title: Ocular syphilis--indicator of previously unknown HIV-infection.
abstract: OBJECTIVE
  To detect the prevalence of HIV-co-infection in patients with ocular syphilis and to compare ocular syphilis in HIV-positive and -negative patients.
  
  
  METHODS
  24 consecutive patients treated for ocular syphilis at our hospital between 1998 and 2006 were evaluated retrospectively. Patients' characteristics, laboratory results (including syphilis serology, HIV status, CSF examination), major ophthalmologic finding, treatment and course were assessed. Data of HIV-positive and -negative patients were compared.
  
  
  RESULTS
  Of the 24 patients with ocular syphilis, 11 were co-infected with HIV. Notably, the HIV-infection had previously been unknown in 7 of the 11 HIV-positive patients. 6 of these were in an early disease stage (CDC category A). Clinical and laboratory findings did not differ between HIV-positive and -negative patients except for the C-reactive protein (CRP), which was significantly higher in HIV-infected patients.
  
  
  CONCLUSIONS
  Ocular syphilis led to new diagnosis of HIV-infection in an unexpectedly high number of patients, which emphasises that patients with ocular syphilis must be screened for HIV-co-infection. According to our study the expected benefit is high because most of the patients newly diagnosed with HIV had high CD4(+) cell counts. These patients can be monitored and treated before the development of AIDS.
authors.affiliation: Department of Medicine I, Gastroenterology, Infectious Diseases & Rheumatology, Charité-University Medicine Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany. jan.kunkel@charite.de
authors.forename: Jan
authors.initials: J
authors.lastname: Kunkel
authors.forename: Dirk
authors.initials: D
authors.lastname: Schürmann
authors.forename: Uwe
authors.initials: U
authors.lastname: Pleyer
authors.forename: Klaus
authors.initials: K
authors.lastname: Rüther
authors.forename: Christiane
authors.initials: C
authors.lastname: Kneifel
authors.forename: Lothar
authors.initials: L
authors.lastname: Krause
authors.forename: Manuela
authors.initials: M
authors.lastname: Reichert
authors.forename: Ralf
authors.initials: R
authors.lastname: Ignatius
authors.forename: Thomas
authors.initials: T
authors.lastname: Schneider
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D015897:Comorbidity; D015818:Eye Infections, Bacterial / Q000150:complications* / Q000453:epidemiology*; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013587:Syphilis / Q000150:complications*