Evidence map›Paper›PMID 25389249›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2015

A single dose of benzathine penicillin G is as effective as multiple doses of benzathine penicillin G for the treatment of HIV-infected persons with early syphilis.

Anuradha Ganesan, Octavio Mesner, Jason F Okulicz, Thomas O'Bryan, Robert G Deiss, Tahaniyat Lalani, Timothy J Whitman, Amy C Weintrob, Grace Macalino, Brian K Agan and 1 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.

  1. Management of Adult Syphilis: Key Questions to Inform the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Pooled it
  2. Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021
    Guideline
  3. Article
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  11. Review
  12. Article
  13. Article
  14. Syphilis.Nature reviews. Disease primers · 2017
    Review
  15. Benzathine penicillin G for the management of early syphilis among HIV co-infected persons: A systematic review.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2016
    Article
  16. Review
  17. Reply to Yang et al.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015
    Article
  18. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Anuradha GanesanInfectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland Walter Reed National Military Medical Center, Washington, District of Columbia.
Octavio MesnerInfectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Jason F OkuliczInfectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland San Antonio Military Medical Center, Texas.
Thomas O'BryanInfectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland San Antonio Military Medical Center, Texas.
Robert G DeissInfectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland Naval Medical Center San Diego, California.
Tahaniyat LalaniInfectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland Naval Medical Center Portsmouth, Virginia.
Timothy J WhitmanInfectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland Walter Reed National Military Medical Center, Washington, District of Columbia.
Amy C WeintrobInfectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland Walter Reed National Military Medical Center, Washington, District of Columbia.
Grace MacalinoInfectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Brian K AganInfectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Infectious Disease Clinical Research Program HIV/STI Working Group
Uniformed Services University of the Health Sciences · USSan Antonio Military Medical Center · USWalter Reed National Military Medical Center · US

Funding

NIAID NIH HHS Y01 AI005072
6 · The paper itself

Abstract

backgroundTreatment guidelines recommend the use of a single dose of benzathine penicillin G (BPG) for treating early syphilis in human immunodeficiency virus (HIV)-infected persons. However, data supporting this recommendation are limited. We examined the efficacy of single-dose BPG in the US Military HIV Natural History Study.

methodsSubjects were included if they met serologic criteria for syphilis (ie, a positive nontreponemal test [NTr] confirmed by treponemal testing). Response to treatment was assessed at 13 months and was defined by a ≥4-fold decline in NTr titer. Multivariate Cox proportional hazard regression models were utilized to examine factors associated with treatment response.

resultsThree hundred fifty subjects (99% male) contributed 478 cases. Three hundred ninety-three cases were treated exclusively with BPG (141 with 1 dose of BPG). Treatment response was the same among those receiving 1 or >1 dose of BPG (92%). In a multivariate analysis, older age (hazard ratio [HR], 0.82 per 10-year increase; 95% confidence interval [CI], .73-.93) was associated with delayed response to treatment. Higher pretreatment titers (reference NTr titer <1:64; HR, 1.94 [95% CI, 1.58-2.39]) and CD4 counts (HR, 1.07 for every 100-cell increase [95% CI, 1.01-1.12]) were associated with a faster response to treatment. Response was not affected by the number of BPG doses received (reference, 1 dose of BPG; HR, 1.11 [95% CI, .89-1.4]).

conclusionsIn this cohort, additional BPG doses did not affect treatment response. Our data support the current recommendations for the use of a single dose of BPG to treat HIV-infected persons with early syphilis.

Indexed as

AdultAgedAge FactorsAntitreponemal AgentsCD4 Lymphocyte CountCohort StudiesDrug Administration ScheduleFemaleFollow-Up StudiesHIV InfectionsHumansInjections, IntramuscularMaleMiddle AgedMultivariate AnalysisPenicillin G BenzathineAntitreponemal AgentsPenicillin G Benzathinebenzathine penicillin Gearly syphilisHIV-infected personstreatment response

Identifiers

PMID25389249
PMCPMC6477935
OpenAlexW2160428372

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.