HIV & syphillis
meduploader - 05-13-09 14:21

HIV infected patient with diagnosed to have syphilis of unknown duration or late latent syphilis
(acquired > 1 yr previously) ------> should have CSF examination before treatment.
• Patient with CD4 <350 and RPR titer > 1:64 ------> increased risk of neurosyphilis.
• If CSF examination is normal -----> Benzathine penicillin G IM weekly X 3 wk
• If CSF examination shows neurosyphilis (symptomatic or asymptomatic) and in syphilitic ocular
disease -----> Aqueous crystalline penicillin G IV X 2 wk
• HIV with early syphilis or early latent syphilis (acquired <1 yr) ------> Benzathine penicillin G
IM single dose