ABSTRACT
@#Objectives: High rates of syphilis have been reported worldwide among men who have sex with men (MSM). This study aims to describe the clinical pattern and treatment response of syphilis among human immunodeficiency virus (HIV)-infected MSM in Malaysia. Methods: This is a retrospective study on all HIV-infected MSM with syphilis between 2011 and 2015. Data was collected from case notes in five centres namely Hospital Kuala Lumpur, Hospital Sultanah Bahiyah, Hospital Umum Sarawak, University of Malaya Medical Centre and Hospital Sungai Buloh. Results: A total of 294 HIV seropositive MSM with the median age of 29 years (range 16-66) were confirmed to have syphilis. Nearly half (47.6%) were in the age group of 20-29 years. About a quarter (24.1%) was previously infected with syphilis. Eighty-three patients (28.2%) had other concomitant sexually transmitted infection with genital warts being the most frequently reported (17%). The number of patients with early and late syphilis in our cohort were almost equal. The median pre-treatment non-treponemal antibody titre (VDRL or RPR) for early syphilis (1:64) was significantly higher than for late syphilis (1:8) (p<0.0001). The median CD4 count and the number of patients with CD4 <200/μl in early syphilis were comparable to late syphilis. Nearly four-fifth (78.9%) received benzathine-penicillin only, 5.8% doxycycline, 1.4% Cpenicillin, 1% procaine penicillin, and 12.4% a combination of the above medications. About 44% received treatment and were lost to follow-up. Among those who completed 1 -year follow-up after treatment, 72.3% responded to treatment (serological non-reactive – 18.2%, four-fold drop in titre – 10.9%; serofast – 43.6%), 8.5% failed treatment and 17% had re-infection. Excluding those who were re-infected, lost to follow-up and died, the rates of treatment failure were 12.1% and 8.8% for early and late syphilis respectively (p=0.582) Conclusion: The most common stage of syphilis among MSM with HIV was latent syphilis. Overall, about 8.5% failed treatment at 1-year follow-up.
ABSTRACT
Objective To study the false positive of enzyme linked immunoinhibition continuous assays to detect CK-MB in clinic,to reasonably explain the results of detection and to get correctly the project of solving.Methods A total of 125 serum specimen of non-myocardial infarction patients were detected by enzyme linked immunoinhibition continuous assays,in retrospective study.To analyze the factors which made the CK-MB enzymatic activity unit pseudo-rising.Results Total CK-MB enzymatic activity was low in 86 serum specimen of adult patients with non-myocardial infarction,but in the patients with tumor,encephalic infarction and allergic disorder the pseudo-positive ratio of the CK-MB enzymatic activity was high.There were 53 cases, in which CK-MB activity accounted for 6%-21% enzymatic activity of CK, and 6 cases accounted for more than 38% in 59 cases in which the CK-MB activity was more than 5% enzymatic activity of CK.In 38 neonate cases, the enzymatic activity of CK ranged from 145U/L to 1974U/L,In 1 case of neonatal respiratory distress syndrome CK-MB activity accounted for more than 90% enzymatic activity of CK.Another haemolytic sample led to false positive result.Conclusion The phenomenon of enzymatic activity rising in the serum specimen of non-myocardial infarction patients may be caused by the factors of lots CK, CK-BB and AK in serum.Those materials maybe have effects on the action between McAb and M subunit of the CK.Some non-inhibit CK-M and the M subunit with B subunit may participate the enzymatic activity together.Because of the shortcoming of method,the single assay should not be taken as the diagnostic basis.