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Liver involvement in HIV-infected patients diagnosed with syphilis

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Abstract

Purpose

Liver involvement in syphilis has been studied in cohorts of human immunodeficiency virus (HIV)-negative individuals despite the scarcity of data on such HIV-infected patients. Th aim of this study was to assess hepatic involvement of HIV-infected patients diagnosed with syphilis.

Methods

Patients with syphilis and liver involvement, including all stages of syphilis, were systematically identified in our HIV cohort between 2004 and 2008.

Results

Of the 1,599 HIV-infected patients identified during the study period, 100 were diagnosed with acute syphilis, all of whom were male. Of these 100 patients, 84 % were men who have sex with men. Laboratory parameters of liver involvement were present in 19 of the 100 HIV-infected patients with syphilis; these resolved after successful antibiotic treatment. Among these 19 patients, six were diagnosed to be in the latent stage, with elevated liver enzymes and parameters of inflammation representing the only distinctive feature.

Conclusions

Based on our results, syphilis should be included in the differential diagnosis of increased liver enzymes in HIV-infected patients.

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References

  1. Golden MR, Marra CM, Holmes KK. Update on syphilis: resurgence of an old problem. JAMA. 2003;290:1510–4.

    Article  PubMed  CAS  Google Scholar 

  2. Marcus U, Bremer V, Hamouda O. Syphilis surveillance and trends of the syphilis epidemic in Germany since the mid-90s. Euro Surveill. 2004;9:11–4.

    PubMed  CAS  Google Scholar 

  3. Kalichman SC, Pellowski J, Turner C. Prevalence of sexually transmitted co-infections in people living with HIV/AIDS: systematic review with implications for using HIV treatments for prevention. Sex Transm Infect. 2011;87:183–90.

    Article  PubMed  Google Scholar 

  4. Stamm WE, Handsfield HH, Rompalo AM, Ashley RL, Roberts PL, Corey L. The association between genital ulcer disease and acquisition of HIV infection in homosexual men. JAMA. 1988;260:1429–33.

    Article  PubMed  CAS  Google Scholar 

  5. Greenblatt RM, Lukehart SA, Plummer FA, et al. Genital ulceration as a risk factor for human immunodeficiency virus infection. AIDS. 1988;2:47–50.

    Article  PubMed  CAS  Google Scholar 

  6. Sheffield JS, Wendel GD Jr, McIntire DD, Norgard MV. Effect of genital ulcer disease on HIV-1 coreceptor expression in the female genital tract. J Infect Dis. 2007;196:1509–16.

    Article  PubMed  CAS  Google Scholar 

  7. Theus SA, Harrich DA, Gaynor R, Radolf JD, Norgard MV. Treponema pallidum, lipoproteins, and synthetic lipoprotein analogues induce human immunodeficiency virus type 1 gene expression in monocytes via NF-kappaB activation. J Infect Dis. 1998;177:941–50.

    Article  PubMed  CAS  Google Scholar 

  8. Lynn WA, Lightman S. Syphilis and HIV: a dangerous combination. Lancet Infect Dis. 2004;4:456–66.

    Article  PubMed  CAS  Google Scholar 

  9. Zetola NM, Klausner JD. Syphilis and HIV infection: an update. Clin Infect Dis. 2007;44:1222–8.

    Article  PubMed  Google Scholar 

  10. Rutland E, Harindra VK. Syphilis: an important cause of infectious hepatitis. Int J STD AIDS. 2010;21:215–6.

    Article  PubMed  CAS  Google Scholar 

  11. Mullick CJ, Liappis AP, Benator DA, Roberts AD, Parenti DM, Simon GL. Syphilitic hepatitis in HIV-infected patients: a report of 7 cases and review of the literature. Clin Infect Dis. 2004;39:e100–5.

    Article  PubMed  CAS  Google Scholar 

  12. Crum-Cianflone N, Weekes J, Bavaro M. Syphilitic hepatitis among HIV-infected patients. Int J STD AIDS. 2009;20:278–84.

    Article  PubMed  CAS  Google Scholar 

  13. Workowski KA, Berman S. Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep. 2010;59:1–110.

    PubMed  Google Scholar 

  14. French P, Gomberg M, Janier M, Schmidt B, van Voorst Vader P, Young H. IUSTI: 2008 European guidelines on the management of syphilis. Int J STD AIDS. 2009;20:300–9.

