Correlation Between Histopathological Findings, CD4 Counts, and Treponeme Quantity in Microscopic Sections and Secondary Syphilis in HIV Positive Individuals

Abstract

Syphilis is not common, although HIV-infected people are far more likely to be infected than the general population. This may be caused by weakened cellular immunity due to HIV infection. This study aimed to find out the correlation between CD4 concentration and T. Pallidum occurrence. Methods: A assessment of a single institution identified ten patients with secondary syphilis diagnosed through a skin biopsy, positive syphilis serology, and high CD4 levels. There were 14 samples obtained from 13 individuals. Immunohistochemistry (IHC) was used to detect the presence of treponemes and CD4 levels in skin samples. These findings have also been compared with results obtained from detecting T. Pallidum by IHC in silver stain sections (Warthin-Starry). A comparison of the histological characteristics of each sample has also been made. IHC was used to determine the number of treponemes on the samples. Results: Silver stain had a sensitivity of 9 percent whereas IHC detected the treponemes at 64 percent. (p-value of 0.04). Spirochetes high incidence found only in people with less than 250 cells/ml of CD4 (>100 per 10 HPF). Conclusions: The utmost persistent histological outcome was low to highlympho-plasmocytic infiltration. However, this research did show that a high spirochete count is associated with a low CD4 count (less than 250 cells/ml). In comparison to Warthin-Starry staining results, IHC staining for T. palidum has shown superior results.