Manifestations of syphilis similar in HIV positive and HIV negative subjects

Despite some minor differences in genital ulcer patterns, the clinical manifestations of syphilis are similar in HIV positive and HIV negative subjects, according to a report published in the March issue of Sexually Transmitted Diseases.

The Syphilis and HIV Study Group, headed by Dr. Anne M. Rompalo of Johns Hopkins School of Medicine in Baltimore, assessed the clinical manifestations of syphilis in 101 HIV positive patients and 440 HIV negative patients.

The median number of ulcers was significantly greater in the HIV-positive group than in the HIV negative group, the authors state. In addition, a greater percentage of the former group had multiple ulcers.

Of the patients with secondary syphilis, concomitant genital ulcers were more common among HIV-positive than in HIV-negative patients. Women presented more often with secondary syphilis than men did, but no other gender-based differences were observed.

“Although most HIV positive patients (80%) were aware of their infection, a higher percentage of HIV positive patients reported current high-risk behaviour than did those who were HIV negative,” the investigators note.

The investigators believe that “research to quantitate HIV viral load in secretions of patients infected with syphilis…is needed to evaluate the HIV transmission potential of these coinfected patients.” They add that “targeted interventions to implement and sustain behaviour change among these core transmitters should be pursued.”