6 курс / Кардиология / Клинико_лабораторная_и_эпидемиологическая_характеристика
.pdf171
majority of patients could be seen to have signs of polyadenitis (78.5% and 78.2%, respectively, χ2 = 0.001, p = 0.970). Typical polymorphism of eruptions was observed in patients from both groups. Among the clinical presentations of secondary syphilis, typhoid maculopapular rash was more common in both groups (69.2% and 72.7%, respectively, χ2 = 0.176, p = 0.675).
Table 5.2.1- Patients in Study Groups by Clinical Picture of Secondary Syphilis
Clinical |
signs |
of |
Main group |
|
|
Comparison group |
|
|
|
|
|||
|
|
|
|
|
|
χ2 |
p |
||||||
Secondary Syphilis |
|
Number |
of |
% |
Number |
of |
% |
||||||
|
|
|
|
|
|||||||||
|
|
|
|
patients |
|
patients |
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
||
Polyadenitis |
|
|
51 |
|
78,5 |
43 |
|
78,2 |
0,001 |
|
0,970 |
|
|
Monomorphic |
|
|
40 |
|
61,5 |
35 |
|
63,6 |
0,056 |
|
0,813 |
|
|
syphiloderms |
|
|
|
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
||
Polymorphic |
|
|
11 |
|
16,9 |
8 |
|
14,5 |
0,126 |
|
0,722 |
|
|
syphiloderms |
|
|
|
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
||
Syphilitic roseola |
|
45 |
|
69,2 |
40 |
|
72,7 |
0,176 |
|
0,675 |
|
||
Syphilitic pupules |
|
25 |
|
38,5 |
16 |
|
29,1 |
1,163 |
|
0,281 |
|
||
Syphilitic pustules |
|
0 |
|
0 |
0 |
|
0 |
- |
|
- |
|
||
Syphilitic leukoderma |
0 |
|
0 |
0 |
|
0 |
- |
|
- |
|
|||
Diffuse |
|
syphilitic |
1 |
|
1,5 |
0 |
|
|
0,853 |
|
0,356 |
|
|
alopecia |
|
|
|
|
|
|
|
|
|||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Focal |
|
syphilitic |
1 |
|
1,5 |
1 |
|
1,8 |
0,014 |
|
0,905 |
|
|
alopecia |
|
|
|
|
|
|
|
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Siphilids |
on |
the |
palm |
17 |
|
26,2 |
10 |
|
18,2 |
1,086 |
|
0,297 |
|
and sole skin |
|
|
|
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
||
Siphilids |
on |
face |
and |
4 |
|
6,2 |
1 |
|
1,8 |
1,402 |
|
0,236 |
|
scalp |
|
|
|
|
|
|
|
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Genital syphilids |
|
10 |
|
15,4 |
12 |
|
21,8 |
0,824 |
|
0,364 |
|
||
Syphilids in the mouth |
6 |
|
9,2 |
10 |
|
18,2 |
2,066 |
|
0,151 |
|
|||
Total |
|
|
|
65 |
|
100 |
55 |
|
100 |
0,932 |
|
0,334 |
|
The presentations of secondary syphilis as papulas were slightly more common in patients from the main group (38.5%) vs patients in the comparison group (29.1%) (χ2 = 1.163, p = 0.281). Neither patient in the comparison groups was found to have either pustular syphilids or signs of syphilitic leukoderma. The presentations of diffuse and focal syphilitic alopecia were observed in two patients from the main group and one patient from the comparison group. Syphilids in the mouth cavity were seen slightly less often in the comparison group (9.2% and 18.2%, respectively) (χ2 = 2.006, p = 0.151).
172
The eruptions on genitals typical for syphilis were equally frequent in both groups (15.4% and 21.8% of patients, respectively) (χ2 = 0.824; p = 0.364). A tendency towards more common siphilid location on the palm and sole skin was seen in the main group (26.2% in the main group vs 18.2% in the comparison group) (χ2 = 1.086, p = 0.297). Patients in the main group most often had siphilids on the hairy part of the head and on the face (6.2% and 1.8%) (χ2 = 1.402, p = 0.236.). No statistically significant differences could be seen between the group.
