Retreatment Of Patients With Syphilis Serofixation And Study On The Mechanism Of Serofixation

Chapter 1 Serological respotreatment protocol remains uncertain due to the paucity of data regarding serological nse to therapy following retreatment of serofast early syphilis patients with benzathine penicillinBackround:Some syphilitic patients remain in a serologically positive state after the recommended therapy.Although we often retreat patients in clinical practice,optimal response to retreatment and long-term outcomes.Objectives and Methods:We examined RPR serological test results of 70 serofast early syphilis cases who were retreated with benzathine penicillin 2.4 million units weekly for 3 weeks.Results:Thirty-four(48.6%)of the patients who failed to achieve serological cure at 6 months after initial therapy achieved serological cure at 12 months.Patients who had higher nontreponemal titers at baseline and at 6 months were more likely to exhibit serological cure after retreatment than those with lower titers.Conclusions:Our results suggest that the incremental benefit of retreating serofast patients with early syphilis is moderate,considering the almost 1:1 ratio of serological response to serofast state at follow up.Chapter 2 Cell-free DNA screening of Treponema pallidum in serofast syphilis patientsbloodBackground:Serofast syphilis refers to patients serologically positive after recommended therapy.There are still discussions of the cause of serofast but persistent infection of Treponema pallidum(TP)cannot be excluded.TP DNA screening could help identify the existence of TP in or cerebrospinal fluid(CSF).Objectives and Methods:We collected blood and CSF samples of serofast syphilis patients,screened TP cfDNA in blood and TP DNA in CSF by NGS to discover the relationship between serofast syphilis and persistent infection of TP.Results:We enrolled 100 syphilis patients screening TP cfDNA in plasma/serum and TP DNA in CSF.The blood sample revealed that 21.6%(8/37)of the serofast patients,94.1%(16/17)of the serological cure patients,and 0%(0/47)of the serological cure patients had positive results,.Among the 9 serofast patients testing both plasma and CSF,the positive rate of TP DNA in CSF sample was 55.6%.Conclusions:Serofast syphilis state is related to persistent infection of TP and neurosyphilis.