Syphilis negatively influences the response to hepatitis C virus treatment in an HIV-infected patient.
Year: 2012
Type: article
Study design: Case Report
Abstract: 134 Syphilis is a chronic inflammatory disease caused by the sexually transmitted pathogen, Treponema pallidum.1 Concomitant HIV and syphilis infections are prevalent among men who have sex with men (MSM).2 Syphilis negatively impacts disease management in the HIV-infected host by causing substantial immune activation, as evidenced by precipitous declines of CD4+ cells and by increased levels of HIV RNA.3,4 Syphilis has also been reported as a risk factor for hepatitis C virus (HCV) acquisition among MSM.5 Whether intercurrent syphilis has any negative impact on HCV treatment response is unknown. We report a case of an HIV/HCVcoinfected man who was treated with peginterferon alfa and ribavirin. He had a very slow attainment of HCV RNA suppression and a dramatic fall of CD4+ cell count in excess of what would be expected in response to HCV therapy. During HCV treatment, the patient was diagnosed with intercurrent syphilis and admitted to the use of methamphetamines; HCV treatment was subsequently discontinued at week 28. After drug rehabilitation and administration of benzathine penicillin for syphilis, the patient underwent retreatment for HCV with remarkably improved viral kinetics and a modest decline in CD4+ cell count. We propose that active syphilis infection may have been a key contributor to the patient’s slow virologic response to his initial course of HCV treatment. Within this report we discuss the public health implications of this case.
Source: Europe PMC (PubMed Central)
Institution: Harvard University
Language: English
Topic: Hepatitis C virus research
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2411006963