| [PMID]: | 25389249 |
| [Au] Autor: | Ganesan A; Mesner O; Okulicz JF; O'Bryan T; Deiss RG; Lalani T; Whitman TJ; Weintrob AC; Macalino G; Agan BK; Infectious Disease Clinical Research Program HIV/STI Working Group |
| [Ad] Endereço: | Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland Walter Reed National Military Medical Center, Washington, District of Columbia. |
| [Ti] Título: | A single dose of benzathine penicillin G is as effective as multiple doses of benzathine penicillin G for the treatment of HIV-infected persons with early syphilis. |
| [So] Source: | Clin Infect Dis;60(4):653-60, 2015 Feb 15. |
| [Is] ISSN: | 1537-6591 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | BACKGROUND: Treatment guidelines recommend the use of a single dose of benzathine penicillin G (BPG) for treating early syphilis in human immunodeficiency virus (HIV)-infected persons. However, data supporting this recommendation are limited. We examined the efficacy of single-dose BPG in the US Military HIV Natural History Study. METHODS: Subjects were included if they met serologic criteria for syphilis (ie, a positive nontreponemal test [NTr] confirmed by treponemal testing). Response to treatment was assessed at 13 months and was defined by a ≥4-fold decline in NTr titer. Multivariate Cox proportional hazard regression models were utilized to examine factors associated with treatment response. RESULTS: Three hundred fifty subjects (99% male) contributed 478 cases. Three hundred ninety-three cases were treated exclusively with BPG (141 with 1 dose of BPG). Treatment response was the same among those receiving 1 or >1 dose of BPG (92%). In a multivariate analysis, older age (hazard ratio [HR], 0.82 per 10-year increase; 95% confidence interval [CI], .73-.93) was associated with delayed response to treatment. Higher pretreatment titers (reference NTr titer <1:64; HR, 1.94 [95% CI, 1.58-2.39]) and CD4 counts (HR, 1.07 for every 100-cell increase [95% CI, 1.01-1.12]) were associated with a faster response to treatment. Response was not affected by the number of BPG doses received (reference, 1 dose of BPG; HR, 1.11 [95% CI, .89-1.4]). CONCLUSIONS: In this cohort, additional BPG doses did not affect treatment response. Our data support the current recommendations for the use of a single dose of BPG to treat HIV-infected persons with early syphilis. |
| [Mh] Termos MeSH primário: |
Antitreponêmicos/administração & dosagem
Infecções por HIV/complicações
Penicilina G Benzatina/administração & dosagem
Sífilis/complicações
Sífilis/tratamento farmacológico
|
| [Mh] Termos MeSH secundário: |
Adulto
Fatores Etários
Idoso
Contagem de Linfócito CD4
Estudos de Coortes
Esquema de Medicação
Feminino
Seguimentos
Seres Humanos
Injeções Intramusculares
Masculino
Meia-Idade
Análise Multivariada
Modelos de Riscos Proporcionais
Sífilis/diagnóstico
Adulto Jovem
|
| [Pt] Tipo de publicação: | JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T |
[Nm] Nome de substância:
| 0 (Antitreponemal Agents); RIT82F58GK (Penicillin G Benzathine) |
| [Em] Mês de entrada: | 1509 |
| [Cu] Atualização por classe: | 150124 |
[Lr] Data última revisão:
| 150124 |
| [Sb] Subgrupo de revista: | IM |
| [Da] Data de entrada para processamento: | 141113 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1093/cid/ciu888 |
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