Frontiers in immunology · 2025
Risk factors of serofast state in patients undergoing syphilis: a meta-analysis of 17 cohort studies.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
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Zeng Xin, Ouyang Yuan, Wang Haoyun, Liu Linna, Chen Jiaxin, Zhu Chengbin, Huang Hong, Lin Jin, Niu Yanan, Liao Lan, Yang Na, Xiao Chunlan, Gong Weidong, Liu Peng
Аннотация
OBJECTIVE: The serofast state in syphilis refers to a persistent serological status where patients maintain stable specific antibody titers despite receiving standardized anti-syphilitic therapy, whose underlying mechanisms remain incompletely elucidated. This study aims to systematically identify risk factors associated with the occurrence of syphilitic serofast state through comprehensive clinical data analysis.
METHOD: We performed a systematic literature search in PubMed and Embase databases for studies published up to February 20, 2025. A random-effects model was employed for meta-analysis, with effect estimates expressed as relative risk (RR) presented with 95% confidence intervals (CIs). Methodological evaluations including sensitivity analyses and publication bias assessment were conducted to assess result robustness.
RESULTS: A total of 17 cohort studies involving 4,662 eligible participants were included in this meta-analysis. The pooled results demonstrated significant associations between serofast state and primary syphilis (RR = 0.65; 95% CI: 0.44-0.96), latent syphilis (RR = 2.14; 95% CI: 1.47-3.11), female gender (RR = 1.19; 95% CI: 1.01-1.41), HIV coinfection (RR = 1.40; 95% CI: 1.09-1.79), and lower rapid plasma reagin (RPR) titers (≤1:32) (RR = 1.47; 95% CI: 1.02-2.13). No statistically significant associations were observed for secondary syphilis (RR = 0.81; 95% CI: 0.59-1.12), age >40 years (RR = 1.41; 95% CI: 0.80-2.49), or benzathine penicillin treatment (RR = 0.99; 95% CI: 0.86-1.13). These findings were validated through leave-one-out sensitivity analysis.
CONCLUSION: Female gender, HIV coinfection, primary syphilis, latent syphilis, and low rapid plasma reagin (RPR) titers (≤1:32) emerged as significant risk factors for serofast state development, requiring particular attention during therapeutic management to optimize syphilis treatment outcomes.
METHOD: We performed a systematic literature search in PubMed and Embase databases for studies published up to February 20, 2025. A random-effects model was employed for meta-analysis, with effect estimates expressed as relative risk (RR) presented with 95% confidence intervals (CIs). Methodological evaluations including sensitivity analyses and publication bias assessment were conducted to assess result robustness.
RESULTS: A total of 17 cohort studies involving 4,662 eligible participants were included in this meta-analysis. The pooled results demonstrated significant associations between serofast state and primary syphilis (RR = 0.65; 95% CI: 0.44-0.96), latent syphilis (RR = 2.14; 95% CI: 1.47-3.11), female gender (RR = 1.19; 95% CI: 1.01-1.41), HIV coinfection (RR = 1.40; 95% CI: 1.09-1.79), and lower rapid plasma reagin (RPR) titers (≤1:32) (RR = 1.47; 95% CI: 1.02-2.13). No statistically significant associations were observed for secondary syphilis (RR = 0.81; 95% CI: 0.59-1.12), age >40 years (RR = 1.41; 95% CI: 0.80-2.49), or benzathine penicillin treatment (RR = 0.99; 95% CI: 0.86-1.13). These findings were validated through leave-one-out sensitivity analysis.
CONCLUSION: Female gender, HIV coinfection, primary syphilis, latent syphilis, and low rapid plasma reagin (RPR) titers (≤1:32) emerged as significant risk factors for serofast state development, requiring particular attention during therapeutic management to optimize syphilis treatment outcomes.