Syphilis and HIV Infection
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Published:
Jun 1, 2016
Keywords:
Syphilis HIV infection
Main Article Content
Abstract
Syphilis and HIV infection, both are sexually transmitted diseases. After outbreak in 80 years ago, penicillin treatment and aggressive syphilis control public health campaigns led to decrease in syphilis cases. Since HIV/AIDS era, the numbers of syphilis cases were upswing. This article intends to review how to manage syphilis that is re-emerged in cases of HIV co-infection. Syphilis infection was associated with elevated risk of HIV infection. Clinical manifestation is more severe in syphilis and HIV co-infection patients. Diagnosis and treatment among individuals with HIV infection who also have syphilis are usually the same as among individuals without HIV infection who acquire syphilis. Parenteral penicillin is the preferred drug for treating persons in all stages of syphilis. The use of highly active antiretroviral therapy may reduce syphilis serologic failure rates among HIV-infected patients who have syphilis. Antiretroviral therapy decreases neurological complications of syphilis. Persons exposed sexually to syphilis patients should be evaluated clinically and serologically and treated. After treatment, clinical and serologic evaluation should be performed longer than in non HIV-infected patients. Penicillin, ceftriaxone and doxycycline can be used as an efficient treatment, and no significant differences in serological response.
Article Details
How to Cite
Munsakul, W. (2016). Syphilis and HIV Infection. Vajira Medical Journal : Journal of Urban Medicine, 60(2), 147–158. Retrieved from https://he02.tci-thaijo.org/index.php/VMED/article/view/194512
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Review Articles
References
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11. Solomon MM, Mayer KH, Glidden DV, Liu AY, McMahan VM, Guanira JV, et al. Syphilis predicts HIV incidence among men and transgender women who have sex with men in a preexposure prophylaxis trial; Clin Infect Dis. 2014; 59: 1020-6.
12. Mwapasa V, Rogerson SJ, Kwiek JJ, Wilson PE, Milner D, Molyneux ME, et al. Maternal syphilis infection is associated with increased risk of mother-to-child transmission of HIV in Malawi. AIDS. 2006; 20: 1869-77.
13. Reynolds SJ, Risbud AR, Shepherd ME, Rompalo AM, Ghate MV, Godbole SV, et al. High rates of syphilis among STI patients are contributing to the spread of HIV-1 in India. Sex Transm Infect. 2006; 82: 121-6.
14. Palacios R, Jiménez-Oñate F, Aguilar M, Galindo MJ, Rivas P, Ocampo A, et al. Impact of syphilis infection on HIV viral load and CD4 cell counts in HIV-infected patients. J Acquir Immune Defic Syndr. 2007; 44: 356-9.
15. Jarzebowski W, Caumes E, Dupin N, Farhi D, Lascaux AS, Piketty C, et al. Effect of early syphilis infection on plasma viral load and CD4 cell count in human immunodeficiency virusinfected men: results from the FHDH-ANRS CO4 cohort. Arch Intern Med. 2012; 172: 1237-43.
16. Kofoed K, Gerstoft J, Mathiesen LR, Benfield T. Syphilis and human immunodeficiency virus (HIV)-1 coinfection: influence on CD4 T-cell count, HIV-1 viral load, and treatment response. Sex Transm Dis. 2006; 33: 143-8.
17. French P. Syphilis. BMJ. 2007; 334: 143-7.
18. Rompalo AM, Joesoef MR, O’Donnell JA, Augenbruan M, Brady W, Radolf JD, et al. Clinical manifestations of early syphilis by HIV status and gender: results of the syphilis and HIV study. Sex Transm Dis. 2001; 28: 158-65.
19. Schöfer H, Imhof M, Thoma-Greber E, Brockmeyer NH, Hartmann M, Gerken G, et al. Active syphilis in HIV infection: a multicentre retrospective survey. The German AIDS Study Group (GASG). Genitourin Med. 1996; 72: 176-81.
20. Sands M, Mark us A. Lues mali g na, or ulceronodular syphilis, in a man infected with human immunodeficiency virus: case report and review. Clin Infect Dis. 1995; 20: 387-90.
