Clinico-serologic Manifestation and Serologic Response to Treatment of Syphilis / 대한피부과학회지

BACKGROUND: Recently, there has been an increase in the prevalence of syphilis in Korea and in case reports of treatment failures of syphilis. OBJECTIVE: This study was designed to explicate the clinical and laboratory features of syphilis, underlying diseases of the VDRL false-positive group, and responses to treatment of patients with syphilis. METHODS: Between January 2001 and June 2010, we selected 115 patients with reactive results on the VDRL test. We evaluated several characteristics including their age, gender, clinical stage, skin lesion, serologic result, the rate and the underlying diseases of the VDRL false-positive group, and their serologic responses to syphilis treatment. RESULTS: There was no significant difference in the incidence of syphilis by gender except in the case of primary syphilis. The annual incidence of syphilis has shown a significant upward trend, especially in the younger age group (10~39 years). Using a serum VDRL titer of 8 as a cut-off value, we found a significant difference between early and latent syphilis. The rate for the VDRL false-positive group was 24.3%. Treatment failures were not reported and the median time to a successful serological response for patients with early syphilis treated with penicillin was 106 days. The Jarish-Herxheimer reaction occurred in 13.7%, and these symptoms were self-limited without any treatment. CONCLUSION: The annual incidence of syphilis in Korea has shown a significantly upward trend, especially in the younger age group. All responses evaluated were reported for those treated successfully without having any significant adverse effects. Thus, continued surveillance and adequate treatment of syphilis is important not only to enhance disease control but also to improve public health.

Antibody Responses to Cryptosporidium Antigen in HIV-positive Patients in the Republic of Korea

The diagnosis of cryptosporidiosis has been carried out using coprologic techniques in the Republic of Korea. However, antibody responses to Cryptosporidium have rarely been studied. Serum antibodies from HIV-positive/oocyst-positive Korean patients recognized significantly 31 and 27 kDa antigens, and HIV-negative/oocyst-positive individuals clearly reacted to 15/17 kDa antigens. Compared with oocyst-positive cases, 18.7% and 75.8% of sera from HIV-positive patients reacted to 31 and 27 kDa antigens. Only 11.1% of HIV-negative individuals reacted to 15/17 kDa. Based on these findings, serum antibody responses were different between HIV-positive and HIV-negative individuals infected with Cryptosporidium, and it is suggested that HIV-positive patients are more frequently exposed to C. parvum compared to HIV-negative individuals.