[Clinical and serological findings of syphilis in HIV-infected patients]. / Klinische und serologische Befunde der Lues bei HIV-infizierten Patienten.

To identify the characteristic features of lues in patients infected with HIV, 402 HIV-positive patients were examined for serological and clinical signs of lues. 141 patients (133 male, 8 female, mean age 36 [18-69] years) had a positive lues serology. Treatment for lues was required in 20 of the 141 cases (14%). In ten patients (one case of lues I, nine cases of lues II) dermatological signs were predominant, macular exanthemas (n = 4) and palmo-plantar syphilides (n = 3) being most frequent. Three patients had seropositive latent lues. Eight patients presented with signs of an active neurolues (lues II: n = 1; lues III: n = 6; lues IV: n = 1). In three of the eight cases the serum FTA-ABS-IgM findings were negative. In these three patients the need for a specific treatment was realized only on the basis of cerebrospinal fluid (CSF) examination in conjunction with the clinical findings and the anamnesis. This result makes it very clear that indication for CSF puncture should be more liberal in some HIV infected patients. The markedly high proportion of cases of neurolues (40% of the luetic patients requiring treatment) is possibly due to reactivation of old lues infections.

[Clinical picture of early syphilis in patients with HIV infection in the light of literature data]. / Obraz kliniczny kily wczesnej u osób zakazonych retrowirusem hiv w swietle danych z pismiennictwa.

A literature survey is presented concerning the clinical pattern of early syphilis in subjects infected with HIV. The course of syphilis infection in HIV-positive subjects differs often from the usual one, the clinical picture may be that of the so called malignant syphilis with early development of syphilitic lesions in the central nervous system and involvement of the visual system; Serological reactions differ also, they may give negative results or may appear with delay, sometimes high titres of these reactions are found.

[Immunologic aspects of the pathogenesis of latent and seroresistant forms of syphilis]. / Immunologicheskie aspekty patogeneza skrytykh i serorezistentnykh form sifilisa.

Studies of the cellular and humoral immunity in patients with latent and seroresistant syphilis have revealed decreased content of T-lymphocytes and elevated levels of B- and antigen-reactive lymphocytes. Reduced T-cell level is due to a decrease of the T-suppressor subpopulation. Unlike latent syphilis, seroresistant form is associated with a complete disappearance of the theophylline-sensitive subpopulation, whereas T-lymphocytes are represented mainly by the theophylline-resistant (helper) subpopulation. Effective therapy of patients with seroresistant syphilis has normalized the counts of T- and B-antigen-reactive lymphocytes, and theophylline-sensitive cells appear in the blood. These data give grounds to prescribe immunostimulating therapy to patients with seroresistant syphilis.