Walsh & Hoyt: Syphilis, Human Immunodeficiency Virus Infection, and the Acquired Immune Deficiency Syndrome (AIDS)

Because they share a common mode of transmission and because a chancre may facilitate entry of HIV-1 into the body, syphilis and HIV-1 infection or AIDS often are present in the same patient. The coinfection of a patient with syphilis with HIV may alter the natural history by several mechanisms: (a) increasing the tendency of such patients to develop neurosyphilis, (b) decreasing the latent period before neurosyphilis develops, (c) increasing the severity of the manifestations, and (d) reducing the response to otherwise appropriate therapy. The ocular and neuro-ophthalmologic manifestations of secondary and tertiary syphilis may be more extensive and severe when associated with concurrent HIV-1 infection.