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Potential Predictors for Serofast State after Treatment among HIV-Negative Persons with Syphilis in China: A Systematic Review and Meta-Analysis.

Qin J, Yang T, Wang H, Feng T, Liu X - Iran. J. Public Health (2015)

Bottom Line: However, there is a remarkable diversity among the results.Compared with healthy group and serological cure group, respectively, the levels of CD4 (+), IL-2, and IL-6 among serofast patients were decreased (standardized mean difference[SMD]<0, P<0.05), but the levels of CD8(+) and IL-10 were increased(SMD>0, P<0.05).Some studies also hinted the serofast was associated with subtypes i of treponema pallidum(TP) repeat gene (RR i vs d=4.67,95%CI: 1.31-;16.69) and TP occult infection.

View Article: PubMed Central - PubMed

Affiliation: Division of Medical Genetics, Maternal and Child Health Hospital of Hunan Province, Hunan, China ; Skate Key Laboratory of Medical Genetics, Central South University, Hunan, China.

ABSTRACT

Background: Several studies have been conducted in China in order to investigate the potential predictors of serofast state after treatment among syphilitic patients. However, there is a remarkable diversity among the results. This meta-analysis was conducted to assess potential predictors of serofast among syphilitic patients in China.

Methods: International and national electronic databases were searched up to September 2013. Reference lists of retrieved articles were also reviewed. Cohort or case-control studies addressing risk factors of serofast among syphilitic patients were included in this study.

Results: We assessed 27 separate studies involving overall 6682 HIV-negative participants with syphilis of which 1962 remained in the serofast state. The serofast was positively associated with older age(P trend=0.001), female(summary risk ratio[sRR]=1.50, 95%CI:1.34-;1.68), latent syphilis(sRRlatent vs primary=3.17, 95%CI: 2.66-;3.77; sRRlatent vs secondary=2.00, 95%CI: 1.48-;2.69) as well as non-penicillin treatment(sRR =2.99, 95%CI:2.45-;3.67), but negatively associated with higher baseline titers(sRR>1:32 vs ≤1:32=0.63, 95%CI: 0.54-;0.75). Compared with healthy group and serological cure group, respectively, the levels of CD4 (+), IL-2, and IL-6 among serofast patients were decreased (standardized mean difference[SMD]<0, P<0.05), but the levels of CD8(+) and IL-10 were increased(SMD>0, P<0.05). Some studies also hinted the serofast was associated with subtypes i of treponema pallidum(TP) repeat gene (RR i vs d=4.67,95%CI: 1.31-;16.69) and TP occult infection.

Conclusion: The age, gender, stage of infection, baseline titers, treatment drug, cellular immune suppression and disorders, TP occult infection and subtypes i of TP repeat gene should be considered as important predictors of serofast. However, until now the definition and mechanism of serofast has still been not clear.

No MeSH data available.


Related in: MedlinePlus

Study identification flowchart
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Figure 1: Study identification flowchart

Mentions: Overall, 1245 studies were identified, of which 402 potentially relevant articles were selected for further screening, and eventually 27 studies (10,11,14,17,18,25–46) involving 6682 HIV-negative participants with Syphilis in China were considered eligible for inclusion (Fig.1). The extracted data involving 11 cohort studies and 16 case-control studies and published between 2005 and 2013 were shown in Table 1. The shortest length from first treatment to diagnosis of serofast after treatment was more than 6 months, and the length in 92.6 %( 25/27) of eligible studies was ≥ one year. In all studies, blood sample were tested for HIV and syphilis. Some studies comprising participants with positive HIV test have been excluded. In included studies, participants with serum positive for both Treponema pallidum particle assay(TPPA) and rapid plasma regain(RPR) or toluidine red unheated serum test(TRUST) were determined to be currently infected with syphilis. RPR or TRUST titers were used to evaluate serological response at 6 and 12 months after treatment for primary and secondary syphilis and, additionally, at 24 months for latent syphilis.


