METHODS: This is a retrospective study on all HIV-infected MSM with syphilis between 2011 and 2015. Data was collected from case notes in five centres namely Hospital Kuala Lumpur, Hospital Sultanah Bahiyah, Hospital Umum Sarawak, University of Malaya Medical Centre and Hospital Sungai Buloh.

RESULTS: A total of 294 HIV seropositive MSM with the median age of 29 years (range 16-66) were confirmed to have syphilis. Nearly half (47.6%) were in the age group of 20-29 years. About a quarter (24.1%) was previously infected with syphilis. Eighty-three patients (28.2%) had other concomitant sexually transmitted infection with genital warts being the most frequently reported (17%). The number of patients with early and late syphilis in our cohort were almost equal. The median pre-treatment non-treponemal antibody titre (VDRL or RPR) for early syphilis (1:64) was significantly higher than for late syphilis (1:8) (p<0.0001). The median CD4 count and the number of patients with CD4 <200/μl in early syphilis were comparable to late syphilis. Nearly four-fifth (78.9%) received benzathine-penicillin only, 5.8% doxycycline, 1.4% Cpenicillin, 1% procaine penicillin, and 12.4% a combination of the above medications. About 44% received treatment and were lost to follow-up. Among those who completed 1 -year follow-up after treatment, 72.3% responded to treatment (serological non-reactive - 18.2%, four-fold drop in titre - 10.9%; serofast - 43.6%), 8.5% failed treatment and 17% had re-infection. Excluding those who were re-infected, lost to follow-up and died, the rates of treatment failure were 12.1% and 8.8% for early and late syphilis respectively (p=0.582).

METHODS: This was a cross-sectional study in a teaching hospital involving HM patients, admitted for chemotherapy or haematopoietic stem cell transplantation (HSCT). Each admission for either chemotherapy or HSCT was considered as a separate event. Patients were followed up for development of IFI from the time of each admission to time of discharge or time of death. Outcomes of patients with IFI upon discharge were recorded. Clinical and mycological data during each admission were collected and analysed.

RESULTS: Eighty-three patients with mean age of 58.8±15.5 years were recruited. Acute myeloid leukemia (AML) was the most common diagnosis (45.8%). A total of 132 admissions were analysed from these 83 patients. Antifungal prophylaxes were prescribed in 94.7% of admissions with fluconazole being the most common agent used (88.6%). The incidence of proven and probable IFI was 7.6%. Candida tropicalis was the most common fungi isolated from these patients (22.7%), followed by Candida krusei (13.6%). The mortality rate due to IFI was 17.6%. Patients with AML and those with concomitant bacteraemia were associated with higher risk of IFI (odds ratio [OR] 3.69, 95% confidence interval [CI] 1.16-11.71, p=0.029 and OR 4.17, 95% CI 1.37-12.66, p=0.009, respectively), while the use of antifungal prophylaxis was associated with lower IFI risk (OR 0.17, 95% CI 0.03-0.83, p=0.045). After multivariate analysis, the use of antifungal prophylaxis remains significantly associated with lower risk of IFI (OR 0.54, 95% CI 0.01-0.62, p=0.019).