Syphilis in the AIDS Era
Abstract
The development of neurologic complications of syphilis in patients infected with the human immunodeficiency virus (HIV) is documented. The pathogenesis of syphilis is brought into sharper focus: the immunologic response of the patient has an important role in controlling the infection, even in the presence of adequate antibiotic therapy. These case reports suggest that penicillin alone is probably not adequate in the absence of a vigorous host response. Anyone who has a compromised immune status for any reason and has contracted syphilis must be treated with higher doses of antibiotics for prolonged periods. Antibiotic therapy for neurosyphilis appears to be the minimal acceptable regimen. The treatments used include aqueous penicillin, procaine penicillin plus probenecid, amoxicillin plus probenecid for 14 days, and doxycycline. Since the vast majority of patients with HIV infection have a personal behavior pattern that puts them at high risk of contracting syphilis, all HIV-infected patients should be screened for syphilis, and vice versa. The same holds true for other sexually transmitted diseases. Serologic tests remain the bedrock for the diagnosis of syphilis, since no attempt is made to isolate the infecting organism an no proved means of detecting T. pallidum antigens exists. The antibody response in HIV-infected patients, particularly in the later stages of AIDS, may be compromised, and thus the diagnosis may be obscured.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 18, 1987
- Accession Number
- ADA200071
Entities
People
- Edmund C. Tramont
Organizations
- Armed Forces Research Institute of Medical Sciences