Treatment of latent syphilis in HIV-infected patients with 10 d of benzylpenicillin G benethamine: a prospective study in Maputo, Mozambique.
Neurosyphilis has been reported in HIV-infected patients previously treated with penicillin G benzathine, which does not achieve treponemicidal levels in cerebrospinal fluid. Therapy combining benzylpenicillin G and its repository form benzylpenicillin G benethamine could be a potentially effective alternative enhanced regimen for treating latent syphilis in HIV-infected patients because peak serum and cerebrospinal fluid concentrations would be achieved early post-administration by the former molecule and sustained for 24 h due to the prolonged half-life of the latter. In this study, 23 asymptomatic HIV and Treponema pallidum co-infected patients received 10 d of combined therapy (2 M IU intramuscular once daily) and were followed up at 3, 6 and 12 months. None experienced side effects or clinical symptoms. Of the 18 patients who were evaluated 1 y later, 8 (44.4%) exhibited serological treatment failure, defined as a positive serum rapid plasma reagin test. In conclusion, a 10-d regimen combining penicillin G and penicillin G benethamine seems to be of no benefit compared to currently recommended treatment.
Tattevin
Pierre
P
Department of Infectious Diseases, CHU Pontchaillou, Rennes, France. ptattevi@univ-rennes1.fr
Renault
Patrick
P
Joly
Véronique
V
Bastos
Rui
R
Coelho
Elisabeth
E
Adda
Christian
C
Ebel
Anne
A
Yeni
Patrick
P
D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D006678:HIV / Q000472:pathogenicity; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009073:Mozambique; D010401:Penicillin G Benzathine / Q000737:chemistry / Q000378:metabolism / Q000627:therapeutic use*; D010406:Penicillins / Q000627:therapeutic use*; D013592:Syphilis, Latent / Q000150:complications / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
D010406:Penicillins; D010401:Penicillin G Benzathine