梅毒合并HIV感染6例报告

Coincident Infections of Syphilis with HIV

目的探讨梅毒合并H IV感染的临床表现及转归。方法对北京佑安医院感染科收治的6例梅毒合并H IV感染者的性别、好发人群、临床表现、实验室检查、诊断方法、治疗经过及转归进行回顾性分析。结果6例梅毒合并H IV感染的患者均为男性同性恋者,其中3例脑脊液有异常改变,所有患者对青霉素治疗均反应良好。结论男性同性恋人群是梅毒和H IV共感染的高危人群,临床表现多样,可以迅速进展到神经梅毒。主要依靠梅毒血清学试验和全面细致的查体进行诊断。青霉素为首选治疗药物,治疗后的密切随访至关重要。

Objective To investigate the manisfetations of coincident infection syphilis with HIV. Methods Patients diagnosed as having HIV and syphilis coinfection in Beijing Youan Hospital were retrospecpectively studied. Their demorgraphic data, clinical manisfetations, diagnostic means, treatment and follow-up results were analyzed. Results 6 patients with syphilis and HIV coinfection were all homosexual men, among them three cases had abnormal CSF, all patients responded well to penicillin. Conclusion There is a high incidence of HIV and syphilis coinfection in homosexual men. Syphilis may present with atypical features in the HIV-positive patients, serious courses with rapid progression and CNS involvement are observed more frequently. Diagnosis is generally made with serology, but the clinician should be aware of the potential for false-negative serology. All HIV-positive patients should be treated with a penicillin-based regimen. All HIV-positive patients should be considered for the evaluation of neurosyphilis. Relapse is a real concern and careful follow up is required.