Timely Topics in Clinical Immunology

Timely Topics in Clinical Immunology 44 7897 074717

Online Journals On Syphilis And HIV

 

The interaction of syphilis and HIV infection is complex and remains the subject of ongoing research. Epidemiologic studies demonstrate that sexually transmitted diseases (STDs) including syphilis, and particularly genital ulcers associated with primary syphilis, are associated with an increased risk of HIV acquisition. Although case reports have suggested that coexisting HIV infection may alter the natural history of syphilis, only a few such effects have been demonstrated in large observational studies, notably presentation with multiple or deeper chancres and overlap of primary- and secondary-stage features of syphilis in coinfected patients. Initial serologic responses to early syphilis were shown to be generally equivalent in HIV-negative and -positive individuals. Like many acute infections in the HIV-infected patient, early syphilis may decrease CD4+ T-cell counts (CD4 cell counts) and increase HIV RNA in plasma and semen, although evidence for these effects has been mixed. Reports of false-positive and false-negative results on serologic tests for syphilis in HIV-infected persons raise questions regarding the specificity and sensitivity of serologic diagnoses in such patients.

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