21. Yanagisawa N, Imamura A. HIV-positive man with ulceronecrotic skin lesions. Clin Infect Dis. 2008; 47: 1068-9.
22. Tucker JD, Shah S, Jarell AD, Tsai KY, Zembowicz A, Kroshinsky D. Lues maligna in early HIV infection case report and review of the literature. Sex Transm Dis. 2009; 36: 512-4.
23. Centers for Disease Control and Prevention (CDC). Symptomatic early neurosyphilis among HIV-positive men who have sex with men - four cities, United States, January 2002 - June 2004. MMWR Morb Mortal Wkly Rep. 2007; 56: 625-8.
24. Ghanem KG, Moore RD, Rompalo AM, Erbelding EJ, Zenilman JM, Gebo KA. Neurosyphilis in a clinical cohort of HIV-1-infected patients. AIDS. 2008; 22: 1145-51.
25. Gayet-Ageron A, Lautenschlager S, Ninet B, Perneger TV, Combescure C. Sensitivity, specificity and likelihood ratios of PCR in the diagnosis of syphilis: a systematic review and meta-analysis. Sex Transm Infect. 2013; 89: 251-6.
26. Heymans R, van der Helm JJ, de Vries HJ, Fennema HAS, Coutinho RA, Bruisten SM.et al. Clinical value of Treponema pallidum real-time PCR for diagnosis of syphilis. J Clin Microbiol. 2010; 48: 497-502.
27. Kongkrerk-kiet N, Paiboonsin N. Syphilis. In: Kongkrerk-kiet N, Kittiyaowamarn R, Dangsaard A, editors. Guideline to Management of Sexually Transmitted Diseases. 2015. Bangkok: Aksorn Graphic and Design Publication Limited Partnership; 2015: p. 14-21.
28. Workowski KA, Bolan GA. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015; 64(RR-03): 34-51.
29. Marra CM, Maxwell CL, Smith SL, Lukehart SA, Rompalo AM, Eaton M, et al. Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features. J Infect Dis. 2004; 189: 369-76.
30. Ghanem KG, Moore RD, Rompalo AM, Erbelding EJ, Zenilman JM, Gebo KA. Antiretroviral therapy is associated with reduced serologic failure rates for syphilis among HIV-infected patients. Clin Infect Dis. 2008; 47: 258-65.
31. Masur H, Brooks JT, Benson CA, Holmes KK, Pau AK, Kaplan JE, et al. Prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: Updated Guidelines from the Centers for Disease Control and Prevention, National Institutes of Health, and HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014 May; 58(9): 1308-11
32. Cohen SE, Chew Ng RA, Katz KA, Bernstein KT, Samuel MC, Kerndt PR, et al. Repeat syphilis among men who have sex with men in California, 2002-2006: implications for syphilis elimination efforts. Am J Public Health. 2012; 102(1): e1-8
33. Psomas KC, Brun M, Causse M, Atoui N, Reynes J, Moing VL. Efficacy of ceftriaxone and doxycycline in the treatment of early syphilis. Médecine et maladies infectieuses. 2012; 42: 15-9.
34. Tsai JC, lin YH, lu Pl, Shen NJ, Yang CJ, Lee NY, et al. Comparison of serological response to doxycycline versus benzathine penicillin G in the treatment of early syphilis in HIV-infected patients: a multi-center observational study. PloS oNE 2014; 9: e109813
35. Liang Z, Chen YP, Yang CS, Guo W, Jiang XX, Xu XF. et al. Meta-analysis of ceftriaxone compared with เพนิซิลลิน for the treatment of syphilis.Int J Antimicrob Agents. 2016 Jan; 47(1): 6-11.
36. Salado-Rasmussen K, Hoffmann S, Cowan S, Jensen JS, Benfeild T, Gertoft T, et al. Serological Response to Treatment of Syphilis with Doxycycline Compared with penicillin in HIV-infected Individuals. Acta Derm Venereol. 2016 Aug 96(6)807-11.
37. Poajinda P, Pankam T, Patanachaiwit S, Wongkanya R, Barisri J, Unyanam A, et al. Recent HIV infected MSM had Higher Syphilis Infection. In: 13th National AIDS Conference; 29-31 Mar 2011. Bangkok.
2. Rompreuk A, Aervijitarun Y. Syphilis andLaboratory test. Thai J Hematol Transfusion Med. 2005; 15: 173-84.
3. Centers for Disease Control and Prevention. 2009 Sexually Transmitted Diseases Surveillance. [internet]. 2009 [updated 2009, cited 2011 August 3]. Available from: http://www.cdc.gov/std/stats09/default.htm.
