medeiros CJ, Scopel CB, Page K,
Miranda AE. Syphilis and HIV co-infection in patients who
attend an AIDS outpatient clinic in Vitoria, Brazil. AIDS Behav
2014; 18: 104-109.
- Turbadkar D, Mathur M, Gaikwad S. Prevalence of syphilis
among HIV-seroreactive patients. Indian J Sex Transm Dis
2007; 28: 91-93.
- Ward H, Rönn M. Contribution of sexually transmitted
infections to the sexual transmission of HIV. Curr Opin HIV
AIDS 2010; 5: 305-310.
- Jarzebowski W, Caumes E, Dupin N, Farhi D, Lascaux AS,
Piketty C, Truchis P, Bouldouyre MA, Derradji O, Pacanowski
J et al. Effect of early syphilis infection on plasma viral load and
CD4 cell count in human immunodeficiency virus infected
men: results from the FHDH-ANRS CO4 cohort. Arch Intern
Med 2012; 172: 1237-1243.
- Zetola NM, Klausner JD. Syphilis and HIV infection: An
update. Clin Infect Dis 2007; 44: 1222-1228.
- Janier M, Hegyi V, Dupin N, Unemo M, Tiplica GS, Potočnik
M, French P, Patel R. 2014 European guideline on the
management of syphilis. J Eur Acad Dermatol Venereol 2014;
28: 1581-1593.
- Kofoed K
, Gerstoft J
, Mathiesen LR
, Benfield T
. Syphilis
and human immunodeficiency virus (HIV)-1 coinfection:
influence on CD4 T-cell count, HIV-1 viral load, and treatment
response. Sex Transm Dis 2006; 33: 143-148.
- Royce RA, Sena A, Cates W Jr, Cohen MS. Sexual transmission
of HIV. N Engl J Med 1997; 336: 1072-1078.
- Marangoni A, Moroni A, Accardo S, Cevenini R. Laboratory
diagnosis of syphilis with automated immunoassays. J Clin Lab
Anal 2009; 23: 1-6.