Melody Ren1, Leah Szadkowski2, Darrell H.S. Tan3, Sharon Walmsley 2,41. Department of Medicine, University of Toronto, Toronto, Canada2. Toronto General Research Institute, University Health Network, Toronto, Canada

BACKGROUND

METHODS

All patients in the Toronto General Hospital HIV Clinic with an abnormal syphilis serology from January 1, 2000 – January 1, 2017, n= 532

Excluded n= 343No reactive RPR n=231No follow-up serology after treatment n=48Not co-infected with HIV n=1

Patients included for data extraction, n= 189

Patient Population Data Extraction

Primary Outcome: To investigate the serological response to syphilis treatment in patients who are co-infected with HIV

Secondary Outcome: To explore any clinical correlates that will predict serologic response to treatment

Statistics

RESULTS

LIMITATIONS

Increasing rates of co-infection between HIV and syphilis, ?nefarious synergyIssues with syphilis management- Imperfect diagnostic test: difficult to differentiate false positive,

treatment failure, serofast, reinfection- Inconsistent guidelines for HIV-positive adults- Prior studies conducted before widespread use of ART

• Retrospective chart review of medical records• First chronologically available syphilis episode fulfilling all inclusion criteria was used;

previous and subsequent episodes of syphilis were ignored• Correlation with demographic data maintained in a database by clinic staff

Patient Demographics

• Kaplan Meier estimates: time to four-fold response and seroreversion from baseline RPR• Univariable and multivariable proportional hazards models: associations between

clinical covariates and time to a four-fold response and seroreversion from baseline RPR

Age, median (IQR) 42 (35.0, 48.0)Caucasian, n (%) 105 (57.1)Male, n (%) 189 (100)MSM, n (%) 158 (87.3)CD4 count, median (IQR) 443 (272, 609)Log10 VL, median (IQR) 1.69 (1.59, 4.14)VL