Factors Associated with Serological Failure After Syphilis
Therapy in People with Hiv-1 with Undetectable Viral Load

Aleksandra Hejnosz; Dagny C. Krankowska; Agnieszka Lembas; Mariusz Sapuła; Mateusz Szczerba; Krzysztof Bratek; Tomasz Mikuła; Andrzej Załęski; Alicja Wiercińska-Drapało

doi:10.5114/dr.2025.158589

eISSN: 2084-9893
ISSN: 0033-2526

Dermatology Review/Przegląd Dermatologiczny

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5/2025
vol. 112

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abstract:

Original paper

Factors Associated with Serological Failure After Syphilis Therapy in People with Hiv-1 with Undetectable Viral Load

Aleksandra Hejnosz

¹

,

Dagny C. Krankowska

^{2, 3}

,

Agnieszka Lembas

^{2, 3}

,

Mariusz Sapuła

^{2, 3}

,

Mateusz Szczerba

¹

,

Krzysztof Bratek

¹

,

Tomasz Mikuła

^{2, 3}

,

Andrzej Załęski

^{2, 3}

,

Alicja Wiercińska-Drapało

^{2, 3}

Students’ Scientific Society of the Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Poland
Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Poland
Hospital for Infectious Diseases, Warsaw, Poland

Dermatol Rev/Przegl Dermatol 2025, 112, 291-296

DOI: https://doi.org/10.5114/dr.2025.158589

Online publish date: 2025/12/30

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AMA

Hejnosz A, Krankowska D, Lembas A, et al. Factors Associated with Serological Failure After Syphilis
Therapy in People with Hiv-1 with Undetectable Viral Load. Dermatology Review/Przegląd Dermatologiczny. 2025;112(5):291-296. doi:10.5114/dr.2025.158589.

APA

Hejnosz, A., Krankowska, D., Lembas, A., Sapuła, M., Szczerba, M.,  & Bratek, K. et al. (2025). Factors Associated with Serological Failure After Syphilis
Therapy in People with Hiv-1 with Undetectable Viral Load. Dermatology Review/Przegląd Dermatologiczny, 112(5), 291-296. https://doi.org/10.5114/dr.2025.158589

Chicago

Hejnosz, Aleksandra, Dagny C. Krankowska, Agnieszka Lembas, Mariusz Sapuła, Mateusz Szczerba, Krzysztof Bratek,  and Tomasz Mikuła et al. 2025. "Factors Associated with Serological Failure After Syphilis
Therapy in People with Hiv-1 with Undetectable Viral Load". Dermatology Review/Przegląd Dermatologiczny 112 (5): 291-296. doi:10.5114/dr.2025.158589.

Harvard

Hejnosz, A., Krankowska, D., Lembas, A., Sapuła, M., Szczerba, M., Bratek, K., Mikuła, T., Załęski, A.,  and Wiercińska-Drapało, A. (2025). Factors Associated with Serological Failure After Syphilis
Therapy in People with Hiv-1 with Undetectable Viral Load. Dermatology Review/Przegląd Dermatologiczny, 112(5), pp.291-296. https://doi.org/10.5114/dr.2025.158589

MLA

Hejnosz, Aleksandra et al. "Factors Associated with Serological Failure After Syphilis
Therapy in People with Hiv-1 with Undetectable Viral Load." Dermatology Review/Przegląd Dermatologiczny, vol. 112, no. 5, 2025, pp. 291-296. doi:10.5114/dr.2025.158589.

Vancouver

Hejnosz A, Krankowska D, Lembas A, Sapuła M, Szczerba M, Bratek K et al. Factors Associated with Serological Failure After Syphilis
Therapy in People with Hiv-1 with Undetectable Viral Load. Dermatology Review/Przegląd Dermatologiczny. 2025;112(5):291-296. doi:10.5114/dr.2025.158589.

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Introduction
Coinfection of human immunodeficiency virus and syphilis pose a global health challenge and present diagnostic complexities. People with human immunodeficiency virus experience a higher rate of syphilis serological failure than patients without human immunodeficiency virus.

Objectives
To assess laboratory characteristics and the course of syphilis treatment in a group of Polish patients with human immunodeficiency virus-1.

Material and methods
Demographic and laboratory data of patients with human immunodeficiency virus-1 and syphilis admitted to one of the infectious diseases departments in Poland in the years 2008–2023 were collected retrospectively. The c2 or Fisher’s exact tests were used to assess differences in categorical variables. Logistic regression analyses evaluated factors related to serological treatment failure in syphilis.

Results
There were n = 59 syphilis infections among n = 43 patients. All patients were male, aged from 21 to 60, all were taking antiretroviral treatment (ART) and had undetectable viral load. Among all syphilis infections, n = 34 were primary, n = 3 were late, and n = 22 were syphilis of unknown duration. The mean lymphocyte T CD4 count was 621 cells/μl. In n = 11 (18.64%) infections there was no 4-fold decline in VDRL in the course of 12 months after treatment. Univariate and multivariate analysis showed VDRL titer < 1 : 32 to be associated with higher odds of serological failure.

Conclusions
People with HIV regardless of their undetectable HIV-1 viral load and their lymphocyte T CD4 count are at risk of syphilis serological failure. Those with VDRL titer < 32 might be at higher risk of serological treatment failure. Regular screening for syphilis and monitoring of serological response to syphilis treatment is recommended for people with HIV-1.

keywords:

human immunodeficiency virus, syphilis, serological failure

Indeks osobowy

Factors Associated with Serological Failure After Syphilis Therapy in People with Hiv-1 with Undetectable Viral Load

Aleksandra Hejnosz 1 , Dagny C. Krankowska 2, 3 , Agnieszka Lembas 2, 3 , Mariusz Sapuła 2, 3 , Mateusz Szczerba 1 , Krzysztof Bratek 1 , Tomasz Mikuła 2, 3 , Andrzej Załęski 2, 3 , Alicja Wiercińska-Drapało 2, 3

human immunodeficiency virus, syphilis, serological failure

Aleksandra Hejnosz

¹

,

Dagny C. Krankowska

^{2, 3}

,

Agnieszka Lembas

^{2, 3}

,

Mariusz Sapuła

^{2, 3}

,

Mateusz Szczerba

¹

,

Krzysztof Bratek

¹

,

Tomasz Mikuła

^{2, 3}

,

Andrzej Załęski

^{2, 3}

,

Alicja Wiercińska-Drapało

^{2, 3}