| Title: |
Seroreduction of syphilis non‐treponemal titers during pregnancy for women with and without HIV co‐infection |
| Authors: |
Webster, Carolyn M.; Kasaro, Margaret P.; Price, Joan T.; Stringer, Elizabeth M.; Wiesen, Christopher A.; Vwalika, Bellington; Stringer, Jeffrey S. A. |
| Contributors: |
Bill and Melinda Gates Foundation; Center for AIDS Research, University of North Carolina at Chapel Hill; Burroughs Wellcome Fund |
| Source: |
International Journal of Gynecology & Obstetrics ; volume 159, issue 2, page 427-434 ; ISSN 0020-7292 1879-3479 |
| Publisher Information: |
Wiley |
| Publication Year: |
2022 |
| Collection: |
Wiley Online Library (Open Access Articles via Crossref) |
| Description: |
Objective To evaluate the effect of HIV co‐infection on non‐treponemal titers during pregnancy in women with syphilis. Methods This is a secondary analysis of pregnant women with syphilis in the prospective, observational Zambian Preterm Birth Prevention Study (ZAPPS). Treponemal ( Treponema pallidum particle agglutination) and non‐treponemal (rapid plasma reagin; RPR) testing were performed on serum biospecimens, resulting in 47 participants with serologically confirmed syphilis (27 HIV‐positive, 20 HIV‐negative). The primary outcome, achievement of RPR titer seroreduction during pregnancy, was analyzed by logistic regression. Secondary outcomes included overall titer reduction, seroreduction rate, serologic cure, and adverse pregnancy outcomes. Results Seroreduction of RPR titer occurred in 78% (21/27) of women with HIV versus 45% (9/20) of women without (adjusted odds ratio 4.66; 95% confidence interval [CI] 1.14 − 19.08). Overall RPR titer reduction, rate of seroreduction per week, and the proportion achieving serologic cure each trended higher among women with HIV compared with those without HIV. There was a trend toward decreased stillbirth incidence in participants achieving seroreduction (odds ratio 0.15, 95% CI 0.01–1.58). Conclusion HIV co‐infection in this cohort of Zambian women with syphilis was associated with greater odds of RPR titer seroreduction during pregnancy. Pregnant women with syphilis and HIV may not be at increased risk for a delayed syphilis treatment response compared with women without HIV. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1002/ijgo.14131 |
| Availability: |
https://doi.org/10.1002/ijgo.14131; https://onlinelibrary.wiley.com/doi/pdf/10.1002/ijgo.14131; https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ijgo.14131; https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1002/ijgo.14131 |
| Rights: |
http://onlinelibrary.wiley.com/termsAndConditions#vor |
| Accession Number: |
edsbas.526E1E8A |
| Database: |
BASE |