[Syphilis meets AIDS. Syphilis seen in relation to the AIDS epidemic--a review]

The incidence of syphilis in Denmark has changed within the last ten years. From being a relatively common disease at the end of the 1970's and beginning of the 1980's, the incidence has fallen considerably. It is assumed that the change is connected with the emergence of AIDS and the resulting increase in information and attention to sexually transmitted diseases. In the USA, after a fall in the beginning of the 1980's, the incidence of syphilis has risen markedly, particularly among heterosexual coloured people in large cities. Recently, there have been some reports claiming atypical syphilis in patients with HIV-infection. To date there are no controlled investigations to corroborate this notion. Seronegative syphilis or delayed seropositivity has been reported in certain immunosuppressed AIDS patients. Otherwise the syphilis serology of HIV-infected patients does not seem to differ essentially from HIV-negative patients. All patients with HIV infection should be counselled about syphilis and offered a test for syphilis, just as patients with syphilis should be encouraged to be tested for HIV antibody after informed consent.