ORIGINAL ARTICLE

The Effects of Syphilis Infection on CD4 Counts and HIV-1 RNA Viral Loads in Blood: A Cohort Study Among MSM with HIV Infection in Sanglah Hospital Bali-Indonesia

I Ketut Agus Somia , Ketut Tuti Parwati Merati, Dewi Dian Sukmawati, Nittaya Phanuphak, IGAA Elis Indira, Made Yogi Oktavian Prasetia, Komang Agus Trisna Amijaya, AA Sagung Sawitri

I Ketut Agus Somia
Tropical and Infectious Disease Division, Department of Internal Medicine, Udayana University- Sanglah Hospital Bali Nusa Indah VCT Clinic,Sanglah Hospital Bali. Email: iketutagussomia@gmail.com

Ketut Tuti Parwati Merati
Tropical and Infectious Disease Division, Department of Internal Medicine, Udayana University- Sanglah Hospital Bali Nusa Indah VCT Clinic,Sanglah Hospital Bali

Dewi Dian Sukmawati
Tropical and Infectious Disease Division, Department of Internal Medicine, Udayana University- Sanglah Hospital Bali Nusa Indah VCT Clinic,Sanglah Hospital Bali

Nittaya Phanuphak
The Thai Red Cross AIDS Research Centre

IGAA Elis Indira
Department of Dermatology and Venerology,Udayana University - Sanglah Hospital Bali

Made Yogi Oktavian Prasetia
Nusa Indah VCT Clinic,Sanglah Hospital Bali

Komang Agus Trisna Amijaya
Nusa Indah VCT Clinic,Sanglah Hospital Bali

AA Sagung Sawitri
Department of Public Health,Udayana University Bali
Online First: September 10, 2016 | Cite this Article
Somia, I., Merati, K., Sukmawati, D., Phanuphak, N., Indira, I., Prasetia, M., Amijaya, K., Sawitri, A. 2016. The Effects of Syphilis Infection on CD4 Counts and HIV-1 RNA Viral Loads in Blood: A Cohort Study Among MSM with HIV Infection in Sanglah Hospital Bali-Indonesia. Bali Medical Journal 5(3): 391-394. DOI:10.15562/bmj.v5i3.283


Background: Men who have sex with men (MSM), particularly those with HIV infection, are at high risk for contracting syphilis. However, little is known about the effect of syphilis on HIV-1 RNA and CD4 count among HIV infected MSM. Methods: MSM were enrolled into the MSM-VCT study cohort at Sanglah Hospital in Bali between June 22nd 2011 to February 13rd 2012. All participants had anti-HIV test and VDRL test at baseline, with TPHA confirmation for reactive VDRL results. Plasma HIV-1 RNA levels and CD4 counts were measured at baseline and month 6 visits. T-test or non-parametric Mann-Whitney test were used to compare changes in CD4 counts and HIV-1 RNA levels between those with and without syphilis. To analyze difference of baseline and 6 month visit in each group, we used paired students t-test. Results: HIV positive MSM with syphilis co-infection had significantly higher mean baseline CD4 count than those without syphilis (P=0.017). No difference was seen for median baseline plasma HIV-1 RNA between HIV positive MSM with and without syphilis (P=0.885). Mean change in CD4 count from baseline to month 6 was similar between HIV positive MSM with syphilis (n=11) and without syphilis (n=20) (P=0.860). Similarly, no significant difference in median HIV-1 RNA change was identified between those with (n=8) and without syphilis (n=11) (P=1.000). Conclusions: HIV positive MSM with syphilis co-infection had higher CD4 cell counts. However, syphilis influences the changes of CD4 cell count and HIV-1 RNA 6 months after HIV diagnosis, but not statistically significance.

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