Controversies Regarding the Natural History and Treatment of Syphilis in HIVDisease

摘要

The majority of patients with coincident HIV and syphilitic infections presentwith the usual manifestations of syphilis. However, a number of anecdotal reports have appeared documenting unusual clinical presentations. This is not surprising given the tremendous variability seen in the preantibiotic era and the dysfunctional immune state common in HIV-infected patients. The most serious consequence of syphilitic dissemination is neurosyphilis. Central nervous system (CNS) involvement occurs in at least 40% of non-HIV-infected persons. The vast majority of immunologically intact persons recover without sequelae, while those that have neurologic progression are usually immunologically impaired. Hence, the predisposition for developing neurosyphilis in HIV-infected persons is not surprising.