Cytotoxic T-cell deficiency and sustained B-cell activation in serofast syphilis: a prospective observational study

Serofast syphilis was associated with reduced cytotoxic T-cell counts and persistent B-cell activation, supporting a model in which impaired cytotoxic clearance of antigen-presenting cells may prolong antibody production despite microbiological cure. The transient nature of infection-induced anticardiolipin antibodies further argues against persistent autoimmunity. These findings provide mechanistic insight into serofast responses and suggest potential immunological determinants of post-treatment serological persistence.