Syphilis serum fixation

The Venereology Group of the Chinese Association of Traditional Chinese and Western Medicine Dermatology and Venereology recently issued the "Expert Consensus on the Clinical Treatment of Syphilis Cytosis". Unified standards have been established for the diagnosis and treatment of syphilitic blood cell fixation.

Definition

The consensus of the paper integrates the views of experts from all over the world and believes that the definition of syphilis cell fixation is: syphilis patients have undergone standard anti-syphilis treatment and adequate follow-up (1 year follow-up for primary syphilis, 2 years for secondary syphilis, and 3 years for late syphilis), and non-treponemal serological tests have remained at a certain titer (generally 1:8 or below, but exceeding 1:8 is not uncommon) for more than 3 months, and have eliminated reinfection, neurosyphilis, cardiovascular syphilis, and molecular biology positivity, which means that syphilis cells have been fixed.

Clinical epidemiology

The consensus emphasizes that the incidence of syphilis blood cell fixation is high, respectively: primary syphilis 3.80%~15.20%, secondary syphilis 11.64%~35.80%, tertiary syphilis 45.02%~45.90%, latent syphilis 27.41%~40.50%. It is not difficult to see that syphilis blood cell fixation has become a relatively complicated problem in clinical medicine.

Pathogenesis

The current consensus analysis believes that the possible mechanisms for the fixation of syphilis cells include: changes in the membrane active polypeptide antigens, proteins and genes of Treponema pallidum that cannot be eliminated by the body's immunity, abnormalities in the body's immunity, including immune disorders and immunosuppression, disorders in the metabolism of T cell subpopulations, NK cells and cytokines, etc.

Prognosis

The consensus is that the continued positive serological response to syphilis mainly affects the patient's psychological and mental state. However, there is currently insufficient clinical research evidence to assess the adverse effects of syphilis cell fixation on whether it causes physiological harm, whether syphilis cell fixation increases the risk of recurrence or transformation to late-stage syphilis, and whether adding penicillin treatment is beneficial.

Resolving relative paths

The consensus has produced treatment guidelines for syphilis blood cell fixation, including: a detailed understanding of the medical history when syphilis is first treated, including sexual history (time of infection, syphilis infection status of sexual partners, recent risk factors and behaviors, etc.), previous treatment history (time of start of treatment, types of commonly used drugs, treatment course, dosage, follow-up status, etc.), in order to predict the patient's post-treatment blood cell response. During follow-up, cerebrospinal fluid examination is recommended for patients with confirmed syphilitic blood cell fixation to rule out neurosyphilis, and repeated examinations should be performed several times if necessary. HIV testing should also be performed to rule out HIV infection.