title: Syphilis and HIV co-infection: excellent response to multiple doses of benzathine penicillin.
abstract: BACKGROUND
  The number of new syphilis diagnoses in Slovenia is steadily increasing, especially among HIV-infected men who have sex with men (MSM). We studied the effect of penicillin for treating syphilis in HIV co-infected patients and risk factors for treatment failure. The primary endpoint was response to therapy (fourfold reduction of VDRL at month 12).
  
  
  METHODS
  Three hundred forty-two paper records were reviewed and MSM with positive VDRL and/or TPHA and serological follow up of at least 12 months were enrolled in the survey.
  
  
  RESULTS
  Incidence of syphilis increased from 1.2% (2005) and 2.9% (2007) to 6.4% (2009) and 3.8% (2011, until July). Two hundred sixty-one (76.3%) were MSM and 102 (29.8%) were co-infected; 54.0% had primary/secondary syphilis, 37.0% latent syphilis, and 9.0% neurosyphilis. Patients with primary/secondary/latent syphilis were treated with three doses of benzathine penicillin (2.4 MU i.m.). Treatment was successful in 92.2%. With respect to risk factors, there was no difference between the "success" and "failure" group. Twenty-six patients (25.5%) had re-infections.
  
  
  CONCLUSIONS
  The rate of cure in our study population was excellent, probably due to a low degree of immunosuppression and a three-dose benzathine penicillin regimen.
authors.affiliation: Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre Ljubljana, Ljubljana, Slovenia. Corresponding author: sajecka@gmail.com.
authors.forename: Andreja
authors.initials: A
authors.lastname: Saje
authors.affiliation: Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre Ljubljana, Ljubljana, Slovenia.
authors.forename: Janez
authors.initials: J
authors.lastname: Tomažič
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D010401:Penicillin G Benzathine / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D017524:Slovenia; D013587:Syphilis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents; D010401:Penicillin G Benzathine