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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present a case of a 38 year old woman with nephrotic syndrome and skin rash. She had been previously healthy. At the beginning she showed nonpruritic macular papular lesion in trunk and upper and lower extremities with twenty days of evolution. The week previous to hospitalization, she presented eyelid and pretibial edema. The laboratory informed normal kidney function with proteinuria of 10 g/day, plasma proteins of 4.20 g/dl., cholesterol 334 mg/l, VDRL (+), 1/32 FTA abs (+) HIV non reactive, normal collagenogram. She was diagnosed as secondary syphilitic nephrotic syndrome. She was prescribed penicillin, rest and salt restriction. She presented good evolution before ending treatment and the syndrome was completely solved at the third week. The incidence of kidney condition associated with early staging of syphilis is lower than 0.3%. We call attention to this association, for such an uncommon case may not be detected.
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PMID:[Acute nephrotic syndrome associated with secondary syphilis]. 1045 69

Much attention has recently been given to the serious health implications of AIDS, hepatitis B infection and the human papillomavirus. In spite of these, syphilis/gonorrhea are still the most common of the "old" sexually transmitted diseases (STDs) and syphilis is, with the exception of AIDS, the STD with potentially the most destructive sequelae. Recent observations indicate that syphilis may be an important cofactor in facilitating transmission of HIV. A history of syphilis or a positive serologic test for syphilis is associated with HIV seropositivity in men. Although the incidence of syphilis in the UK is 1 of the lowest in the world, syphilis is increased in most countries. In several areas of the US there has been a dramatic increase in the prevalence of syphilis and in some first-world areas congenital syphilis is now considered epidemic. Syphilis is considerably more common in Africa than in Europe/US. Syphilis is also prevalent in most developing countries. The worldwide resurgence of syphilis has a serious implication on neonatal morbidity. The aim of this study was to evaluate the seroprevalence of syphilis in men attending and infertility clinic. Blood samples from 782 males were screened using the titrated RPR/TPHA tests. If either of these tests was positive, FTA-Abs IgG was performed. The RPR was positive in 63 (8%) cases. In 24 (3%) patients the titer was or= 1/8 with positive TPHA and FTA-Abs IgG tests and these were regarded as current infections. 39 (5%) cases had RPR titers 1/8 with positive specific tests (Table 1). These were probably patients either treated inadequately, or in the early stage of primary syphilis. In addition 92 (2%) patients were RPR negative but TPHA and FTA positive. This was evidence of previous exposure to syphilis. The overall seropositivity in this group was 20% (155 cases). 627 (80%) tested negative with RPR and TPHA. Syphilis may still have a major impact on health in Southern Africa. Since syphilis is significantly associated with HIV seropositivity, efforts to prevent and control syphilis may also be important in limiting HIV spread. The 3-8% incidence of active disease among an asymptomatic group of men, referred for evaluation of infertility underlines the statement that "serologic screening should be done at the least indication". A community-based program with continuous adequate screening and treatment would be of great help. While the absolute yield for such screening may be low, the potential for reducing the morbidity and mortality of congenital syphilis is great. (full text)
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PMID:Syphilis serology in men at an andrology clinic in South Africa. 1234 7

Syphilis is an uncommon cause of uveitis in HIV-infected patients. We report a case of bilateral panuveitis and describe its characteristics as the initial manifestation of HIV infection. A 74-year-old heterosexual male complained of blurred vision and floaters in both eyes for 40 days. Slit lamp examination showed diffuse keratic precipitates and cells in the anterior chamber of both eyes. Fundus examination revealed multiple small white dots and scattered retinal hemorrhage over the mid-equatorial retina with marked vitritis. Physical examination disclosed multiple erythematous papules over bilateral palms compatible with secondary syphilis. Serologic tests--the venereal disease research laboratory (VDRL) test, fluorescent treponemal antibody absorption (FTA-ABS) test, and Treponema pallidum hemagglutination (TPHA) test--were all positive. Aqueous fluid also showed positive FTA-ABS reaction. Under the impression of acquired secondary syphilis, enzyme-linked immunosorbent assay and Western blot test were performed and revealed concurrent HIV infection. After intravenous administration of penicillin-G, 18 million units daily for 2 weeks, the vitritis and retinochoroiditis improved. All patients with panuveitis of unknown cause should undergo VDRL and FTA-ABS screening. Subsequent testing for HIV antibody in leutic uveitis is also mandatory.
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PMID:Syphilitic uveitis as the initial manifestation of HIV infection. 1264 92

