Prevalence of syphilis among patients living with HIV treated in Bialystok HIV/AIDS Center

Introduction: In recent years, the incidence of syphilis rise globally. Men who have sex with men (MSM) with human immunodeficiency virus (HIV) infection are at higher risk for syphilis coinfection than general population.

Material and methods: This study evaluated the prevalence and clinical presentation of Treponema pallidum infection among adult people living with HIV (PLHIV) in North-Eastern Poland, between 2014-2016. Venereal disease research laboratory (VDRL) titer test for syphilis was performed as a screening. Fluorescent treponemal antibody (FTA), fluorescent treponemal antibody absorption (FTA-ABS), and Treponema palli­dum hemagglutination assay (TPHA) were used as confirmatory tests.

Results: Two hundred and fifty HIV-infected patients participated in the study, including 25 MSM (10%). VDRL was positive in 15 patients (14 males and 1 female), and in 12 of them confirmatory tests were positive (4.8% tested). All of them were male, with median age of 41 years. Syphilis was diagnosed in 8 of homosexual and/or bisexual, which is 32% of HIV-infected MSM patients. Only 5 patients (62%) with HIV and syphilis coinfection demonstrated clinical symptoms: tongue and hard palate lesions, pharyngitis with exanthema on hands and feet, penile primary chancre, and alopecia areata.

Conclusions: We demonstrated high prevalence of syphilis and asympto-matic course of the disease among HIV-positive MSM patients in North-Eastern Po-land, that stress the necessity of regular syphilis testing in this population. Early di-agnosis and proper treatment of syphilis is crucial to reduce spread of this infection.