Potential Predictors for Serofast State after Treatment among HIV-Negative Persons with Syphilis in China: A Systematic Review and Meta-Analysis.

Qin J, Yang T, Wang H, Feng T, Liu X - Iran. J. Public Health (2015)

Study identification flowchart
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4401873&req=5

Figure 1: Study identification flowchart
Mentions: Overall, 1245 studies were identified, of which 402 potentially relevant articles were selected for further screening, and eventually 27 studies (10,11,14,17,18,25–46) involving 6682 HIV-negative participants with Syphilis in China were considered eligible for inclusion (Fig.1). The extracted data involving 11 cohort studies and 16 case-control studies and published between 2005 and 2013 were shown in Table 1. The shortest length from first treatment to diagnosis of serofast after treatment was more than 6 months, and the length in 92.6 %( 25/27) of eligible studies was ≥ one year. In all studies, blood sample were tested for HIV and syphilis. Some studies comprising participants with positive HIV test have been excluded. In included studies, participants with serum positive for both Treponema pallidum particle assay(TPPA) and rapid plasma regain(RPR) or toluidine red unheated serum test(TRUST) were determined to be currently infected with syphilis. RPR or TRUST titers were used to evaluate serological response at 6 and 12 months after treatment for primary and secondary syphilis and, additionally, at 24 months for latent syphilis.

Bottom Line: However, there is a remarkable diversity among the results.Compared with healthy group and serological cure group, respectively, the levels of CD4 (+), IL-2, and IL-6 among serofast patients were decreased (standardized mean difference[SMD]<0, P<0.05), but the levels of CD8(+) and IL-10 were increased(SMD>0, P<0.05).Some studies also hinted the serofast was associated with subtypes i of treponema pallidum(TP) repeat gene (RR i vs d=4.67,95%CI: 1.31-;16.69) and TP occult infection.

View Article: PubMed Central - PubMed

Affiliation: Division of Medical Genetics, Maternal and Child Health Hospital of Hunan Province, Hunan, China ; Skate Key Laboratory of Medical Genetics, Central South University, Hunan, China.

ABSTRACT

Background: Several studies have been conducted in China in order to investigate the potential predictors of serofast state after treatment among syphilitic patients. However, there is a remarkable diversity among the results. This meta-analysis was conducted to assess potential predictors of serofast among syphilitic patients in China.

Methods: International and national electronic databases were searched up to September 2013. Reference lists of retrieved articles were also reviewed. Cohort or case-control studies addressing risk factors of serofast among syphilitic patients were included in this study.

Results: We assessed 27 separate studies involving overall 6682 HIV-negative participants with syphilis of which 1962 remained in the serofast state. The serofast was positively associated with older age(P trend=0.001), female(summary risk ratio[sRR]=1.50, 95%CI:1.34-;1.68), latent syphilis(sRRlatent vs primary=3.17, 95%CI: 2.66-;3.77; sRRlatent vs secondary=2.00, 95%CI: 1.48-;2.69) as well as non-penicillin treatment(sRR =2.99, 95%CI:2.45-;3.67), but negatively associated with higher baseline titers(sRR>1:32 vs ≤1:32=0.63, 95%CI: 0.54-;0.75). Compared with healthy group and serological cure group, respectively, the levels of CD4 (+), IL-2, and IL-6 among serofast patients were decreased (standardized mean difference[SMD]<0, P<0.05), but the levels of CD8(+) and IL-10 were increased(SMD>0, P<0.05). Some studies also hinted the serofast was associated with subtypes i of treponema pallidum(TP) repeat gene (RR i vs d=4.67,95%CI: 1.31-;16.69) and TP occult infection.

Conclusion: The age, gender, stage of infection, baseline titers, treatment drug, cellular immune suppression and disorders, TP occult infection and subtypes i of TP repeat gene should be considered as important predictors of serofast. However, until now the definition and mechanism of serofast has still been not clear.

No MeSH data available.


Related in: MedlinePlus