title: Clinical Aspects of Syphilis Reinfection in HIV-Infected Patients.
abstract: BACKGROUND
  The incidence of HIV-syphilis co-infection has risen since 2000, especially among men having sex with men (MSM). Syphilis reinfection can occur, but the clinical features of such events remain poorly characterized.
  
  
  OBJECTIVE
  To compare the cutaneous lesions seen with syphilis reinfections with those of first episodes in HIV-infected patients.
  
  
  METHODS
  In a cohort of HIV-infected patients, syphilis reinfection was established both clinically and biologically by evaluating changes in Venereal Disease Research Laboratory titers. Photographs and medical records were studied in order to determine the type of skin lesions and their quantification.
  
  
  RESULTS
  Among 533 HIV-infected patients, 42 (8%) experienced a first syphilis infection. Thirteen episodes of reinfection occurred in 12/42 (28%) patients, all MSM. In 78% of cases, reinfections were less symptomatic than first episodes. All patients presented classical syphilis lesions.
  
  
  CONCLUSIONS
  We observed a high rate of reinfection, but with less severe skin manifestations during reinfection episodes.
authors.affiliation: Unité de Maladies Infectieuses et Dermatologie, Hôpital Bonnet, Centre Hospitalier Intercommunal Fréjus Saint-Raphaël, Fréjus, France.
authors.forename: Johan
authors.initials: J
authors.lastname: Courjon
authors.forename: Thomas
authors.initials: T
authors.lastname: Hubiche
authors.forename: Nicolas
authors.initials: N
authors.lastname: Dupin
authors.forename: Philippe Alain
authors.initials: PA
authors.lastname: Grange
authors.forename: Pascal
authors.initials: P
authors.lastname: Del Giudice
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D010781:Photography; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013587:Syphilis / Q000150:complications* / Q000473:pathology*