Analysis of Factors Determining Serologic Response to Treatment of Early Syphilis in Adult Men

<b>Background:</b> Syphilis is an infectious systemic disease that remains a public health threat, with an increasing incidence worldwide. Despite the availability of diagnostic tests and effective treatments, achieving a serological cure remains challenging for some patients. <b>M...

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Main Authors: Justyna Czarny, Damian Kadylak, Małgorzata Sokołowska-Wojdyło, Roman J. Nowicki
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Infectious Disease Reports
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Online Access:https://www.mdpi.com/2036-7449/17/3/41
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author Justyna Czarny
Damian Kadylak
Małgorzata Sokołowska-Wojdyło
Roman J. Nowicki
author_facet Justyna Czarny
Damian Kadylak
Małgorzata Sokołowska-Wojdyło
Roman J. Nowicki
author_sort Justyna Czarny
collection DOAJ
description <b>Background:</b> Syphilis is an infectious systemic disease that remains a public health threat, with an increasing incidence worldwide. Despite the availability of diagnostic tests and effective treatments, achieving a serological cure remains challenging for some patients. <b>Methods:</b> A retrospective cohort study of 130 male patients with early syphilis who attended the Department of Dermatology Venereology and Allergology in Gdansk was carried out between 2021 and 2024. This study assessed the rates of proper serological response and seroreversion of the VDRL test during the posttreatment follow-up period and analyzed selected factors influencing the achievement of these points. <b>Results:</b> The treatment outcomes were favorable; 96.15% of the patients achieved a proper serological response at a median of 1.54 months and seroreversion of the VDRL test within 18 months (median time = 7 months). A significantly greater proper serological response was observed in the primary and secondary syphilis patients than in the early latent syphilis patients (<i>p</i> = 0.005). A proper serological response was associated with age over 30 years (risk ratio (<i>RR</i>) = 1.381, <i>p</i> = 0.008) and VDRL baseline titers (≥1:32) (RR = 1.484, <i>p</i> = 0.005). The patients in the secondary or latent stage of early syphilis had a lower risk of seroreversion than those in the primary stage did (RR = 0.590, <i>p</i> = 0.030; <i>RR</i> = 0.560, <i>p</i> = 0.019, respectively). High titers at baseline (≥1:32) were also associated with a 30.8% reduced risk of seroreversion compared with lower titers (<i>RR</i> = 0.692, <i>p</i> = 0.038). <b>Conclusions</b>: These results suggest that age, syphilis stage, and titer level are significant predictors of the response rate. Based on these results, it is recommended that serological follow-up be concentrated within the first three months posttreatment, as this period accounts for the majority of treatment responses.
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spelling doaj-art-6907df8af76c4fb1b2da4b6fdc85089c2025-08-20T03:27:15ZengMDPI AGInfectious Disease Reports2036-74492025-04-011734110.3390/idr17030041Analysis of Factors Determining Serologic Response to Treatment of Early Syphilis in Adult MenJustyna Czarny0Damian Kadylak1Małgorzata Sokołowska-Wojdyło2Roman J. Nowicki3Department of Dermatology, Venerology and Allergology, Medical University of Gdańsk, Mariana Smoluchowskiego 17 Street, 80-214 Gdańsk, PolandDepartment of Dermatology, Venerology and Allergology, Medical University of Gdańsk, Mariana Smoluchowskiego 17 Street, 80-214 Gdańsk, PolandDepartment of Dermatology, Venerology and Allergology, Medical University of Gdańsk, Mariana Smoluchowskiego 17 Street, 80-214 Gdańsk, PolandDepartment of Dermatology, Venerology and Allergology, Medical University of Gdańsk, Mariana Smoluchowskiego 17 Street, 80-214 Gdańsk, Poland<b>Background:</b> Syphilis is an infectious systemic disease that remains a public health threat, with an increasing incidence worldwide. Despite the availability of diagnostic tests and effective treatments, achieving a serological cure remains challenging for some patients. <b>Methods:</b> A retrospective cohort study of 130 male patients with early syphilis who attended the Department of Dermatology Venereology and Allergology in Gdansk was carried out between 2021 and 2024. This study assessed the rates of proper serological response and seroreversion of the VDRL test during the posttreatment follow-up period and analyzed selected factors influencing the achievement of these points. <b>Results:</b> The treatment outcomes were favorable; 96.15% of the patients achieved a proper serological response at a median of 1.54 months and seroreversion of the VDRL test within 18 months (median time = 7 months). A significantly greater proper serological response was observed in the primary and secondary syphilis patients than in the early latent syphilis patients (<i>p</i> = 0.005). A proper serological response was associated with age over 30 years (risk ratio (<i>RR</i>) = 1.381, <i>p</i> = 0.008) and VDRL baseline titers (≥1:32) (RR = 1.484, <i>p</i> = 0.005). The patients in the secondary or latent stage of early syphilis had a lower risk of seroreversion than those in the primary stage did (RR = 0.590, <i>p</i> = 0.030; <i>RR</i> = 0.560, <i>p</i> = 0.019, respectively). High titers at baseline (≥1:32) were also associated with a 30.8% reduced risk of seroreversion compared with lower titers (<i>RR</i> = 0.692, <i>p</i> = 0.038). <b>Conclusions</b>: These results suggest that age, syphilis stage, and titer level are significant predictors of the response rate. Based on these results, it is recommended that serological follow-up be concentrated within the first three months posttreatment, as this period accounts for the majority of treatment responses.https://www.mdpi.com/2036-7449/17/3/41syphilistreatmentsexually transmitted infections
spellingShingle Justyna Czarny
Damian Kadylak
Małgorzata Sokołowska-Wojdyło
Roman J. Nowicki
Analysis of Factors Determining Serologic Response to Treatment of Early Syphilis in Adult Men
Infectious Disease Reports
syphilis
treatment
sexually transmitted infections
title Analysis of Factors Determining Serologic Response to Treatment of Early Syphilis in Adult Men
title_full Analysis of Factors Determining Serologic Response to Treatment of Early Syphilis in Adult Men
title_fullStr Analysis of Factors Determining Serologic Response to Treatment of Early Syphilis in Adult Men
title_full_unstemmed Analysis of Factors Determining Serologic Response to Treatment of Early Syphilis in Adult Men
title_short Analysis of Factors Determining Serologic Response to Treatment of Early Syphilis in Adult Men
title_sort analysis of factors determining serologic response to treatment of early syphilis in adult men
topic syphilis
treatment
sexually transmitted infections
url https://www.mdpi.com/2036-7449/17/3/41
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AT małgorzatasokołowskawojdyło analysisoffactorsdeterminingserologicresponsetotreatmentofearlysyphilisinadultmen
AT romanjnowicki analysisoffactorsdeterminingserologicresponsetotreatmentofearlysyphilisinadultmen