HIV Treatment Contributes To Syphilis Outbreaks, New Study Finds

Kayleigh Armstrong

Antiretroviral drugs or drugs used in the treatment of infections caused by the Human Immunodeficiency Virus (HIV) could make patients more susceptible to diseases, particularly syphilis, a new study by researchers at the University of British Columbia has found.

The study published on Jan. 16 in the journal Sexually Transmitted Infections found that taking drugs for HIV treatment can contribute to the outbreak of the sexually transmitted disease, syphilis. Taking antiretroviral drugs means that HIV is no longer a feared disease and this very absence of fear of the disease resulted in a spike in the cases of sexually transmitted infections due to unprotected sex, primarily among gay and bisexual men.

Study lead author Michael Rekart observed that there is a drastic increase in the number of syphilis cases and that there is a "huge gap" between this disease and other common sexually transmitted infections such as gonorrhea and chlamydia.

It was initially thought that syphilis outbreak among patients taking HIV treatment could be due to the absence of the "fear factor." However, the new study offers evidence that a lot of men with HIV do not practice unprotected sex and most of the syphilis cases involved those who are taking highly active antiretroviral therapy (HAART).

To arrive at their conclusion, a team of scientists looked into the impact that HAART had on behavioral and immune system change. They then created risk models to evaluate how likely HIV patients will develop syphilis. When risky sexual behavior was taken into consideration, the calculated rate of increase in syphilis cases was lower than the actual rate.

But when scientists took into consideration both factors -- behavior changes and immune system effects from taking HAART -- the calculated rate is close to the actual syphilis incidence. Scientists have yet to compare the data of patients taking HAART and contracted syphilis to those who are not taking the drugs but have contracted the infection to draw a connection.

The researchers also explained that while they view HAART as an effective HIV treatment with its suppression of the proinflammatory response, this very reduction will result in patients' susceptibility to infections such as syphilis. The body clears out T. pallidum by relying on the number of T-cells and the stimulation of inflammatory responses, but they are inhibited by HAART.

The study suggests that clinicians and researchers should look into this matter but that does not mean that HIV patients should stop taking their treatment. Rekart even advised that it is imperative for patients to continue with their HAART, according to a report from the University of British Columbia.

"HAART drugs are life-saving; syphilis is curable. HAART drugs bring people with HIV back to a normal state of immunity, they can have a normal life, they don't get most opportunistic infections such as tuberculosis."

Syphilis is an ulcerative disease in the genitals that can bring complications if not managed properly by a medical professional. Complicated cases can also result in the transmission of HIV infections.

In 2015, a total of 23,872 primary and secondary syphilis cases were reported in the United States, according to the Centers for Disease Control and Prevention. This translates to 7.5 cases in 100,000 people and an increase of 19.0 percent in the rate compared to the statistics from 2014, which was 6.3 cases per 100,000.

Syphilis rates are 107 times higher in gay or bisexual men compared to straight men. In 2015, 81.7 percent of the reported male cases were from men who had sex with other men.

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