    Article  PubMed  CAS  Google Scholar 

  15. Workowski KA, Berman SM. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep. 2006;55:1–94.

    PubMed  Google Scholar 

  16. Farhi D, Benhaddou N, Grange P, et al. Clinical and serologic baseline and follow-up features of syphilis according to HIV status in the post-HAART era. Medicine. 2009;88:331–40.

    Article  PubMed  Google Scholar 

  17. Romeu J, Rybak B, Dave P, Coven R. Spirochetal vasculitis and bile ductular damage in early hepatic syphilis. Am J Gastroenterol. 1980;74:352–4.

    PubMed  CAS  Google Scholar 

  18. Feher J, Somogyi T, Timmer M, Jozsa L. Early syphilitic hepatitis. Lancet. 1975;2:896–9.

    Article  PubMed  CAS  Google Scholar 

  19. Urbanus AT, van de Laar TJ, Stolte IG, et al. Hepatitis C virus infections among HIV-infected men who have sex with men: an expanding epidemic. AIDS. 2009;23:F1–7.

    Article  PubMed  Google Scholar 

  20. Palacios R, Jimenez-Onate F, Aguilar M, et al. Impact of syphilis infection on HIV viral load and CD4 cell counts in HIV-infected patients. J Acquir Immune Defic Syndr. 2007;44:356–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the German Federal Ministry of Research and Education (BMBF) (grant numbers 01KI0771 to NJ, CL, CW and GF and 01KN1106 to OAC).

Conflict of interest

NJ has received honoraria for talks from Roche and Biomérieux. TK has received honoraria for lectures and consulting from Abbott, Bristol Myers Squibb, Gilead, Glaxo Smith Kline, Janssen, and Pfizer, and CL has received honoraria for talks and research support from Roche and Abbott. CW has received consulting fees from Boehringer Ingelheim, fees for speaking engagements from Bristol-Myers Squibb, Gilead Sciences, ViiV Healthcare, MSD, Janssen-Cilag, Essex, Pfizer, and Abbott. JJV has served as a consultant to Merck/MSD and Gilead, is on the speakers’ bureau of Astellas, Gilead, Merck/Schering-Plough, and Pfizer, and received research grants by Astellas, Merck/Schering-Plough, and Pfizer. OAC has received research grants from Actelion, Astellas, Basilea, Bayer, Biocryst, Celgene, F2G, Genzyme, Gilead, Merck/Schering, Miltenyi, Optimer, Pfizer, Quintiles, and Viropharma, is a consultant to Astellas, Basilea, F2G, Gilead, Merck/Schering, Optimer, and Pfizer, and received lecture honoraria from Astellas, Gilead, Merck/Schering, and Pfizer. GF has received honoraria for talks and consulting from Abbott, Bristol Myers Squibb, Gilead, Glaxo Smith Kline, Janssen, Merck Sharp & Dohme, Novartis and Pfizer SDB. JG, AB, JF, DG, and SK have nothing to declare.

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Authors and Affiliations

  1. First Department of Internal Medicine, Medical Hospital of the University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany

    N. Jung, T. Kümmerle, S. D. Brengelmann, C. Lehmann, C. Wyen, A. Birtel, J. Fischer, D. Gillor, J. J. Vehreschild, O. A. Cornely & G. Fätkenheuer

  2. Clinical Trials Centre Cologne, ZKS Köln, University of Cologne, Cologne, Germany

    O. A. Cornely

  3. Center for Integrated Oncology (CIO) Köln Bonn, University of Cologne, Cologne, Germany

    O. A. Cornely

  4. Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany

    O. A. Cornely

  5. Private Practice for Hematology, Oncology and Infectious Diseases, Bremen, Germany

    S. Koch

  6. Institute for Medical Microbiology, Immunology and Hygiene, Medical Hospital of the University of Cologne, Cologne, Germany

    J. Gielen

Authors
  1. N. Jung
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  2. T. Kümmerle
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  3. S. D. Brengelmann
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  4. J. Gielen
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  5. C. Lehmann
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  6. C. Wyen
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  7. A. Birtel
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  8. J. Fischer
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  9. D. Gillor
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  10. S. Koch
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  11. J. J. Vehreschild
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  12. O. A. Cornely
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  13. G. Fätkenheuer
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Corresponding author

Correspondence to N. Jung.

Additional information

N. Jung and T. Kümmerle have contributed equally to this work.

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Jung, N., Kümmerle, T., Brengelmann, S.D. et al. Liver involvement in HIV-infected patients diagnosed with syphilis. Infection 40, 543–547 (2012). https://doi.org/10.1007/s15010-012-0264-3

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  • DOI: https://doi.org/10.1007/s15010-012-0264-3

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