Serological tests revealed that a vast majority of all patients diagnosed with secondary syphilis in both groups had MPT titres of 1/16 and 1/32 (Table 5.2.2). Titre 1/32 was more common in the main group (17 patients, 26,2%). Ten (18.2%) patients in the comparison group had MPT titre of 1/32, (χ2 = 1.558; p = 0.493). MPT titre of 1/16 prevailed in the comparison group (13 patients, 23.6%). Thirteen (20%) patients with this MT titre were also identified in the main group (χ2 = 1.558; p = 0.493).
Table 5.2.2 - MPT Results in Patients with Secondary Syphilis in the Comparison Groups before Therapy Initiation
|
|
|
|
Groups |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Main group |
|
|
Comparison group |
|
|
||
Name of |
|
|
|
|
|
|
|
|
χ2; p |
reaction |
|
|
|
|
|
|
|
|
|
|
|
Number of |
|
|
|
Number |
|
||
|
|
|
|
|
|
|
|||
|
Titer |
|
% |
|
Titer |
of |
% |
|
|
|
|
patients |
|
|
|||||
|
|
|
|
|
|
patients |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
negative |
|
2 |
3,1 |
|
negative |
2 |
3,6 |
|
|
|
|
|
|
|
|
|
|
|
|
2ps |
|
1 |
1,5 |
|
3 ps |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
1/2 |
|
2 |
3,1 |
|
1/2 |
8 |
14,5 |
|
|
|
|
|
|
|
|
|
|
|
|
1/4 |
|
9 |
13,8 |
|
1/4 |
7 |
12,7 |
|
|
|
|
|
|
|
|
|
|
|
MPT |
1/8 |
|
4 |
6,2 |
|
1/8 |
6 |
10,9 |
1,558; |
|
|
|
|
|
|
|
|
||
1/16 |
|
13 |
20 |
|
1/16 |
13 |
23,6 |
||
|
|
|
0,493 |
||||||
|
|
|
|
|
|
|
|
|
|
|
1/32 |
|
17 |
26,2 |
|
1/32 |
10 |
18,2 |
|
|
|
|
|
||||||
|
|
|
|
|
|
|
|
|
|
|
1/64 |
|
9 |
13,8 |
|
1/64 |
8 |
14,5 |
|
|
|
|
|
|
|
|
|
|
|
|
1/128 |
|
4 |
6,2 |
|
1/128 |
1 |
1,8 |
|
|
|
|
|
|
|
|
|
|
|
|
1/256 |
|
3 |
4,6 |
|
1/256 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
1/512 |
|
1 |
1,5 |
|
1/512 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
Total |
- |
|
65 |
|
|
- |
55 |
|
|
|
|
|
|
|
|
|
|
|
|
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173
Two patients with negative MPT were identified in both groups each (3.1% and 3.6%, respectively). There were 17 patients (26.2%) with a high MPT titre of 1/64 and more in the main group. High MPT titre in the comparison group was determined in nine patients (16.3%).
Both comparison groups were found to have patients with strong positive total ELISA tests (Table 5.2.3). IgM ELISA test was positive in 52 (80%) patients from the main group and in 43 (78.2%) patients from the comparison group (χ2 = 0.060; p < 0.807).
