International Journal of STD & AIDS > Volume 20, Number 4 > Pp. 278-284

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Case reports

Syphilitic hepatitis among HIV-infected patients

N Crum-Cianflone MD MPH ^*  , J Weekes MPH ^*  and M Bavaro MD ^*

^* HIV Clinic, Naval Medical Center San Diego, San Diego, CA; Infectious Diseases Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

Correspondence to: Dr N Crum-Cianflone, c/o Clinical Investigation Department (KCA), Naval Medical Center San Diego, 34800 Bob Wilson Drive, Ste. 5, San Diego, CA 92134-1005, USA Email: nancy.crum{at}med.navy.mil

Syphilis is an important public health issue and continues to occur at high rates among HIV-infected patients. Although abnormal liver function tests are common among HIV-infected persons, the incidence of syphilitic hepatitis in this population is currently unknown. We present two cases of syphilitic hepatitis and performed a retrospective study to determine the incidence of hepatitis during early syphilis infections among HIV-infected persons. Our study showed that syphilitic hepatitis is common, occurring in 38% (12/32) of HIV-positive patients with early stages of syphilis infection. Most cases occurred during secondary syphilis, with the most common finding being a maculopapular rash. Syphilis should be included in the differential diagnosis of HIV patients presenting with liver test abnormalities, rash and/or sexual risk factors.

Key Words: HIV • syphilis • hepatitis • liver involvement

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This article has been cited by other articles:

				R J Doyle, M Desai, and J White Response to Crum-Cianflone et al., Syphilitic hepatitis among HIV-infected patients Int J STD AIDS, October 1, 2009; 20(10): 739 - 740. [Full Text] [PDF]