Photo: Bruce Blaus

Syphilis patients who also have HIV are almost twice as likely to have ocular syphilis (OS) than those who don’t have (or don’t know they have) human immunodeficiency virus (HIV) according to researchers in North Carolina.

The researchers reviewed all syphilis cases (early and late) reported to the North Carolina Division of Public Health during 2014 to 2016 and categorised the HIV status (positive, negative, unknown) and OS status based on report of ocular symptoms with no other defined etiology.

Among 7123 confirmed syphilis cases, 2846 (39.9%) were living with HIV, 109 (1.5%) had OS, and 59 (0.8%) had both. Ocular syphilis was more prevalent in syphilis patients with HIV compared to HIV-negative/unknown-status patients (PR, 1.8; 95% CI, 1.2–2.6). Compared with other patients with HIV, the prevalence of OS was higher in patients with viral loads greater than 200 copies/mL (1.7; 1.0–2.8) and in patients with a CD4 count of 200 cells/mL or less (PR, 2.3; 95% CI, 1.3–4.2). Among 11 patients with severe OS, 9 (81.8%) were HIV-positive. Among 39 interviewed OS patients, OS symptom resolution was similar for HIV-positive (70.0%) and HIV-negative/unknown-status (68.4%) patients.

They concluded human immunodeficiency virus–related immunodeficiency possibly increases the risk of OS development in co-infected patients.