2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE
Unusual presentations • T. pallidum PCR+ 1° anogenital lesions (Towns et al.STI 2016) • Anal lesions were more common in HIV+ (34.2%) vs. HIV- (11.6%). • 49.2% of 1° anal or genital lesions were painful , 37.7% were multiple . Of n=37 with painful and multiple lesions, only 8% had concurrent HSV
Slide16of47FromKAWorkowski,MDatNewOrleans, LA,December4-7,2019,RyanWhiteHIV/AIDSProgramCLINICALCONFERENCE, IAS USA.
Slide17of47FromKAWorkowski,MDatNewOrleans, LA,December4-7,2019,RyanWhiteHIV/AIDSProgramCLINICALCONFERENCE, IAS USA.
Syphilis serologic screening algorithms
Traditional
Reverse sequence
RPR (Sensitivity)
EIA orCIA
Quantitati veRPR
Primary 62-78% Secondary 97-100% EL 82-100% Tertiary 47-64%
EIA/CIA+
EIA/CIA-
RPR+
RPR-
Early primary, requires RPR (active), false +
Quantitative RPR
TP-PAor other trep. test
RPR+ Syphilis (pastorpresent)
TP-PA+ Syphilis (pastorpresent)
TP-PA- Syphilis unlikely
RPR-
TP-PA
Active infection, F+, miss early
TP-PA+ Syphilis (pastorpresent)
TP-PA- Syphilis unlikely
MMWR 60(5);2011
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