Double Trouble: Challenges in the Diagnosis and Management of Ocular Syphilis in HIV-infected Individuals

ABSTRACT

Syphilis and HIV infection may coexist in the same individual. Ocular syphilis and/or neurosyphilis may develop at any stage of coinfection, with a stronger association between ocular and neurosyphilis in individuals living with HIV, than in HIV-uninfected individuals. The diagnosis of ocular syphilis in HIV-infected and -uninfected patients remains with some controversy due to unspecific clinical manifestations and limited diagnostic tests. Penicillin is the mainstay of treatment of ocular syphilis, but alternative options are warranted. This review describes the epidemiology, pathophysiology, and clinical manifestations, as well as the diagnostic and therapeutic challenges posed by ocular syphilis against the background of HIV coinfection.

KEYWORDS:

• Challenges
• diagnosis
• HIV
• management
• ocular syphilis

Declaration of Interest

DVVS receives lecture fees from Abbvie, not related to this work.

Additional information

Funding

This work was supported by the Financial support: Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq (DVV-S, Bolsa de Produtividade em Pesquisa) [313293/2018-0].