Trial reportSexually transmitted diseases2017
Rate of Decline in Nontreponemal Antibody Titers and Seroreversion After Treatment of Early Syphilis.
Trial report in Sexually transmitted diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled 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
- Comparable treatment response rates with benzathine penicillin and doxycycline in early syphilis: evidence from a large German cohort.Infection · 2026Article
- Syphilis Diagnosis and Interest in Doxycycline Postexposure Prophylaxis Among Young Black Sexual and Gender Minorities.Open forum infectious diseases · 2026Article
- Sexually transmitted infection prevalence and Neisseria gonorrhoeae antimicrobial resistance patterns in men who have sex with men with or without urethral discharge syndrome in Johannesburg, South Africa, 2024.PLOS global public health · 2026Article
- Hairy Cell Leukemia: A Differential Diagnosis of Hepatitis B-Associated Aplastic Anemia and Syphilis.Hematology reports · 2025Article
- Sexually transmitted infections and bacterial vaginosis in women of child-bearing age in Antananarivo, Madagascar: prevalence and risk factors from a cross-sectional study.BMC infectious diseases · 2025Article
- CDC Laboratory Recommendations for Syphilis Testing, United States, 2024.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2024Article
- Southern African HIV Clinicians Society Guideline for the clinical management of syphilis.Southern African journal of HIV medicine · 2024Article
- Presentation of Ocular Syphilis with Bilateral Optic Neuropathy.Neuro-ophthalmology (Aeolus Press) · 2023Article
- Article
- Brazilian Protocol for Sexually Transmitted Infections 2020: acquired syphilis.Revista da Sociedade Brasileira de Medicina Tropical · 2021Article
- Brazilian Protocol for Sexually Transmitted Infections, 2020: congenital syphilis and child exposed to syphilis.Revista da Sociedade Brasileira de Medicina Tropical · 2021Article
- Comparison of Manual and Fully Automated AIX1000 Rapid Plasma Reagin Assays for Laboratory Diagnosis of Syphilis.Journal of clinical microbiology · 2018Article
- Advantages and limitations of current diagnostic laboratory approaches in syphilis and congenital syphilis.Expert review of anti-infective therapyReview
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundSyphilis management is complex and demonstration of treatment response requires monitoring of nontreponemal antibody titers for a ≥ 4-fold decline and/or seroreversion to nonreactive titers.
methodsWe evaluated data from a multicenter clinical trial of syphilis treatment conducted from 2000 to 2009 involving human immunodeficiency virus (HIV)-negative patients 18 years or older with early syphilis. To assess the rate of titer decline and seroreversion after effective therapy, rapid plasma reagin (RPR) titers were analyzed at 1, 3, 6, 9, and 12 months among patients with an appropriate treatment response. We plotted the rate of RPR titer decline after treatment, estimated the frequency of seroreversion, and conducted multivariate analyses to assess characteristics associated with seroreversion.
resultsAmong 369 (79.4%) of 465 HIV-negative patients with early syphilis who had an appropriate treatment response, 333 participants had complete RPR data over 12 months. Although the decline in RPR titers was ≥ 4-fold among 88.0% (293/333) of participants at 3 months and ≥ 8-fold among 77.8% at 6 months, only 9.6% achieved complete RPR seroreversion at 6 months and 17.1% at 12 months after therapy. Male sex (adjusted odds ratio, 4.3; 95% confidence interval, 1.8-10.5) and baseline RPR titers ≤ 1:32 (adjusted odds ratio, 14.5; 95% confidence interval, 6.8-31.2) were associated with higher odds of seroreversion compared with females and titers > 1:32, respectively.
conclusionsDespite a ≥ 4-fold RPR titer decline after treatment, the majority of HIV-negative patients with early syphilis failed to have seroreversion at 12 months. Nontreponemal antibody titers often persist despite an appropriate treatment response.
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