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Author Topic: Syphilis / Roller coaster results  (Read 803 times)

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Offline virgo313

  • Member
  • Posts: 222
Syphilis / Roller coaster results
« on: August 28, 2019, 12:20:24 pm »
Just back from Dr today. Syphilis is at 1:256 Sigh!

Briefly. Got to know i have Syphilis when Dx in Nov 2015. Treated & result down to 1:2

For 3 years Dr did not follow up. Late 2018, check & was at 1:128
(ok, possible sexual exposure). 3 Dose of penicillin. Did not work. Went to 1:256
Started new treatment (antibiotic), result better 1:64.
Continue monitoring (stop antibiotic, as it is going down)

3 Months later (Aug 2018), now it is 1:256). Starting 1st dose of penicillin today
Will check again on Nov 2018

Ok, this is the puzzling part. I have not had any sexual this year. Dr keep asking lots of question on my sex life. She say, there is only 2 possibilities why result goes up
1) Wrong lab result
2) Sexual exposure. (i told her there was no sexual risk when i started treatment this round)

Question is that what would cause result to increase from 1:64 to now 1:256 when no sexual risk? Thanks
RVD Nov 2015. VL --> Log 5.32 HAART on 23/11/15
TDF+FTC+EFV / Chemo KS - 25/11/15 - 20/01/16.
CD4 - 4 (3/11/15) / VL - 225,000   ~ CD4 - 65 (7/03/16) / VL - UD
CD4 - 153 (8/09/16) / VL - UD (20) / CD4% -6%   ~   CD4 - 215 (11/03/17) / VL - No Result / CD4% -8%
CD4 - No Result (10/04/17) / VL - UD (20)   ~   CD4 - 455 (11/05/18) / VL - UD / CD4% -14%
CD4 + CD4% (18/10/18) - Dr not going to  do this anymore / VL - To test only yearly. This Sucks..!
CD4 - 472 (10/04/19) / VL - UD / CD4% - 42%

Offline Expat1

  • Member
  • Posts: 311
Re: Syphilis / Roller coaster results
« Reply #1 on: August 28, 2019, 09:30:14 pm »
Sorry about your recent results.

I am not a doctor but....

It appears you had syphilis (let's call this episode 1) were treated and cured.  Evidence going from 1:128 to 1:2.

Then you probably were reinfected.  Episode 2.  Initial reading 1:128.  Were treated and tested at 1:256  a two-fold increase which is not significant.  They look for a 4 fold increase up or down.  So 1:512 meaning treatnent failure or 1:32 meaning treatment success.  This would be unrelated to your tests on episode 1.  So you currently are a non-responder.   Management would probably be to retreat and check for CNS involvement, meaning lumbar puncture (spinal tap). 

Some people are serofast after treatment.  It goes neither up or down those fourfold amounts.

If central nervous system involvement ,  a treatment with appropriate penicillin for an appropriate amount of time.
« Last Edit: August 28, 2019, 10:01:46 pm by Expat1 »

Offline Expat1

  • Member
  • Posts: 311
Re: Syphilis / Roller coaster results
« Reply #2 on: August 28, 2019, 09:54:06 pm »
This article in pubmed gives some insight.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3590030/

Response to Therapy Following Retreatment of Serofast Early Syphilis Patients With Benzathine Penicillin

Arlene C. Seņa,1 Mark Wolff,2 Frieda Behets,1,3 Kathleen Van Damme,3 David H. Martin,4 Peter Leone,1 Linda McNeil,5 and Edward W. Hook6

Abstract
Persistent nontreponemal titers after treatment are common among patients with early syphilis. We retreated 82 human immunodeficiency virus–negative early syphilis participants who were serofast at 6 months using benzathine penicillin. Only 27% exhibited serological response after retreatment and after an additional 6 months of follow-up.

Keywords: syphilis, serofast, retreatment, serological response
« Last Edit: August 28, 2019, 09:57:59 pm by Expat1 »

Offline virgo313

  • Member
  • Posts: 222
Re: Syphilis / Roller coaster results
« Reply #3 on: August 29, 2019, 02:15:06 am »
Hi Expat,

Thank you very much for the explanation. Yeah, i will need to separate & looking at "Episode 2" now. I guess for now i will just need to go through current treatment of 3 shots of Benzathine Penicillin. Testing again in Nov 19 for results.

I did brought up briefly the topic of lumbar puncture. For now she say it is not needed as i do not show any symptoms of dizzy/tipsy/not able to "balance".

