HIV and syphilis: a deadly mix
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Sexual health experts are warning that the recent upsurge
in cases of syphilis may result in newer and more deadly presentations
of the disease.
Nervous-system syphilis symptoms such as paralysis and stroke are normally
only associated with the tertiary stage of the disease - which occurs
decades after infection, and then only if it goes untreated.
But Dr Gail Bolan of the California Department of Health
Sciences at Berkeley told the 42nd ICAAC conference in September that
one to two per cent of patients co-infected with HIV and syphilis had
neurological symptoms during the secondary stage of the disease, which
happens within two to four months of infection. The syphilis microbe crossed
over during early infection into the nervous systems of 30 to 40 per cent
of HIV positive patients.
Treatment for syphilis has hardly changed since antibiotics were introduced
in the 1940s. The only clinical trial of syphilis treatment since then
resulted in the standard treatment of benzathine penicillin failing to
clear the infection in a quarter of cases.
Syphilis cases in the USA have more than quadrupled during the last three
years, and have gone up 20-fold among gay men. This alarming increase
is blamed on three factors: a threefold increase in gay men reporting
anonymous sex: the popularity of crystal meth (methamphetamine) as a sex
drug: and the fact that HIV positive men are now taking fewer antibotics
for HIV-related illnesses, which may also have helped keep syphilis in
check.
Gus Cairns
Victims, and rumoured victims, of syphilis (clockwise from top left): Nietzsche, Pocahontas, Al Capone, Cesare Borgia, Mozart
