SynthesisBMC infectious diseases2015
A systematic review of syphilis serological treatment outcomes in HIV-infected and HIV-uninfected persons: rethinking the significance of serological non-responsiveness and the serofast state after therapy.
Synthesis in BMC infectious diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 5 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
65 citing papers in PubMed, 5 syntheses or guidelines pooled it, 141 citations in OpenAlex.
- Treponemal and Lipoidal Immunoglobulin M Tests in the Diagnosis and Management of Syphilis Among Nonpregnant Adults: A Systematic Review.Sexually transmitted diseases · 2026Pooled it
- Risk factors of serofast state in patients undergoing syphilis: a meta-analysis of 17 cohort studies.Frontiers in immunology · 2025Pooled it
- 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 · 2022Pooled it
- Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Guideline
- The prevalence of asymptomatic neurosyphilis among HIV-negative serofast patients in China: A meta-analysis.PloS one · 2020Pooled it
- Hepatitis B, Hepatitis C, tuberculosis and sexually-transmitted infections among HIV positive patients in Kazakhstan.Scientific reports · 2021Trial
- Rate of Decline in Nontreponemal Antibody Titers and Seroreversion After Treatment of Early Syphilis.Sexually transmitted diseases · 2017Trial
- Clinical and serological outcomes of syphilis: an 18-year retrospective cohort study on predictors of treatment response and seroreversion in Türkiye.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Comparable treatment response rates with benzathine penicillin and doxycycline in early syphilis: evidence from a large German cohort.Infection · 2026Article
- German guideline on neurosyphilis.Neurological research and practice · 2026Review
- Evaluation of the Electronic Health Record as a Tool for Maternal and Congenital Syphilis Surveillance.Sexually transmitted diseases · 2026Article
- A Diagnostic Pitfall: Secondary Syphilis Mimicking Psoriasis in a Patient With Alcoholic Liver Disease.Cureus · 2026Article
- Clinical manifestations and serological rebound in HIV and syphilis co-infection: a case report and literature review.AIDS research and therapy · 2026Review
- Cytotoxic T-cell deficiency and sustained B-cell activation in serofast syphilis: a prospective observational study.Frontiers in immunology · 2026Observational
- Antiquated Tools to Fight an Ancient Foe.The New England journal of medicine · 2025Article
- Comparison of 3 Treatment Regimens for Latent Syphilis of Late or Unknown Duration Using Public Health Surveillance Data.Sexually transmitted diseases · 2025Article
- Community and Hospital HIV Follow-Up Clinics Achieve Similar Lumbar Puncture and Syphilis Treatment Success in Patients with HIV-Syphilis Coinfection: Saskatoon, SK, Canada.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2025Article
- Serofast state after syphilis treatment: implications and recommendations for clinical practice. Narrative review.Postepy dermatologii i alergologii · 2025Review
- Opportunities to Optimize Outcomes of Diagnosis and Treatment of HIV and Syphilis in Pregnancy: the Quest to Eliminate Maternal and Vertical Transmission.Current HIV/AIDS reports · 2025Review
- Type 2 Diabetes Impacts the Efficacy of Syphilis Treatment and is a Risk Factor for Late Syphilis: A Retrospective Cohort Study.Acta dermato-venereologica · 2025Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundSyphilis remains a global public health threat and can lead to severe complications. In addition to resolution of clinical manifestations, a reduction in nontreponemal antibody titers after treatment is regarded as "proof of cure." However, some patients manifest < 4-fold decline ("serological non-response") or persistently positive nontreponemal titers despite an appropriate decline ("serofast") that may represent treatment failure, reinfection, or a benign immune response. To delineate these treatment phenomena, we conducted a systematic review of the literature regarding serological outcomes and associated factors among HIV-infected and -uninfected subjects.
methodsSix databases (PubMed, Embase, CINAHL, Web of Science, Scopus, and BIOSIS) were searched with no date restrictions. Relevant articles that evaluated serological treatment responses and correlates of serological cure (≥ four-fold decline in nontreponemal titers) were included.
resultsWe identified 1693 reports in the literature, of which 20 studies met selection criteria. The median proportion of patients who had serological non-response was 12.1% overall (interquartile range, 4.9-25.6), but varied depending on the time points after therapy. The serofast proportion could only be estimated from 2 studies, which ranged from 35.2-44.4%. Serological cure was primarily associated with younger age, higher baseline nontreponemal titers, and earlier syphilis stage. The relationship between serological cure and HIV status was inconsistent; among HIV-infected patients, CD4 count and HIV viral load was not associated with serological cure.
conclusionsSerological non-response and the serofast state are common syphilis treatment outcomes, highlighting the importance of determining the immunological and clinical significance of persistent nontreponemal antibody titers after therapy.
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Registered trials
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.