Cramb, "Prevalence of hepatitis in early syphilis
among an HIV cohort," International Journal of STD and AIDS, vol.
Reagin tests are more sensitive in the detection of early syphilis
, whereas TPHA is more sensitive in the detection of latent and late syphilis.
Congenital syphilis (prenatal syphilis) is acquired in utero from the mother, who must have had an early syphilis
. The mother herself is infected, but the infection of the fetus can be prevented if the mother is treated correctly before the fourth month.
In the summer of 1999--just as the CDC rolled out its elimination plan--San Francisco saw a spike in early syphilis
among MSM who corralled sex mates on the Internet (Figure 1).
This is unfortunate because recognition of the clinical signs and symptoms of early syphilis
is often needed to prompt the physician to order a blood test.
By the rime penicillin became a standard treatment for early syphilis
in the 1940's, most of the Study's participants had late stage syphilis.
In the mid 1940s, with the availability of penicillin, contact tracing "emerged as a key activity in syphilis control," according to the Centers for Disease Control (CDC), and "this effort was followed by a precipitous decline (76.5%) in reported cases of early syphilis
between 1947 and 1952." Federal funding of contact tracing "declined significantly between 1950 and 1955--from $16,000,000 to $3,000,000" and "a resurgence in early syphilis
followed in the late 1950s."
In most jurisdictions, the percentage was similar to data from a study in England that estimated ocular syphilis affected approximately 0.6% of early syphilis
cases from 2009 to 2010 (5).
Although the treatment protocols for syphilis have been clearly defined, few randomized clinical studies have been conducted to ascertain whether azithromycin or penicillin G are more effective to treat early syphilis
. For each individual case, the decision to prescribe one or other of these drugs should be based on an evaluation of the cost-benefit relationship and on any risks the patient may have to face.
The rate of successfully treated individuals in our cohort was surprisingly good, which was most probably due to the low degree of immunosuppression and more intensive treatment regimen for early syphilis
. The latter has already been advised by some authors (18-20).
Although liver involvement with early syphilis
is an infrequently recognized complication, it is an especially challenging diagnosis in HIV-infected individuals who often have abnormal liver function tests from any one of multiple potential causes .
If you look at early syphilis
cases--the cases used to calculate syphilis incidence per year--almost 70% of new cases in 2010 are among MSM.