Table 5.2.3 - Serological Tests among Patients Diagnosed with Secondary Syphilis in Comparison Groups
Serological |
Result |
Main group |
|
Comparison group |
|
|
||
|
|
|
|
|
|
|||
positive (+); |
|
|
|
|
χ2 |
p |
||
test |
|
|
|
|
||||
negative (-) |
|
|
|
|
|
|
||
Number |
|
Number |
|
|
|
|||
|
|
|
|
|
||||
|
|
% |
% |
|
|
|||
|
|
of patients |
of patients |
|
|
|||
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
MPT |
+ |
63 |
96,9 |
53 |
96,4 |
0,029 |
0,865 |
|
|
|
|
|
|
||||
- |
2 |
3,1 |
2 |
3,6 |
||||
|
|
|
||||||
|
|
|
|
|
|
|
|
|
IgM+ |
+ |
65 |
100 |
55 |
100 |
|
|
|
IgG |
|
|
|
|
|
- |
- |
|
- |
0 |
0 |
0 |
0 |
||||
ELISA |
|
|
||||||
|
|
|
|
|
|
|
||
IgM ELISA |
+ |
52 |
80 |
43 |
78,2 |
0,060 |
0,807 |
|
- |
13 |
20 |
12 |
21,8 |
||||
|
|
|
||||||
|
|
|
|
|
|
|
|
|
IgG |
+ |
65 |
100 |
55 |
100 |
0,060 |
0,807 |
|
ELISA |
- |
0 |
0 |
0 |
0 |
|||
|
|
|||||||
|
|
|
|
|
|
|
|
|
TPHA |
+ |
65 |
100 |
55 |
100 |
- |
- |
|
|
|
|
|
|
||||
- |
0 |
0 |
0 |
0 |
||||
|
|
|
||||||
|
|
|
|
|
|
|
|
|
IFA (abs). |
+ |
52 |
80 |
50 |
90,9 |
2,781 |
0,095 |
|
|
|
|
|
|
||||
- |
0 |
0 |
0 |
0 |
||||
|
|
|
||||||
|
|
|
|
|
|
|
|
|
|
+ |
45 |
69,2 |
43 |
78,2 |
|
|
|
IFA-200 |
|
|
|
|
|
|
- |
|
- |
1 |
1,5 |
3 |
5,5 |
|
|||
|
uncertain |
7 |
10,8 |
4 |
7,3 |
|
|
|
Total |
|
65 |
100 |
55 |
100 |
0,932 |
0,334 |
|
IFA-200 tests were positive in 45 (69.2%) and 43 (78.2%) patients, respectively, while negative tests were observed in one (1.5%) patient from the main group and in
174
three patients from the comparison group (5.5%). Seven (10.8%) patients from the main group and four (7.3%) patients from the comparison group were observed to have an equivocal test result. Therefore, no reliable differences were found in the results of the serological tests used.
A vast majority of patients in both groups had strong positive TPHA test (Table 6.2.4) (4+): 87.7% in the main group and 89.1% in the comparison group (χ2 = 0.057, p = 0.812).
Table 5.2.4 – TPHA Results Before Initiating Specific Treatment in Patients Diagnosed with Secondary Syphilis in Comparison Groups
Serological |
|
Main group |
|
|
Comparison group |
|
|
|
|
|
|
|
|
|
|
χ2; p |
|
test |
|
|
|
|
|
|
|
|
Result |
Number of patients |
% |
Result |
|
Number of patients |
% |
|
|
|
|
|
||||||
|
|
|
|
|
|
|
|
|
|
Отрицат. |
0 |
0 |
Отрицат. |
|
0 |
0 |
|
TPHA |
|
|
|
|
|
|
|
|
2(+) |
3 |
4,6 |
2 (+) |
|
2 |
3,6 |
0,057; |
|
|
|
|
|
|
|
|
|
0,812 |
|
3(+) |
5 |
7,7 |
3 (+) |
|
4 |
7,3 |
|
|
|
|
||||||
|
|
|
|
|
|
|
|
|
|
4(+) |
57 |
87,7 |
4 (+) |
|
49 |
89,1 |
|
|
|
|
|
|
|
|
|
|
Total |
- |
65 |
0 |
- |
|
55 |
100 |
|
|
|
|
|
|
|
|
|
|
A weak positive result (3+) of the qualitative TPHA test was recorded in five (7.7%) patients from the main group and in four (7.3%) patients from the comparison group. A weak positive result (2+) of the qualitative TPHA test was also recorded in three (4.6%) patients from the main group and in two (3.6%) comparison patients. No patient in either group was recorded to have a negative test.
Therefore, patients with secondary syphilis from the main group were observed to have a tendency towards more common siphilid location on the palm and sole skin, hairy part of the head and on the face (χ2 = 1.402, p = 0.236; χ2 = 1.086, p = 0.297) along the a trend towards more frequent determination of MPT titre of 1/32(χ2 = 1.558; p = 0,493). No statistically significant differences were identified in the clinical and laboratory presentations of secondary syphilis in the observation groups.
