[Acquired syphilis and HIV infection]

Area of Science:

• Infectious Diseases
• Immunology
• Public Health

Context:

• Observed increase in syphilis prevalence among individuals with human immunodeficiency virus (HIV) infection.
• Potential contributing factors include increased sexual risk behaviors or enhanced viral transmission through genital ulcerations.
• Viral-immunological interactions in HIV-positive individuals may alter the natural history of syphilis.

Purpose:

• To highlight the need for revising diagnostic and therapeutic criteria for syphilis in HIV-positive patients.
• To investigate the impact of HIV on syphilis presentation and treatment response.
• To address the increased frequency of unsuccessful syphilis treatments and early neurological/ocular manifestations.

Summary:

• HIV infection may influence syphilis presentation, potentially leading to a resurgence of past clinical manifestations due to modified host responses.
• Interactions between HIV and syphilis impact treatment efficacy, contributing to recent increases in treatment failures.
• Early neurological and ocular syphilis are becoming more frequent in coinfected patients.

Impact:

• Clinicians must reassess and adapt current therapeutic strategies for syphilis in the context of HIV coinfection.
• Revised treatment protocols are crucial to improve outcomes and prevent severe complications of syphilis in HIV-positive individuals.
• This underscores the importance of understanding complex viral interactions in managing coinfections.