4. Taylor MM, Aynalem G, Smith LV, Montoya J, Kerndt P. Methamphetamine use and sexual risk behaviours among men who have sex with men diagnosed with early syphilis in Los Angeles County. Int J STD AIDS. 2007; 18: 93-7.
5. Wong W, Chaw JK, Kent CK, Klausner JD. Risk factors for early syphilis among gay and bisexual men seen in an STD clinic: San Francisco, 2002-2003. Sex Transm Dis. 2005; 32: 458-63.
6. Thurnheer MC, Weber R, Toutous-Trellu L, Cavassini M, Elzi L, Schmid P, et al. Occurrence, risk factors, diagnosis and treatment of syphilis in the prospective observational Swiss HIV Cohort Study. AIDS. 2010; 24: 1907-16.
7. Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health. Sexually Transmitted Infection. Annual Epidemiology Surveillance Report 2013. Nonthaburi: Ministry of Public Health; 2013. p. 98-9.
8. Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health. National Disease Surveillance (Report 506) [Internet]. Nonthaburi: Ministry of Public Health; 2015 [cited 2015 April 29]. Available from: http://www.boe.moph.go.th/boedb/d506_1/ds_wk2pdf.php?ds=37&yr=59
9. UNAIDS Gap Report 2014. [internet] 2014 [cited 2014 Sep 15,] Available from: http://www.unaids.org/en/resources/documents/2014/name, 97466,en.asp.
10. Thailand National Guidelines on HIV/AIDS Treatment and Prevention 2014. Department of Disease Control, Ministry of Public Health, Thailand. Agricultural cooperative printing demonstrations of Thai Ltd. 2014.
11. Solomon MM, Mayer KH, Glidden DV, Liu AY, McMahan VM, Guanira JV, et al. Syphilis predicts HIV incidence among men and transgender women who have sex with men in a preexposure prophylaxis trial; Clin Infect Dis. 2014; 59: 1020-6.
12. Mwapasa V, Rogerson SJ, Kwiek JJ, Wilson PE, Milner D, Molyneux ME, et al. Maternal syphilis infection is associated with increased risk of mother-to-child transmission of HIV in Malawi. AIDS. 2006; 20: 1869-77.
13. Reynolds SJ, Risbud AR, Shepherd ME, Rompalo AM, Ghate MV, Godbole SV, et al. High rates of syphilis among STI patients are contributing to the spread of HIV-1 in India. Sex Transm Infect. 2006; 82: 121-6.
14. Palacios R, Jiménez-Oñate F, Aguilar M, Galindo MJ, Rivas P, Ocampo A, et al. Impact of syphilis infection on HIV viral load and CD4 cell counts in HIV-infected patients. J Acquir Immune Defic Syndr. 2007; 44: 356-9.
15. Jarzebowski W, Caumes E, Dupin N, Farhi D, Lascaux AS, Piketty C, et al. Effect of early syphilis infection on plasma viral load and CD4 cell count in human immunodeficiency virusinfected men: results from the FHDH-ANRS CO4 cohort. Arch Intern Med. 2012; 172: 1237-43.
16. Kofoed K, Gerstoft J, Mathiesen LR, Benfield T. Syphilis and human immunodeficiency virus (HIV)-1 coinfection: influence on CD4 T-cell count, HIV-1 viral load, and treatment response. Sex Transm Dis. 2006; 33: 143-8.
17. French P. Syphilis. BMJ. 2007; 334: 143-7.
18. Rompalo AM, Joesoef MR, O’Donnell JA, Augenbruan M, Brady W, Radolf JD, et al. Clinical manifestations of early syphilis by HIV status and gender: results of the syphilis and HIV study. Sex Transm Dis. 2001; 28: 158-65.
19. Schöfer H, Imhof M, Thoma-Greber E, Brockmeyer NH, Hartmann M, Gerken G, et al. Active syphilis in HIV infection: a multicentre retrospective survey. The German AIDS Study Group (GASG). Genitourin Med. 1996; 72: 176-81.
20. Sands M, Mark us A. Lues mali g na, or ulceronodular syphilis, in a man infected with human immunodeficiency virus: case report and review. Clin Infect Dis. 1995; 20: 387-90.
