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Prestileo T.S., Di Lorenzo F., Di Bella
HIV;AIDS;,syphilis;,condom,SecondarysyphilisinHIVinfectedpatientswithnocondomuse,INTRODUCTION,CLINICALPRESENTATION,DISCUSSION,REFERENCES
Secondary syphilis in HIV infected patients with no condom use(pdf)
Correspondence to Tullio Prestileo, MD,Largo Giuliana 2, 90124 Palermo, Italy
Tel:+39 091 6302541 (home),+39 091 7033217 (hospital),Fax:+39 091 7033297,Mobile:+39 333 3207437
E-mail:tullioprestileo@virgilio.it
[Abstract] Objective Syphilis is a chronic infectious disease caused by the spirochete Treponema pallidum. It is transmitted during sexual intercourse and vertically, from the mother to the child during the pregnancy or the birth. Syphilis became a predominant Sexually Transmitted Disease (STD) disease among homo and heterosexual men and commercial sex workers. Syphilis has been and continues to be a disease often accompanying HIV. Methods Authors describe characteristic clinical courses of 14 patients with HIV infection diagnosed from, at least, 3 months. All patients were consecutively observed during the last 18 months. Results Patients presented maculopapular eruptions (duration 3~12 days) on extremities, trunk, face, palms and soles. They had no history of fever, chills, malaise, headache or previous rectal or genital ulcer. The diagnosis was established in all ten patients with the combination of two non-treponemal reaginic tests: Venereal Disease Research Laboratory (VDRL) test with a titre of 1：32 or more and qualitative Rapid Plasma Reagin (RPR). In addition one specific treponemal test was performed: Fluorescent Treponema Antibody (FTA-abs). Nine patients were treated with 2.4 million units of intramuscular benzathine penicillin the first time; then we continued with 1.2 million units every week for 4 weeks. These patients' maculopapular eruption vanished 10~20 days after initiation of therapy. The last five patients preferred to be treated with ceftriaxone, 1 gr intramuscular every day for 1 week, because they feared pain in the injection site. During the next follow-up, we observed no signs of significant HIV disease progression. Conclusions The authors believe that health policies should be formulated and designed to promote STD prevention strategies in the general population and in HIV infected patients. Condoms provide a very safe and cheap solution to the transmission of these diseases.
Correspondence to Tullio Prestileo, MD,Largo Giuliana 2, 90124 Palermo, Italy
Tel:+39 091 6302541 (home),+39 091 7033217 (hospital),Fax:+39 091 7033297,Mobile:+39 333 3207437
E-mail:tullioprestileo@virgilio.it
[Abstract] Objective Syphilis is a chronic infectious disease caused by the spirochete Treponema pallidum. It is transmitted during sexual intercourse and vertically, from the mother to the child during the pregnancy or the birth. Syphilis became a predominant Sexually Transmitted Disease (STD) disease among homo and heterosexual men and commercial sex workers. Syphilis has been and continues to be a disease often accompanying HIV. Methods Authors describe characteristic clinical courses of 14 patients with HIV infection diagnosed from, at least, 3 months. All patients were consecutively observed during the last 18 months. Results Patients presented maculopapular eruptions (duration 3~12 days) on extremities, trunk, face, palms and soles. They had no history of fever, chills, malaise, headache or previous rectal or genital ulcer. The diagnosis was established in all ten patients with the combination of two non-treponemal reaginic tests: Venereal Disease Research Laboratory (VDRL) test with a titre of 1：32 or more and qualitative Rapid Plasma Reagin (RPR). In addition one specific treponemal test was performed: Fluorescent Treponema Antibody (FTA-abs). Nine patients were treated with 2.4 million units of intramuscular benzathine penicillin the first time; then we continued with 1.2 million units every week for 4 weeks. These patients' maculopapular eruption vanished 10~20 days after initiation of therapy. The last five patients preferred to be treated with ceftriaxone, 1 gr intramuscular every day for 1 week, because they feared pain in the injection site. During the next follow-up, we observed no signs of significant HIV disease progression. Conclusions The authors believe that health policies should be formulated and designed to promote STD prevention strategies in the general population and in HIV infected patients. Condoms provide a very safe and cheap solution to the transmission of these diseases.