Infectious Diseases Division, Johns Hopkins University Bayview Medical Center, 4940 Eastern Avenue, B3N, Suite 352, Baltimore, MD, 21224, USA,
Curr Infect Dis Rep. 2010 Mar;12(2):140-6. doi: 10.1007/s11908-010-0083-6.
Rates of syphilis continue to increase in the United States and HIV-infected patients make up a large proportion of cases. The interaction between syphilis and HIV is complex and still incompletely understood. Although diagnosis and management of HIV-infected patients with syphilis is, in general, similar to HIV-uninfected patients, the former may be at increased risk for complications. Recent data suggest that HIV-induced immunosuppression may alter the course of syphilis and that highly active antiretroviral therapy may have a beneficial effect on syphilis outcomes. Prevention strategies consisting of sexual risk assessments, condom use, treatment of infected partners, yearly screening for syphilis of all HIV-infected patients, and enhanced clinical and serologic follow-up of treated HIV-infected patients are critical components of a comprehensive approach to care.
梅毒在美国的发病率持续上升，HIV 感染者在病例中占很大比例。梅毒和 HIV 之间的相互作用很复杂，目前仍不完全清楚。虽然 HIV 感染者合并梅毒的诊断和管理与 HIV 未感染者大致相同，但前者可能有更高的并发症风险。最近的数据表明，HIV 诱导的免疫抑制可能改变梅毒的病程，高效抗逆转录病毒治疗可能对梅毒结局有有益影响。预防策略包括性风险评估、使用安全套、治疗感染的性伴侣、对所有 HIV 感染者进行梅毒年度筛查，以及加强对接受治疗的 HIV 感染者的临床和血清学随访，这些都是综合治疗方法的重要组成部分。
