ReviewSexually transmitted infections2017
A double-edged sword: does highly active antiretroviral therapy contribute to syphilis incidence by impairing immunity to
Review in Sexually transmitted infections, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled 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.
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
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Effect of syphilis infection on HIV acquisition: a systematic review and meta-analysis.Sexually transmitted infections · 2021Pooled it
- Article
- Epidemiological trends of syphilis and the analysis of knowledge and attitudes of future healthcare professionals on its prevention in the autonomous Province of Vojvodina, Serbia.Journal of health, population, and nutrition · 2025Article
- High Incidence of syphilis seroconversion among people living with HIV in Hainan, south China.Scientific reports · 2024Article
- Seroprevalence of Treponema pallidum infection in Brazilian indigenous people: a cross-sectional study.Scientific reports · 2024Article
- Sero-prevalence of syphilis infection among people living with HIV in Sierra Leone: a cross-sectional nationwide hospital-based study.BMC infectious diseases · 2023Article
- Syphilis screening coverage and positivity by HIV treatment status among South African pregnant women enrolled in the 2019 antenatal HIV sentinel survey.Scientific reports · 2023Article
- Consequences of HIV/Syphilis Co-Infection on HIV Viral Load and Immune Response to Antiretroviral Therapy.Infection and drug resistance · 2021Article
- Chlamydia trachomatis transmission between the oropharynx, urethra and anorectum in men who have sex with men: a mathematical model.BMC medicine · 2020Article
- Increased repeat syphilis among HIV-infected patients: A nationwide population-based cohort study in Taiwan.Medicine · 2020Article
- Article
- Repeated Syphilis Episodes in HIV-Infected Men Who Have Sex With Men: A Multicenter Prospective Cohort Study on Risk Factors and the Potential Role of Syphilis Immunity.Open forum infectious diseases · 2020Article
- Early syphilis: risk factors and clinical manifestations focusing on HIV-positive patients.BMC infectious diseases · 2019Article
- HIV-Related Skin Disease in the Era of Antiretroviral Therapy: Recognition and Management.American journal of clinical dermatology · 2019Review
- Sexually transmitted infections, the silent partner in HIV-infected women in Zimbabwe.Southern African journal of HIV medicine · 2019Article
- Characteristics of Persons With Repeat Syphilis-Idaho, 2011 to 2015.Sexually transmitted diseases · 2018Article
- Clinical Manifestations and Ophthalmic Outcomes of Ocular Syphilis at a Time of Re-Emergence of the Systemic Infection.Scientific reports · 2018Observational
- A retrospective study of the clinical features of new syphilis infections in an HIV-positive cohort in Alberta, Canada.BMJ open · 2018Article
- The development of an online risk calculator for the prediction of future syphilis among a high-risk cohort of men who have sex with men and transgender women in Lima, Peru.Sexual health · 2018Article
- Syphilis incidence in men who have sex with men with human immunodeficiency virus comorbidity and the importance of integrating sexually transmitted infection prevention into HIV care.Expert review of anti-infective therapy · 2018Review
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
background and hypothesisRecently, the world has experienced a rapidly escalating outbreak of infectious syphilis primarily affecting men who have sex with men (MSM); many are taking highly active antiretroviral therapy (HAART) for HIV-1 infection. The prevailing hypothesis is that HAART availability and effectiveness have led to the perception among both individuals who are HIV-1 infected and those who are uninfected that HIV-1 transmission has become much less likely, and the effects of HIV-1 infection less deadly. This is expected to result in increased sexual risk-taking, especially unprotected anal intercourse, leading to more non-HIV-1 STDs, including gonorrhoea, chlamydia and syphilis. However, syphilis incidence has increased more rapidly than other STDs. We hypothesise that HAART downregulates the innate and acquired immune responses to
methodsWe performed a literature search and developed a mathematical model of HIV-1 and CONCLUSIONS AND IMPLICATIONS: Since rising syphilis incidence appears to have outpaced gonorrhoea and chlamydia, predominantly affecting HIV-1 positive MSM, behavioural factors alone may be insufficient to explain the unique, sharp increase in syphilis incidence. HAART agents have the potential to alter the innate and acquired immune responses in ways that may enhance susceptibility to
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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.