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175
5.3. Laboratory Characteristics of (Early and Late) Latent Syphilis in Patients with HIV Infection
An analysis of the laboratory signs of early latent syphilis were performed in 40 patients from the main group and in 44 patients from the comparison group.
Total ELISA tests were positive in a vast majority of patients in both groups (Table 5.3.1).
Table 5.3.1- Serological Tests in Patients with Early Latent Syphilis in Comparison Groups
|
|
Main group |
|
Comparison |
|
|
||
|
Result |
|
group |
|
|
|
||
Serological |
|
|
|
|
|
|
||
positive (+); |
|
|
|
|
|
χ2 |
p |
|
test |
|
|
|
|
|
|||
negative (-) |
Number |
|
|
Number |
|
|
|
|
|
|
|
|
|
|
|||
|
|
of |
|
% |
of |
% |
|
|
|
|
patients |
|
|
patients |
|
|
|
MPT |
+ |
30 |
|
75 |
38 |
86,4 |
1,755 |
0,185 |
|
|
|
|
|
|
|||
- |
10 |
|
25 |
6 |
13,6 |
|||
|
|
|
|
|||||
|
|
|
|
|
|
|
|
|
IgM+ |
+ |
40 |
|
100 |
41 |
93,2 |
|
|
IgG |
|
|
|
|
|
|
2,828 |
0,093 |
- |
0 |
|
0 |
3 |
6,8 |
|||
ELISA |
|
|
|
|||||
|
|
|
|
|
|
|
|
|
IgM ELISA |
+ |
13 |
|
32,5 |
26 |
59,1 |
5,956 |
0,015 |
|
|
|
|
|
|
|||
- |
27 |
|
67,5 |
18 |
40,9 |
|||
|
|
|
|
|||||
|
|
|
|
|
|
|
|
|
IgG ELISA |
+ |
40 |
|
100 |
41 |
93,2 |
2,828 |
0,093 |
- |
0 |
|
0 |
3 |
6,8 |
|||
|
|
|
|
|||||
|
|
|
|
|
|
|
|
|
|
+ |
39 |
|
97,5 |
44 |
100 |
|
|
TPHA |
- |
0 |
|
0 |
0 |
0 |
1,113 |
0,291 |
|
uncertain |
1 |
|
2,5 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
+ |
31 |
|
77,5 |
38 |
97,4 |
|
|
|
|
|
|
|
|
|
|
|
IFA abs. |
- |
0 |
|
0 |
1 |
2,6 |
0,806 |
0,369 |
|
|
|
|
|
|
|
|
|
|
not made |
9 |
|
22,5 |
5 |
11,4 |
|
|
|
|
|
|
|
|
|
|
|
|
+ |
22 |
|
70,1 |
34 |
87,2 |
|
|
|
|
|
|
|
|
|
- |
- |
IFA-200 |
- |
7 |
|
22,6 |
4 |
10,3 |
||
uncertain |
2 |
|
6,5 |
1 |
2,6 |
|
|
|
|
|
|
|
|||||
|
not made |
9 |
|
22,5 |
5 |
11,4 |
|
|
Total |
|
40 |
|
100 |
44 |
100 |
|
|
176
ELISA (IgM) test in patients from the main group with early latent syphilis was positive apparently rarer and seen in 13 (32.5%) patients only. A positive test in the comparison group was obtained for 26 (59.1%) patients (χ2 = 5.956, р = 0.015). ELISA (IgG) tests were positive in all patients in the main group and in 41 (93.2%) patients in the comparison group (χ2 = 2.828, р = 0.093). Both groups had mostly positive TPHA tests and just one (2.5%) patient in the main group had an equivocal test result. IFA-200 and IFA abs. tests were not performed for nine (22.5%) patients from the main group and five (11.4%) patients from the comparison group. IFA abs. test results were positive in all patients from the main group and in 38 (97.4%) patients from the comparison group (χ2 = 0.806, р = 0.369). Negative IFA abs. tests were seen in seven (17.5%) patients from the main group and in four (9.1%) patients from the comparison group, while two (6.5%) patients from the main group and one (2.6%) patient from the comparison group had equivocal test results.
