Exploring syphilis activity for personalized treatment strategies in latent syphilis: a 2-year cohort study
Jia-Wen Xie A B # , Ya-Wen Zheng A C # , Shu-Hao Fan A B , Yin-Feng Guo A B , Ying Zheng A B , Yu Lin A B , Man-Li Tong A B and Li-Rong Lin
A B *
A
B
C
# These authors have contributed equally to this work and share first authorship
Handling Editor: Michael Marks
Abstract
Relying simply on the stage of latent syphilis may lead to excessive treatment strategies. Utilizing nontreponemal immunoglobulin M (IgM) antibodies to assess syphilis activity and tailor treatment strategies may offer enhanced therapeutic advantages.
To investigate whether nontreponemal IgM antibodies can serve as a serological marker for assessing the activity of latent syphilis and inform personalized treatment strategies.
We evaluated nontreponemal IgM antibodies in 412 latent syphilis patients and conducted a 2-year follow up to analyze their rate of seroconversion (the change from seropositive to seronegative status), to evaluate whether nontreponemal IgM antibodies could assess the activity of latent syphilis.
The positive nontreponemal IgM group demonstrated a lower seroconversion rate (P = 0.0178) and achieved seroconversion slower compared with the negative group (hazard ratio: 0.386). Early-stage patients exhibited higher nontreponemal IgM antibody levels (P < 0.0001) and lower seroconversion rates (P = 0.018) than late-stage patients. Elderly patients showed lower nontreponemal IgM antibody levels (P < 0.0001) and higher seroconversion rates (P = 0.0022) than non-elderly patients.
Latent syphilis patients with positive nontreponemal IgM require a longer time to seroconversion and exhibit a lower seroreversion rate, indicating their higher syphilis activity. Nontreponemal IgM antibodies can serve as a serological marker for detecting syphilis activity in latent syphilis. It is recommended to test for nontreponemal IgM antibodies before treatment to identify syphilis activity for personalized treatment.
Keywords: cohort study, latent syphilis, nontreponemal IgM antibody, serological marker, syphilis, syphilis activity, Treponema pallidum, treatment strategies.
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