Sexual Health | Genital ulcer disease | HIV in Syphilis

HIV in Syphilis
Session Overview
Description
This session covers the additional clinical features, natural history and pathogenesis, investigation and management of patients with HIV and syphilis co-infection. It also discuses the role of partner notification for such cases.

Learning Objectives
By the end of this session you will be able to:

• Describe how the natural history of untreated syphilis differs in those with co-infection with HIV
• Describe how tests for syphilis perform in the context of HIV infection
• Explain how a patient with early syphilis should be managed
• Explain how a patient with late syphilis should be managed
• Explain how to manage patients with co-infection who are allergic to first line therapies for syphilis
• Describe the follow-up arrangements needed for those with treated syphilis (in the context of co-infection) and the management of serofast or serological relapses upon follow-up

Prerequisites
Before commencing this session you should have completed:

• Module 1/Sexual History (260-0004)
• Module 1/Male Genital Examination (260-0009)
• Module 1/Female Genital Examination (260-0010)
• Module 2/Diagnosing Syphilis (260-0023)
• Module 4/Genital Ulceration: Causes and Investigation (260-0051)
• Module 4/Early Infectious Syphilis (260-0052)
• Module 4/Diagnosis and Management of Late Syphilis (260-0054)

Syphilis has been a major problem in those with HIV in recent years and remains an ongoing issue in the UK, with a 20% increase in syphilis from 2016 to 2017 and 148% increase relative to 2008 [1](read details regarding the reference). The natural history of syphilis may be modified with HIV co-infection, although the clinical features and presentation are often similar to those who are HIV negative.

This session looks at the major differences to consider in those with co-infection, focussing on the clinical presentation of early and late syphilis, tests for syphilis and interpreting the results in the context of HIV co-infection. It then goes on to discuss the management and follow-up of such patients.