A negative MPT test result prevailed in the main group among patients with early latent syphilis (Table 5.3.2) (seven patients, 17.5%) along with a titre of 1/4 (seven patients, 17.5%). At the same time, titres of 1/16 (10 patients, 22.7%) and 1/32 (eight patients, 18.2%) prevailed in the comparison group (χ2 = 5.899, р = 0.823)
Table 5.3.2 - MPT Results in Patients with Early Latent Syphilis in the Comparison Groups before Therapy Initiation
|
|
Comparison groups |
|
|
|
|||
|
|
|
|
|
|
|
|
|
Serological |
|
Main |
|
Comparison |
|
χ2; p |
||
|
|
|
|
|
|
|||
test |
|
|
|
|
|
|
||
Titer |
Number |
% |
Titer |
Number |
% |
|
||
|
|
|||||||
|
of patients |
of patients |
|
|||||
|
|
|
|
|
|
|||
|
Negative |
7 |
17,5 |
Negative |
7 |
15,9 |
|
|
|
|
|
|
|
|
|
|
|
|
2 ps |
1 |
2,5 |
2 ps |
2 |
4,5 |
|
|
|
|
|
|
|
|
|
|
|
|
1/2 |
4 |
10 |
1/2 |
4 |
9,1 |
5,899; |
|
|
|
|
|
|
|
|
||
МРT |
1/4 |
7 |
17,5 |
1/4 |
6 |
13,6 |
||
0,823 |
||||||||
|
|
|
|
|
|
|
||
|
1/8 |
8 |
20 |
1/8 |
4 |
9,1 |
||
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
1/16 |
6 |
15 |
1/16 |
10 |
22,7 |
|
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|
|
|
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1/32 |
4 |
10 |
1/32 |
8 |
18,2 |
|
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|
|
|
|
|
|
|
|
|
|
1/64 |
2 |
5 |
1/64 |
2 |
4,5 |
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|
|
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177 |
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Table 5.3.2 continued |
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Comparison groups |
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Serological |
|
|
Main |
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|
|
Comparison |
|
χ2; p |
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|
test |
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Titer |
Number |
|
% |
|
Titer |
|
Number |
% |
|
|
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|
|
|
||||||
|
|
|
of patients |
|
|
of patients |
|
|||||
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|
|||
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|
|
1/128 |
0 |
|
0 |
|
1/128 |
|
1 |
2,3 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
МРT |
|
1/256 |
1 |
|
2,5 |
|
1/256 |
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1/512 |
0 |
|
0 |
|
1/512 |
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
40 |
|
100 |
|
|
|
44 |
100 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
MPT titre of 1/8 was more common in the main group with eight (20%) patients in the main group and four (9.1%) patients in the comparison group, respectively. However, the MPT titre of 1/32 was more common in patients from the comparison group (eight people [18.2%] and four people [10%], respectively). The main group had three patients (7.5%) with a high MPT titre of 1/64 and more. High MPT titre in the comparison group was also determined in three patients (6.8%).
Laboratory finding in late latent syphilis were studied in 37 patients from the main group and in 50 patients from the comparison group.
Positive MPT tests prevailed in both comparison groups among patients with late latent syphilis with 56.8% in the main group and 58% in the comparison group, respectively. Total ELISA test results in all patients from the comparison groups were positive (Table 5.3.3).