The incidence of oral manifestations of HIV infection is changing markedly. Oral afflictions previously uncommon in HIV condition are now emerging in this scenario and may be underestimated. Clinical characteristics of some oral diseases could change in the presence of HIV/AIDS infection and health care professionals must be made aware of such changes. Oral lesions of secondary syphilis are rare, however they can occur and the dentist should be able to diagnose them. In some cases the anamnesis and the clinical features of the lesions are not enough to diagnose this disease. Histological features and an acute knowledge on laboratory exams, as well as its applicability and limitations are necessary to diagnose it. The present report describes a case of secondary syphilis in an HIV positive patient. The patient showed red spots in the torso of skin and abdomen. The spots were also present on the hands but the color was darker. The oral mucosa had several ulcers, with variable shapes, sometimes recovered by a white and resistant membrane. They were present in the buccal mucosa, palate, gingiva, tongue and labial mucosa. Those clinical manifestations appeared 6 months earlier. Exams were performed (VDRL, FTA-abs, direct fungal exams in the skin and oral mucosa and a biopsy in the oral mucosa) but the diagnose remained unclear. Clinical and laboratory features disagreed and postponed the final diagnosis and the treatment for more than 6 months.
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PMID:Secondary syphilis in an HIV positive patient. 1470 15

The stability of human immunodeficiency virus type 1 (HIV-1) DNA in whole blood collected on filter paper (FTA Card) was evaluated. After >4 years of storage at room temperature in the dark our qualitative assay detected virus at a rate similar to that of our initial test (58 of 60, 97%; P = 0.16), suggesting long-term HIV-1 DNA stability.
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PMID:Persistence of human immunodeficiency virus type 1 subtype B DNA in dried-blood samples on FTA filter paper. 1529 46

Sexually transmitted disease (STD) remains a major public health challenge in developed countries, exacerbated by the advent of the HIV epidemic. The objectives of this study were to assess the prevalence of serological markers of syphilis, HIV-1/2, HTLV-I/II, HBV, and HCV infections among immigrant sex workers in Madrid, Spain and to characterize the HIV-1 variants in seropositive individuals. Sera from 762 immigrant commercial sex workers (75.3% from sub-Saharan Africa, 18.2% from South America, and 6.4% from Eastern Europe) were collected between 1998 and 2003 in Madrid and examined. Antibody detection was performed by screening assays (RPR, ELISAs) and confirmed by FTA-Abs, LIAs and Western-blot tests. HIV-1 subtyping was carried out by phylogenetic analyses of the protease and envelope genes. Antibodies to HIV-1 were found in 5.2%, while 3.5% tested positive for HBsAg, 3% for syphilis antibodies, 0.8% for HCV antibodies, and 0.2% for HTLV-I antibodies. None were reactive for HIV-2 or HTLV-II antibodies. HIV-1 seroprevalence among Africans and Ecuadorians was 4.5 and 10.9%, respectively. All HIV-1 seropositive Ecuadorians were transsexual men, and 28.6% had active syphilis infection. Up to 80% of HIV-1 positive specimens were characterized as non-B subtypes, with subtypes G, A, and G/A recombinants being the most frequent among African individuals. In contrast, South Americans with HIV-1 infection carried exclusively subtype B variants. A relatively high proportion of immigrant sex workers in Madrid were infected with HIV-1 and syphilis, whereas infections with hepatitis viruses or HTLV were uncommon.
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PMID:Prevalence of HIV-1 non-B subtypes, syphilis, HTLV, and hepatitis B and C viruses among immigrant sex workers in Madrid, Spain. 1548 70

The incidence of syphilis, an infectious disease caused by Treponema pallidum, is low worldwide. The knowledge of its symptoms is however important, since the infectivity is high and therapy is comparatively easy. The first feature of an infection is the chancre, which is nearly always located in the genital region. In half of the infected patients after 8-12 weeks, if untreated, a generalisation takes place, during which the bacteria affect all organ systems. At first the skin diseases are most prominent; in long-term disease (late syphilis) symptoms of the central nervous system and the cardiovascular system become more relevant. In the chancre the infectious agent may be proven natively, but not in a culture. At about 3-6 weeks after infection specific serum antibodies may be proven with very sensitive and specific methods. Mainly the TPHA and FTA tests are used. These tests allow a reliable diagnosis to be made also in cases with ambiguous clinical features. The treatment of syphilis is performed by using parenteral depot penicillins for 14 days. It may also be applied as post-exposure prophylaxis. Specifics of the course have to be take into consideration in cases of coexisting HIV infections and neurosyphilis. The disease has a favourable prognosis, when treatment starts early enough.
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PMID:[Syphilis]. 1708 43

