Prevalence of syphilis among HIV-seroreactive patients

Abstract

Presence of genital ulcer disease facilitates human immunodeficiency virus (HIV) transmission and their ­diagnosis is essential for the proper management. Venereal Disease Research Laboratory (VDRL) test is used as a screening test for the diagnosis of syphilis. However, unusual VDRL test results have been reported in HIV-infected persons with syphilis. There are reports showing higher than expected VDRL titers as well as biological false positive in most of the studies. A negative Rapid Plasma Reagin (RPR) test or VDRL test result may not rule out syphilis in patients with HIV infection. For laboratory confirmation of syphilis, one specific Treponemal test, namely, Fluroscent Treponemal Antibody Absorption (FTA-ABS) test or Treponema Pallidum Haemagglutination Assay (TPHA) should be done along with VDRL.<br>In the present study, 88 HIV-seropositive patients with history of high-risk behaviour were screened for syphilis by VDRL test. Out of these 88 cases, 42 (47.7%) patients were positive for TPHA and eight (9.1%) patients were reactive for VDRL in various titers. All the eight patients who were reactive for VDRL test were also positive for TPHA test.<br>Persons with HIV infection acquired through sexual route should be screened for sexually transmitted infections (STIs), and all patients with STIs should be counselled for HIV testing. This will help in proper management of patients having STIs and HIV coinfection.