Table 5.3.3– Serological Serum Tests in Patients with Late Latent Syphilis in Comparison Groups
|
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|
Comparison groups |
|
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|||
|
Result |
|
|
|
|
|
|
|
|
Serological |
Main |
Comparison |
|
|
|
||||
positive (+); |
|
|
|
|
|
|
|
p |
|
test |
|
|
|
|
|
|
χ2 |
||
negative (-) |
Number |
|
|
Number of |
|
|
|
||
|
|
|
|
|
|
|
|||
|
|
of |
|
% |
|
% |
|
|
|
|
|
|
patients |
|
|
|
|||
|
|
patients |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
МРT |
+ |
21 |
|
56,8 |
29 |
|
58 |
0,013 |
0,908 |
|
|
|
|
|
|
|
|||
- |
16 |
|
43,2 |
21 |
|
42 |
|||
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|||||
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178 |
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Table 5.3.3 continued |
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|
|
Result |
Comparison groups |
|
|
|
|||
|
Serological |
|
|
|
|
|
|
|
|
|
Main |
|
|
Comparison |
|
|
|||
|
positive (+); |
|
|
|
p |
||||
|
test |
|
|
|
|
|
χ2 |
||
|
negative (-) |
Number of |
|
% |
Number |
% |
|
||
|
|
|
|
|
|||||
|
|
patients |
|
of patients |
|
|
|||
|
|
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|
|
|
||||
|
|
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|
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|
IgM+ |
+ |
37 |
|
100 |
50 |
100 |
|
|
|
IgG |
|
|
|
|
|
|
- |
- |
|
- |
0 |
|
0 |
0 |
0 |
|||
|
ELISA |
|
|
|
|||||
|
|
|
|
|
|
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|
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|
|
IgM ELISA |
+ |
0 |
|
0 |
3 |
6 |
2,299 |
0,129 |
|
|
|
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|
|
|
|||
|
- |
36* |
|
97,3 |
47 |
94 |
|||
|
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|
|||||
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|
|
|
IgG ELISA |
+ |
37 |
|
100 |
50 |
100 |
- |
- |
|
|
|
|
|
|
|
|||
|
- |
0 |
|
0 |
0 |
0 |
|||
|
|
|
|
|
|||||
|
|
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|
|
|
|
|
|
|
|
|
+ |
37 |
|
100 |
50 |
100 |
|
|
|
TPHA |
- |
0 |
|
0 |
0 |
0 |
- |
- |
|
|
uncertain |
0 |
|
0 |
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
+ |
22 |
|
91,7 |
36 |
97,3 |
|
|
|
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|
|
|
|
|
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|
|
IFA abs. |
- |
1 |
|
4,2 |
0 |
0 |
0,987 |
0,320 |
|
|
|
|
|
|
|
|||
|
uncertain |
1 |
|
4,2 |
1 |
2,7 |
|||
|
|
|
|
|
|||||
|
|
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|
|
|
|
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|
|
|
not made |
13 |
|
35,1 |
13 |
26 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
+ |
12 |
|
66,7 |
27 |
77,1 |
|
|
|
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|
|
|
|
|
|
|
|
IFA-200 |
- |
4 |
|
22,2 |
2 |
5,7 |
0,671 |
0,413 |
|
uncertain |
2 |
|
11,1 |
6 |
17,1 |
|||
|
|
|
|
|
|||||
|
|
not made |
19 |
|
51,4 |
15 |
30 |
|
|
|
|
Total |
37 |
|
100 |
50 |
100 |
|
|
*The test was not performed for one patient for technical reasons
A vast majority of patients in both groups mostly had negative ELISA (IgM) tests in 97.3% of patients from the main group (since a test was not performed for one patient due to technical reasons) and in 94% of patients in the comparison group, respectively (three patients had a positive test). IFA abs. test was not performed for 13 (35.1%) patients from the main group and for 13 (16%) patients from the comparison group. IFA abs. test was positive in 22 (91.7%) patients from the main group and in 36 (97.3%) patients from the comparison group (χ2 = 0.987, < 0.320). A total of 19 (51.4%) patients from the main group and 15 (30%) patients from the comparison group did not take IFA abs. test. IFA-200 test was positive in 12 (66.7%) patients from the main group and in 27 (77.1%) patients from the comparison group (χ2 = 0.671, < 0.413). IFA-200 test was found to be negative in four (22.2%) patients from the main group and two (5.7%)
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179
patients from the comparison group. An equivocal test result was observed in two (11.1%) patients from the main group and six (17.1%) patients from the comparison group.
A negative MPT titre was prevalent in the comparison groups with late latent syphilis (Table 5.3.4) with no reaction in 16 (43.2%) patients from the main group and in 21 (42%) patients from the comparison group. MPT titre of 1/2 was recorded among patients from the main group in 10 cases (20%) with the same titre identified in five (13.5%) patients from the comparison group (χ2 = 7.880; р = 0.641).
