Syphilis with HIV

[Doctor with hiv]

Hey everyone...So october 2018 i was diagnosed with hiv with cd4 340 vl 20k and was put on atripla...after 3 months my vl was undetectable (yeahh ) and cd4 was 500 so i was going great but i strtd havng anxiety and depressive episodes on and off..then i switched to another doctor(thank god i did that ) as he planned to switched me to tivicay plus descovy in the month of february and also suggested me to go vdrl and tpha test...and they both came out to be positive vdrl 1:32 !
According to my sexual history i must have contracted syphilis one and a half year ago..that means i am in late latent syphilis stage ..so i got those 3 shots of penicillin once every week for 3 consecutive weeks..today after 2 months of follow up my titre is still at 1:32..i dnt have any symptom and actually i never got sick..
Its just i can handle hiv well but this bug has strted made me feel a lil worry..m doing v well physically and mentally..just needed some advise that when shud i actually expect the titres to go down..do i need another treatment..what abt alternative medications like doxycycline ? my doctor didnt actually suggested LP neihter am intrstd for it and abt the that iv treatment makes me feel alrdy sick..is someone else too also in my shoes..wud love to hear there syphilis story..thanks..love to all

[Expat1]

Repeated identical titre  scores although unnerving are not really very meaningful. 

What indicates positive response is a four fold decrease so from 1:32 to 1:4.

A bad response (treatment failure) would be a 4 fold increase from  1:32 to 1:128.

Serofast states are not uncommon in HIV+ individuals. 

It is important to keep testing the titre every 3 months, and watching for a trend.

If you are concerned, a lumbar puncture can help to determine if you have neurological involvement.

https://www.nature.com/articles/s41598-017-15641-w

[Hope4life]

Nontreponemal test titers usually decline after treatment and might become nonreactive with time; however, in some persons, nontreponemal antibodies can persist for a long period of time, a response referred to as the “serofast reaction.” Most patients who have reactive treponemal tests will have reactive tests for the remainder of their lives, regardless of treatment or disease activity. However, 15%–25% of patients treated during the primary stage revert to being serologically nonreactive after 2–3 years.
https://www.cdc.gov/std/tg2015/syphilis.htm

[Doctor with hiv]

Hmmm....m doing fine..just want to avoid the LP ..and go with the flow of serofast.. although what I have heard and studies is that the titres follow up should be done after 6 months to 1 year in case of late latent syphilis.. anyways thanks for all the lovely replies..god bless you all..💙💙

[virgo313]

Hi All,

Just to share my current situation on my Syphilis. When i was tested poz, i had Syphilis. response well to 3 shots of penicillin (1:2)

Did not do follow test for 3 yrs & did a test early this year. it was 1:128.
Took 3 shot of penicillin in Feb 2019. re-tested. Result sucks... 1:256

Currently taking antibiotic (Doxycycline) for 4 week. Will run another blood test in May. Hopefully there is positive response & readings goes down.. otherwise, i will ask Dr to test with lumbar puncture..

feeling worried & life sucks now.. Haiz...   

[happy74]

I think most of us on starting the HARRT should consider the time to start. HIV seems only attack our immune system, but it can immerse into any kinds of cell and hidden as nothing However, it can harm you in someway you may not know. So , if your immune system already in weak stage(AIDS stage as example), you are going to defeat other diseae may become difficult. In consequence, the efficacy for treating other disease becoming in lesser successful. Hence, you should get your body in healthy condition including  physical and mentally fit. Keep smile for everything, don't get on any stress. Share with others about your condition. Here is good platform for us to share with.


09-13-18 Diagnosed HIV +, Syphilis titre 1:64
09-20,27-18 Treatment of Syphilis completed
09-28-18 CD4:329(11.75%), VL: 640000
10-16-18 Start on Triumeq
10-25-18 Syphilis titre 1:32
12-04-18 CD4:411 by PIMA test
12-27-18 Syphilis titre 1:4
01-23-19 CD4:465(19.38%), VL:48, Syphilis:Reactive, no more titre

[Expat1]

To Virgo 313.  A result of 1:128 compared to 1:256 in not significant.  They look for a four fold increase or decrease.  So  at 1:128 that would be either 1:32  or lower or 1:512.  The 1:32 would mean a good response to treatment.  The 1:512 result would mean additional tests to determine if there was central nervous system involvement  (lumbar puncture) and related analysis.  And additional treatment.

[MadDog125]

Been there, better question is will we ever read non reactive.

[joemutt]

Once. October 2015. One shot. Disappeared quickly. Reads reactive.

[virgo313]

Thank you all & appreciate all useful info here.

I am going to a Dr appointment in few hours time & hopefully there is a decrease.
Hopefully, there will not be a need to do lumbar puncture.
Same time also seeing another Dr for my half yearly routine VL check.

Will update my result again later. Again, Many thanks to all.

[virgo313]

Hi Evibodi,

Just a quick update. Syphilis is now down to 1:64. Happy. another test in 3 mts.
Also happy CD4 up slightly, VL still UD & beaming with smile that CD4% is now 42% 

Thanks