I all can do is follow the current treatment & monitor moving forward.
Again, thank you so much for sharing this info. Will update again. Thank you.     
RVD Nov 2015. VL --> Log 5.32 HAART on 23/11/15
TDF+FTC+EFV / Chemo KS - 25/11/15 - 20/01/16.
CD4 - 4 (3/11/15) / VL - 225,000   ~ CD4 - 65 (7/03/16) / VL - UD
CD4 - 153 (8/09/16) / VL - UD (20) / CD4% -6%   ~   CD4 - 215 (11/03/17) / VL - No Result / CD4% -8%
CD4 - No Result (10/04/17) / VL - UD (20)   ~   CD4 - 455 (11/05/18) / VL - UD / CD4% -14%
CD4 + CD4% (18/10/18) - Dr not going to  do this anymore / VL - To test only yearly. This Sucks..!
CD4 - 472 (10/04/19) / VL - UD / CD4% - 42%

Offline Expat1

  • Member
  • Posts: 311
Re: Syphilis / Roller coaster results
« Reply #4 on: August 29, 2019, 11:47:46 pm »
Yes it looks like your doctor is on top of this.  Good luck to you.

Offline virgo313

  • Member
  • Posts: 222
Re: Syphilis / Roller coaster results
« Reply #5 on: August 30, 2019, 03:09:04 am »
Thanks Expat
RVD Nov 2015. VL --> Log 5.32 HAART on 23/11/15
TDF+FTC+EFV / Chemo KS - 25/11/15 - 20/01/16.
CD4 - 4 (3/11/15) / VL - 225,000   ~ CD4 - 65 (7/03/16) / VL - UD
CD4 - 153 (8/09/16) / VL - UD (20) / CD4% -6%   ~   CD4 - 215 (11/03/17) / VL - No Result / CD4% -8%
CD4 - No Result (10/04/17) / VL - UD (20)   ~   CD4 - 455 (11/05/18) / VL - UD / CD4% -14%
CD4 + CD4% (18/10/18) - Dr not going to  do this anymore / VL - To test only yearly. This Sucks..!
CD4 - 472 (10/04/19) / VL - UD / CD4% - 42%

Offline wardp

  • Member
  • Posts: 151
Re: Syphilis / Roller coaster results
« Reply #6 on: September 01, 2019, 09:58:30 pm »
What is the time frame from exposure  to syphilis.to when syphilis will show up in a blood  test?
Diagnosed 20,July 2017. Cd4 289, 21% vld .3,462 Started atripla 4 Aug 2017 5oct 2017 cd4 384 21%, vl ud less than 20. Switch to complera 4 Nov 2017 switched to stribild 15 the Nov. Switched to truvada efavirence 200mgx2 14 Dec 2017, 2 Feb 2018, us cd4  466, 25%  CD 8 ,595, 32%..1 may 2018
switched  to instgra truvada.7th june switched to truvada  nevirapine stavudine. .21 june switched to truvada nevirapine. X 2 a day...9 aug 2018 ud. 2n Nov 2018 CD 4. 455..22.70% 13th Nov switched  to lamivir and nevirapine  due to kidney issues...jan 10,2019 UD..may 13 2019 ud  cd4 482 28% 14th nov 2019 ud. Cd4 414 .27% cd8 444 29%

Offline virgo313

  • Member
  • Posts: 222
Re: Syphilis / Roller coaster results
« Reply #7 on: September 02, 2019, 12:24:29 am »
Hi wardp,
I really have no idea on this. I think just like any other infections, it will show up within a week or two. Tks
RVD Nov 2015. VL --> Log 5.32 HAART on 23/11/15
TDF+FTC+EFV / Chemo KS - 25/11/15 - 20/01/16.
CD4 - 4 (3/11/15) / VL - 225,000   ~ CD4 - 65 (7/03/16) / VL - UD
CD4 - 153 (8/09/16) / VL - UD (20) / CD4% -6%   ~   CD4 - 215 (11/03/17) / VL - No Result / CD4% -8%
CD4 - No Result (10/04/17) / VL - UD (20)   ~   CD4 - 455 (11/05/18) / VL - UD / CD4% -14%
CD4 + CD4% (18/10/18) - Dr not going to  do this anymore / VL - To test only yearly. This Sucks..!
CD4 - 472 (10/04/19) / VL - UD / CD4% - 42%

 


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