Treatment of neurosyphilis in HIV-infected patients . A systematic review .

Introduction After a large decrease in the number of cases of syphilis in the past decades, the incidence of syphilis is rising again.(1) At the end of the nineties, a new epidemic of syphilis has been documented in Western-Europe and the United States.(2) Although the number of patients seems to be decreasing again, this disease is still an important infectious disease that is sexually transmitted. Many patients with newly diagnosed syphilis are also HIV-infected. These patients have a higher risk to develop neurosyphilis, an inflammation of the central nerve system. Several case reports have shown that a concurrent infection with HIV may change the natural course of neurosyphilis.(3,4,5) This might mean that patients with HIV respond different on treatment for neurosyphilis. Though, it is not known whether patients with neurosyphilis and concurrent HIV infection really respond different to treatment compared to patients without concurrent HIV-infection. But if they do, what is the best treatment for HIV-infected patients? The purpose of this systematic review is to describe what is already known about treatment of neurosyphilis in HIV-infected patients. Do they respond different and if they do, what is the best treatment option?

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