Syphilis treatment in the presence of HIV

Lawrence, David; Cresswell, Fiona V; Whetham, Jennifer; Fisher, Martin

doi:10.1097/qco.0000000000000132

Cited by 24 publications

(14 citation statements)

References 41 publications

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“…6,21 It is well known that patients with any levels of CD4 cell count could get infected by T pallidum , presumably, the CD4 cell counts was not related to the diagnosis of syphilis or neurosyphilis. 22 However, we were unable to explain the finding that CD4 <350 per μL was a predictor for neurosyphilis among all the co-infected patients with or without neurological symptoms. Therefore, we thought that the different composition of sample was the main reason for this discrepancy.…”

Section: Discussionmentioning

confidence: 70%

Serum TRSUT Titer ≥1

et al. 2015

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Section: Discussionmentioning

confidence: 70%

Serum TRSUT Titer ≥1

et al. 2015

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“…Thus unusual presentation of syphilis is possible in patients with PLHWA as observed in other studies. [5][6][7] Resistance to antimicrobial therapy at the standard dosage, requirement of higher dosage, resistance and relapse of infections were observed in the patients with PLWH. This is similar to the observations in the other studies.…”

Section: Discussionmentioning

confidence: 99%

A study of clinical course and therapeutic response of sexually transmitted infections in people living with HIV/AIDS

Halder¹,

Balasubramanian

2019

Int J Res Dermatol

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Background: Human immunodeficiency virus (HIV) continues to be a major public health problem worldwide. Once a person is infected with HIV, the manifestations of other infections and diseases are altered due to waning of the host immunity.Methods: This study was carried out in HIV reactive patients in Command Hospital, Pune. The types of sexually transmitted infections (STIs) in those patients and the response to therapy were studied in detail. The statistical data was expressed as number and percentages.Results: In this study, 52 people living with HIV/AIDS (PLWHA) who were having various STIs were included. Majority of the patients in this study belonged to the age group of 20-34 years (75%). The most common STIs encountered were condyloma acuminata (38.45%) followed by syphilis (30.77%), lymphogranuloma venereum, herpes genitalis, chancroid, molluscum contagiosum, gonorrhea and granuloma inguinale. Resistance to antimicrobial therapy at the standard dosage, requirement of higher dosage, resistance and relapse of infections were observed in the patients with PLWH.Conclusions: Several STIs coexisted with HIV infected patients. Unusual clinical presentations, clinical course and treatment failure in STI were common in HIV infected individuals. Hence all STI patients should be screened for HIV and vice-versa.

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“…Despite the fact that treatment guidelines unanimously state that clinical management of HIV-infected patients does not differ, some providers use three dose BPG in HIV-infected patients for several reasons: 1) a higher risk of asymptomatic neurosyphilis, 2) reduced immune clearance of infection, and 3) higher serological failure compared to HIV-uninfected patients [60, 79]. In fact, a 2009 study found that 62% of American infectious disease clinicians would prescribe three doses of BPG to treat an HIV-infected patient with secondary syphilis, even though the recommendation only requires one dose [51].…”

Section: Clinical Managementmentioning

confidence: 99%

“…Although enhanced treatment can be rationalized, the evidence is lacking [80]. Experts have acknowledged that the available research on syphilis treatment among HIV-infected patients has been limited and primarily focused on serological outcomes [79, 81, 82]. Even though non-treponemal titers have been used to monitor syphilis response for decades, Tuddenham and Ghanem argue that serological titers may not correlate to clinical outcomes, especially for HIV-infected patients who can have persistently elevated non-treponemal levels unrelated to syphilis activity [83].…”

Section: Clinical Managementmentioning

confidence: 99%

Global challenges in human immunodeficiency virus and syphilis coinfection among men who have sex with men

Roberts

Klausner

2016

Expert Review of Anti-infective Therapy

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Introduction Syphilis and human immunodeficiency virus (HIV) co-infection disproportionately affects men who have sex with men (MSM), and the rate of co-infection has been increasing over the last decade. HIV and syphilis co-infection is particularly challenging because the infections interact synergistically thereby increasing the risk of acquisition and transmission as well as accelerating disease progression. Areas Covered This paper reviews and summarizes the epidemiology, pathogenesis, diagnosis, clinical management and prevention of HIV and syphilis co-infection among MSM. Expert Commentary Research does not support a different syphilis treatment for co-infected individuals; however, co-infection may warrant a recommendation for antiretroviral therapy. In order to reverse the epidemic of syphilis and HIV co-infection, there needs to be greater awareness, improved cultural sensitivity among health care providers, improved access to preventative services and increased screening for syphilis and HIV.

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Syphilis treatment in the presence of HIV

Abstract: Until a prospective, randomized study is conducted, inconsistency with treatment will continue. We offer a pragmatic approach to recognizing patients who may require further investigation or neuropenetrative antibiotic treatment.

Cited by 24 publications

References 41 publications

Serum TRSUT Titer ≥1

Serum TRSUT Titer ≥1

A study of clinical course and therapeutic response of sexually transmitted infections in people living with HIV/AIDS

Global challenges in human immunodeficiency virus and syphilis coinfection among men who have sex with men

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