Syphilis in HIV

Types of other Sexual Transmitted Diseases Related to HIV Infection

Sexually transmitted diseases (STDs) occur frequently in HIV-infected persons. Although these pathogens cause well-recognized clinical syndromes, most are initially asymptomatic and occur without clinical signs. Therefore, screening for asymptomatic infections is essential to interrupt the chain of transmission and adverse sequele. All patients in HIV care settings should be routinely assessed at every visit, if possible, for risky sexual and drug use behaviors and that all HIV-positive persons be screened at least annually for common STDs using the most sensitive test available. Condom use can also reduce the risk for STDs, including chlamydia, gonorrhea, genital types of human papillomavirus, genital herpes, and trichomoniasis, and might reduce the risk of women developing pelvic inflammatory disease.

Syphilis

Syphilis are likely to encounter in HIV positive persons. Primary syphilis refers to the chancre, occurring 1 week to 1 month after exposure. Chancres are classically single, painless lesions with a clean (nonpurulent) base and an indurated, raised border.

Secondary syphilis typically occurs 3 weeks to 3 months after exposure and is often characterized by a rash. The rash is usually maculopapular and involves the palms and soles but can take any of several forms. Other signs of secondary syphilis include condyloma lata (broad-base, fleshy war-like lesions that occur in moist, warm body areas, often in the perianal region) and oral mucous patches, which can be confused with aphtous ulcers or oral hairy leukoplakia.

Latent syphilis is defined by positive serology in the absence of an clinical signs or symptoms. Early latent syphilis is defined as that acquired within the preceding year. All other forms are either late latent syphilis or latent syphilis of unknown duration. Because many syphilis cases are latent (positive serology in the absence of clinical signs), screening HIV-infected patients with serology is critical).

Primary prevention of syphilis depends on the use of barrier protection, primarily condoms. Syphilis detection in pregnancy is important, since treatment of pregnant women can prevent the devastating consequences of congenital syphilis. Penicillin is generally included in the recommendations for syndromic management of genital ulcer disease.