21. Yanagisawa N, Imamura A. HIV-positive man with ulceronecrotic skin lesions. Clin Infect Dis. 2008; 47: 1068-9.
22. Tucker JD, Shah S, Jarell AD, Tsai KY, Zembowicz A, Kroshinsky D. Lues maligna in early HIV infection case report and review of the literature. Sex Transm Dis. 2009; 36: 512-4.
23. Centers for Disease Control and Prevention (CDC). Symptomatic early neurosyphilis among HIV-positive men who have sex with men - four cities, United States, January 2002 - June 2004. MMWR Morb Mortal Wkly Rep. 2007; 56: 625-8.
24. Ghanem KG, Moore RD, Rompalo AM, Erbelding EJ, Zenilman JM, Gebo KA. Neurosyphilis in a clinical cohort of HIV-1-infected patients. AIDS. 2008; 22: 1145-51.
25. Gayet-Ageron A, Lautenschlager S, Ninet B, Perneger TV, Combescure C. Sensitivity, specificity and likelihood ratios of PCR in the diagnosis of syphilis: a systematic review and meta-analysis. Sex Transm Infect. 2013; 89: 251-6.
26. Heymans R, van der Helm JJ, de Vries HJ, Fennema HAS, Coutinho RA, Bruisten SM.et al. Clinical value of Treponema pallidum real-time PCR for diagnosis of syphilis. J Clin Microbiol. 2010; 48: 497-502.
27. Kongkrerk-kiet N, Paiboonsin N. Syphilis. In: Kongkrerk-kiet N, Kittiyaowamarn R, Dangsaard A, editors. Guideline to Management of Sexually Transmitted Diseases. 2015. Bangkok: Aksorn Graphic and Design Publication Limited Partnership; 2015: p. 14-21.
28. Workowski KA, Bolan GA. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015; 64(RR-03): 34-51.
29. Marra CM, Maxwell CL, Smith SL, Lukehart SA, Rompalo AM, Eaton M, et al. Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features. J Infect Dis. 2004; 189: 369-76.
30. Ghanem KG, Moore RD, Rompalo AM, Erbelding EJ, Zenilman JM, Gebo KA. Antiretroviral therapy is associated with reduced serologic failure rates for syphilis among HIV-infected patients. Clin Infect Dis. 2008; 47: 258-65.
31. Masur H, Brooks JT, Benson CA, Holmes KK, Pau AK, Kaplan JE, et al. Prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: Updated Guidelines from the Centers for Disease Control and Prevention, National Institutes of Health, and HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014 May; 58(9): 1308-11
32. Cohen SE, Chew Ng RA, Katz KA, Bernstein KT, Samuel MC, Kerndt PR, et al. Repeat syphilis among men who have sex with men in California, 2002-2006: implications for syphilis elimination efforts. Am J Public Health. 2012; 102(1): e1-8
33. Psomas KC, Brun M, Causse M, Atoui N, Reynes J, Moing VL. Efficacy of ceftriaxone and doxycycline in the treatment of early syphilis. Médecine et maladies infectieuses. 2012; 42: 15-9.
34. Tsai JC, lin YH, lu Pl, Shen NJ, Yang CJ, Lee NY, et al. Comparison of serological response to doxycycline versus benzathine penicillin G in the treatment of early syphilis in HIV-infected patients: a multi-center observational study. PloS oNE 2014; 9: e109813
35. Liang Z, Chen YP, Yang CS, Guo W, Jiang XX, Xu XF. et al. Meta-analysis of ceftriaxone compared with เพนิซิลลิน for the treatment of syphilis.Int J Antimicrob Agents. 2016 Jan; 47(1): 6-11.
36. Salado-Rasmussen K, Hoffmann S, Cowan S, Jensen JS, Benfeild T, Gertoft T, et al. Serological Response to Treatment of Syphilis with Doxycycline Compared with penicillin in HIV-infected Individuals. Acta Derm Venereol. 2016 Aug 96(6)807-11.
37. Poajinda P, Pankam T, Patanachaiwit S, Wongkanya R, Barisri J, Unyanam A, et al. Recent HIV infected MSM had Higher Syphilis Infection. In: 13th National AIDS Conference; 29-31 Mar 2011. Bangkok.