Table 5.3.4 – MPT Serum Test Results in Patients with Late Latent Syphilis in Comparison Groups before Therapy Initiation
Serological |
|
Main group |
|
|
Main group |
|
|
||
|
|
|
|
|
|
|
|
χ2; p |
|
test |
|
|
|
|
|
|
|
|
|
Titer |
|
Titer |
% |
Titer |
|
Titer |
% |
|
|
|
|
|
|
||||||
|
|
|
|
|
|
|
|
|
|
|
Negative |
|
16 |
43, |
Negative |
|
21 |
42 |
|
|
|
2 |
|
|
|||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
2 ps |
|
3 |
8,1 |
2 ps |
|
3 |
6 |
|
|
|
|
|
|
|
|
|
|
|
|
1/2 |
|
5 |
13, |
1/2 |
|
10 |
20 |
|
|
|
5 |
|
|
|||||
|
|
|
|
|
|
|
|
|
|
|
1/4 |
|
1 |
2,7 |
1/4 |
|
6 |
12 |
|
|
|
|
|
|
|
|
|
|
|
|
1/8 |
|
4 |
10, |
1/8 |
|
2 |
4 |
|
МРT |
|
8 |
|
|
|||||
|
|
|
|
|
|
|
7,880; |
||
|
1/16 |
|
4 |
10, |
1/16 |
|
5 |
10 |
|
|
|
|
0,641 |
||||||
|
|
8 |
|
||||||
|
|
|
|
|
|
|
|
|
|
|
1/32 |
|
1 |
2,7 |
1/32 |
|
1 |
1 |
|
|
|
|
|
|
|
|
|
|
|
|
1/64 |
|
1 |
2,7 |
1/64 |
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
1/128 |
|
0 |
0 |
1/128 |
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
1/256 |
|
1 |
2,7 |
1/256 |
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
|
1/512 |
|
0 |
0 |
1/512 |
|
0 |
0 |
|
|
|
|
|
|
|
|
|
|
|
Total |
- |
|
37 |
10 |
- |
|
50 |
100 |
|
|
0 |
|
|
||||||
|
|
|
|
|
|
|
|
|
|
MPT titre of 1/16 was observed in four (10.8%) patients from the main group and in five (10%) patients from the comparison group. High MPT titres (1/64 and more) were seen in two (5.4%) patients from the main group only and in none of the patients
180
from the comparison group. Patients with latent forms of syphilis were distributed evenly across the comparison groups by MPT antibody titre when hospitalised.
Thus, patients with early latent syphilis from the comparison group (59.1%,) were recorded to have a positive ELISA (IgM) test more often than patients from the main group (32.5%) (χ2 = 5.956, р = 0.015). No other reliable differences were found based on serological tests.
5.4. Characteristics of the Clinical Status and Laboratory Presentations in Patients with Neurosyphilis и and HIV Infection
Neurosyphilis was diagnosed in 115 (42.3%) patients from the main group and 105 patients (38.2%) from the comparison group. Thus, 98 (85.2%) patients from the main group and 77 (73.3%) patients from the comparison group were diagnosed with early neurosyphilis, while 17 (14.8%) and 28 (26.7%) patients were diagnosed with late neurosyphilis.
During examination and treatment, most patients were recommended to have lumbar puncture performed by a neurologist. Thus, the number of such patients was 268 (98.5%) in the main group and 250 (90.9%) in the comparison group (Table 5.4.1). The puncture was not performed for 78 (29.1%) and 68 (27.2%) of the patients who were recommended to have it done since they refused. The investigative procedure was not performed in three (1.1%) patients from the main group and in four (1.6%) patients from the comparison group due to contraindications.
Table 5.4.1- Frequency and Results of Lumbar Puncture in Comparison Groups
|
|
|
Main group |
|
Comparison group |
||||
|
Lumbar puncture |
|
|
|
|
|
|
||
Number |
of |
% |
Number |
of |
% |
||||
|
|
|
|||||||
|
|
|
patients |
|
patients |
|
|||
|
|
|
|
|
|
|
|||
|
Recommended |
268 |
|
100 |
250 |
|
100 |
||
|
|
|
|
|
|
|
|
|
|
|
Cases of refuses |
78 |
|
29,1 |
67 |
|
27,2 |
||
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
Not punctured up to contraindications |
|
3 |
|
1,1 |
4 |
|
1,6 |
|
|
|
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