       Document 0023
 DOCN  M9650023
 TI    Serologic response to treatment of syphilis in patients with HIV
       infection.
 DT    9605
 AU    Yinnon AM; Coury-Doniger P; Polito R; Reichman RC; Infectious Diseases
       Unit, University of Rochester Medical Center,; NY, USA.
 SO    Arch Intern Med. 1996 Feb 12;156(3):321-5. Unique Identifier : AIDSLINE
       MED/96163313
 AB    BACKGROUND: Much controversy exists concerning the manifestations,
       therapy, and response to treatment of syphilis in patients coinfected
       with the human immunodeficiency virus (HIV). OBJECTIVE: To assess the
       effect of HIV infection on the serologic response to treatment of
       patients with syphilis. METHODS: Sixty-four HIV-seropositive patients
       with syphilis were matched with 64 patients with syphilis who were HIV
       negative. Matching criteria included age (+/- 5 years), sex, race,
       initial rapid plasma reagin (RPR) titer (+/- 1 dilution), and stage of
       syphilis at entry. There were 26 matched patients with early syphilis,
       26 matched patients with late syphilis, and 12 matched patients with
       biological false-positive RPR. The HIV-positive patients with early
       syphilis received three doses of penicillin G benzathine. All other
       patients received treatment as recommended by the Centers for Disease
       Control and Prevention, Atlanta, Ga. Our study's major end points were
       clinical and serologic response to treatment. RESULTS: All 16 patients
       with symptomatic syphilis were cured. No patient developed clinical
       signs of neurosyphilis during the 12-month follow-up period. Twenty-nine
       (56%) of 52 HIV-positive patients with early or late syphilis did not
       have a fourfold decrease in RPR titer 6 months after treatment compared
       with 20 (38%) of 52 matched controls (P = .06). No unique
       characteristics identifying patients who did not respond serologically
       could be established. The HIV-positive patients with initial RPR less
       than 1:32 experienced a significantly slower decrease in RPR at 12
       months than did the controls (P < .001). CONCLUSIONS: Patients with
       syphilis who are HIV positive are less likely to experience serologic
       improvement after recommended therapy than are patients with syphilis
       who are HIV negative. Patients with HIV infection who contract syphilis
       should receive intensive and prolonged follow-up, and consideration
       should be given to designing alternative regimens.
 DE    Adult  Case-Control Studies  Female  Human  HIV
       Infections/*COMPLICATIONS  Male  Penicillin G, Benzathine/THERAPEUTIC
       USE  Syphilis/COMPLICATIONS/*DIAGNOSIS/DRUG THERAPY/IMMUNOLOGY  Syphilis
       Serodiagnosis  Treatment Outcome  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