The authors investigated the utility of both a nontreponemal (RPR) test and a treponemal (FTA-ABS) test for the diagnosis of primary syphilis during the emergence of the HIV epidemic in southern Africa. The serological tests were performed on 868 patients with genital ulcerations, seen in five centres. While primary syphilis was diagnosed by multiplex PCR in 163 cases (18.8%), the overall RPR and FTA-ABS seroprevalences were 24.3% and 51.5% respectively. The sensitivities of the RPR and FTA-ABS to detect primary syphilis were 69.3% and 89.6% respectively, while the specificities were 86.1% and 58.5% respectively. The performance characteristics of these tests were influenced negatively by concomitant HIV infection and the presence of other genital ulcer disease pathogens in lesions found to be Treponema pallidum PCR positive.
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PMID:The influence of concomitant HIV infection on the serological diagnosis of primary syphilis in southern Africa. 1825 Sep 27

To determine the frequency of hepatitis B, hepatitis C, Human Immunodeficiency Virus (HIV) and syphilis infections in Iranian blood donors. The prevalence of serological markers of hepatitis B, hepatitis C, HIV and syphilis infections were evaluated in 318029 consecutive volunteer blood donors attending to Tehran blood transfusion service from March 2005 to March 2006. Those positive for hepatitis B surface antigen, anti-HCV, anti-HIV1/2 and VDRL (venereal disease research laboratory) reactivity were analyzed with a second independent HBsAg enzyme immunoassay (EIA) and neutralization assay; an additional independent anti-HCV EIA and HCV-RIBA assay; second independent anti-HIV1/2 test, HIV western blot and fluorescent Treponemal Antibody Absorbed (FTA-ABS), respectively. In 318029 participants, prevalence of positive HBsAg, HCV RNA, HIV western blot and FTA-ABS was 1684 (0.487%), 323 (0.093%), 11 (0.003%) and 19 (0.005%), respectively. In 1014 subjects randomly selected from these 318029 participants, besides standard interview, physical exam and routine serologic tests; anthropometric and biochemical were studies. In this selected group frequency of HBsAg was 3 (0.29, 95% CI: 0-0.64%); frequency of anti-HCV was 21 (2.07%), but it was (0.09%, 95% CI: 0-0.30%) by confirmatory HCV RNA test; frequency of HIV-Abl, 2 was 8 (0.78%), but it was 2 (0.19%, 95% CI: 0-0.48%) by confirmatory test; frequency of RPR was 0 (0%, 95% CI: 0-0.30%). Despite excluding subjects with high-risk behaviors by standard interview and physical examination, still a few asymptomatic hepatitis B, hepatitis C, HIV-infected subjects existed among volunteer blood donors with demographic and biochemical findings similar to non-infected ones.
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PMID:Seroepidemiologic study of hepatitis B virus, hepatitis C virus, human immunodeficiency virus and syphilis infections in Iranian blood donors. 1909 12

The wide scale application of dried blood spots (DBS) as a collection tool for low-cost HIV drug resistance testing requires a greater understanding of the accuracy of DBS for genotype analysis and the stability of DBS under various environmental conditions. Analysis of a 50microl DBS via a single amplicon, nested PCR-based in-house assay (the Burnet genotyping assay) showed an average nucleotide concordance of 98.9% with plasma samples, although only 65% of nucleotide mixtures detected in plasma were also detected within DBS. The analysis of three DBS resulted in the detection of a greater number of nucleotide mixtures (72 and 109 mixtures detected within one and three DBS, respectively, n=10). Two DBS extraction protocols (silica particle; NucliSENS, bioMerieux and spin column extraction; High Pure, Roche) were assessed and found to be equivalent (79% and 84% recovery success respectively, n=19). FTA Elute paper (Whatman) was an inferior DBS collection medium compared to Whatman 903 paper. DBS appeared relatively tolerant to multiple freeze/thaw cycles, with 79% of DBS subjected to ten freeze/thaw cycles successfully amplified compared to 93% of DBS defrosted once (n=14). High temperature (37 degrees C) and high humidity (>90%) substantially impaired DBS recovery within two weeks of storage (38%, n=8), whilst storage at -20 degrees C or 4 degrees C adequately preserved DBS for this period (100% recovery, n=8). Therefore, whilst DBS are suitable for HIV drug resistance surveillance, the use of multiple DBS may be required to ensure accurate detection of minor HIV quasispecies and short-term storage of samples at either 4 degrees C or -20 degrees C is recommended.
Curr HIV Res 2010 Mar
PMID:Stability of dried blood spots for HIV-1 drug resistance analysis. 2016 43


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