MEDizzy - A 30-year-old woman with a history of pelvic inflammatory

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Syphilis and Nonvenereal Treponematoses

A 30-year-old woman with a history of pelvic inflammatory disease has recently tested positive for HIV. On a follow-up visit, she expresses concern about the possibility of other sexually transmitted diseases. As part of her initial workup, you recommend that she undergo testing for syphilis. Which of the following statements regarding coinfection with HIV and syphilis is false?

ExplanationSyphilis and HIV are both sexually transmitted diseases, and risk behaviors that contribute to the transmission of syphilis are clearly associated with transmission of HIV. Thus, coinfection is common. Each disease has been shown to have an important impact on the course of the other. Primary syphilis enhances the transmission of HIV, probably because of the increased ability of the HIV virus to enter a sexual partner at the site of a genital ulcer (chancre). Since the beginning of the HIV epidemic, multiple reports have suggested that syphilis may follow an accelerated course in HIV-infected individuals and that it has a propensity to involve the CNS in such patients. It has repeatedly been demonstrated that single-dose penicillin therapy for early symptomatic syphilis is more likely to fail in an HIV-infected patient than in a patient with syphilis alone. HIV-infected patients have higher rates of false positive nontreponemal serologic test results