POZ Community Forums

Main Forums => Living With HIV => Topic started by: alexdyk.j on October 26, 2019, 09:48:23 am

Title: Poz with syphilis. Your story.
Post by: alexdyk.j on October 26, 2019, 09:48:23 am
Hello guys, here's a little introduction about me.

I am from Malaysia, 28 yo. I have been poz for a little over 2 years now (confirmed July 2017), and have been on HAART since then. (tenofovir+emtricitabine and efavirenz)

Now the main story.

I have been experiencing scrotal itchiness for nearly a month. I experienced that when I was first diagnosed. Actually, that was the reason I did HIV testing. However, it got better as my CD4 increased. Unfortunately, it came back about four weeks ago.

I suspected that I had syphilis. My last testing was in June 2019, and it was negative (I presume since my doc didn't mention anything about it). My next scheduled testing doesn't not include syphilis. Therefore, I decided to go to a private healthcare lab to do some screening.

I did the screening on 21 Oct and received my results today (26 Oct). My VDRL result came back with a titer of 1:32. Since there is no doctor on duty at the lab today, I cannot get further explanation until next Tuesday.

I am worried about the titer because it is quite high. I suspect that I contracted syphilis within the last three months. I am also very worried about seeing the doctor at the hospital (not the lab doctor) as I had two episodes of syphilis infection before. One was in Aug 2017 and another one was in Aug 2018.

Interesting thing is, the test done in Aug 2017 was one of the comprehensive STDs testings after I had been tested positive HIV. It went unnoticed by multiple doctors until in March 2018 when the ID doc that saw me asked me if had done treatment for my syphilis. I was given 3 doses of penicillin G IM, once weekly.

This time, I noticed faint rash on my body. No visible rash on palms and soles. I feel tired, a little feverish and sore right arm. I don't mind getting 3 shots in the butt again, but I am worried that I might have neurosyphilis. I don't want to be hospitalised since I am in closet and my family and friends don't know my status.

What is my possibility of getting neurosyphilis?

And have any of you had multiple infections of syphilis? How did your health care provider react?

Please contribute anything, I really appreciate it.

Have a great day everybody!
Title: Re: Poz with syphilis. Your story.
Post by: virgo313 on October 27, 2019, 01:47:51 am
Hi Alex,

Looks like you are aware on how syphilis is generally treated.
Lets not worry on how Dr think of you. Just tell them that you have done a test & show them the result (in case you are going to gov Dr).

Just ask that you would like to go thru treatment for syphilis. They will not be judgmental. I personally have a "repeat" of syphilis & is currently waiting for result. Just got 3 jab also.

Bottom line is that you need to get treated & what Dr views on your lifestyle is secondary. Lets not think about neurosyphilis for now. Dont think unless u have balancing issue. Thanks
Title: Re: Poz with syphilis. Your story.
Post by: BlueMoon on October 28, 2019, 12:02:11 am
Alexdyk.j, I am sorry to read about your problems.  I have some experience with syphilis, and it is a nuisance.

It is my understanding that once you have been infected with syphilis then the antibodies persist in your blood so that you will always test positive.  What is used to diagnose a reinfection is the titer ratio.

According to my doctor, treatment is considered successful if your titer drops by a certain magnitude; I think at least fourfold but am unsure of the exact number.  For example, if your titer at treatment is 1:256 and drops to 1:16 after, then treatment was successful and 1:16 becomes your base number.  The titer can vary slightly at subsequent tests, so it could be 1:8 one time and 1:32 another, but as long as it stays close to the base number of 1:16 then you are ok. 

Neurosyphilis is diagnosed by checking the spinal fluid.  That is a risky procedure and should be undertaken only if you do not respond to the conventional treatment of three penicillin shots.

Based on my reading of your account, neurosyphilis is unlikely.  Depending on your base number after your previous treatment, you may not even have been reinfected.  Let your doctor decide.  He may suggest another course of penicillin shots to be on the safe side.  Hopefully everything works out for you and the worst that happens is that you get a few shots that you do not need.

 
Title: Re: Poz with syphilis. Your story.
Post by: bocker3 on October 28, 2019, 06:43:38 am
Alexdyk.j, I am sorry to read about your problems.  I have some experience with syphilis, and it is a nuisance.

It is my understanding that once you have been infected with syphilis then the antibodies persist in your blood so that you will always test positive.  What is used to diagnose a reinfection is the titer ratio.

According to my doctor, treatment is considered successful if your titer drops by a certain magnitude; I think at least fourfold but am unsure of the exact number.  For example, if your titer at treatment is 1:256 and drops to 1:16 after, then treatment was successful and 1:16 becomes your base number.  The titer can vary slightly at subsequent tests, so it could be 1:8 one time and 1:32 another, but as long as it stays close to the base number of 1:16 then you are ok. 

This is not exactly true, or at least it is incomplete.

Antibodies MAY persist for some time or they may persist forever, in some individuals.  However, for a large number of people the RPR antibody titre does revert to "Negative" at some point after treatment.

The rest of your info is correct -- seeing a drop in titre is generally indicative of successful treatment -- even if it doesn't return to "Negative".

Mike
Title: Re: Poz with syphilis. Your story.
Post by: Jim Allen on October 29, 2019, 06:21:23 pm
Hiya alexdyk.j

Sorry to hear about the problems and hope things get sorted soon.
I would agree with the gents comments above particular this;

Hi Alex,

Looks like you are aware on how syphilis is generally treated.
Lets not worry on how Dr think of you. Just tell them that you have done a test & show them the result (in case you are going to gov Dr).

Just ask that you would like to go thru treatment for syphilis. They will not be judgmental. I personally have a "repeat" of syphilis & is currently waiting for result. Just got 3 jab also.

Bottom line is that you need to get treated & what Dr views on your lifestyle is secondary. Lets not think about neurosyphilis for now. Dont think unless u have balancing issue. Thanks

Just get your health sorted, that's the focus. Reading your first post in the thread the concern seems to be about not being out, being judged but in all fairness, syphilis can be acquired by anybody who is sexually active regardless of background,  lifestyles etc, etc, etc.