{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:56:08Z","timestamp":1787014568712,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2005,1,12]],"date-time":"2005-01-12T00:00:00Z","timestamp":1105488000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2005,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective\u2002<\/jats:bold>\n                    To document the manifestations of syphilis among patients with concurrent HIV infection over a 12\u2010month period.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Method\u2002<\/jats:bold>\n                    Descriptive, cross\u2010sectional, hospital\u2010based study of all adult patients with syphilis and HIV infection who attended the skin clinic of the University of Nigeria, Teaching Hospital, Enugu, between July 2000 and June 2001. A standardized questionnaire was used to record age, sex, marital status, occupation and risk factor for HIV infection; initial site of onset of rash\/ulcers, duration of the illness, any concomitant affection of mucosa, hair and nails as well as treatments received by each patient prior to presentation. Morphological distribution of lesions, mucosal surface (conjuctival, vulval and rectal) examinations and documentation of concomitant disorders with HIV were noted by the examining dermatologist. Lesional biopsy and dark\u2010field microscopy were undertaken to confirm diagnosis where serologic (non\u2010treponemal and treponemal specific) tests for syphilis were inconsistent with clinical suspicion. Each patient had a routine chest x\u2010ray, mantoux and purified protein derivative (PPD) status taken.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results\u2002<\/jats:bold>\n                    Thirty\u2010one patients (21 males) with concurrent syphilis and HIV were seen during the study period. Primary syphilis was diagnosed in nine (29%), secondary syphilis in 20 (64.5%) and latent syphilis in two (6.5%). Neurosyphilis was not observed. Prevalence of syphilis for these patients with concurrent HIV was 2.1%. Mean duration of syphilis was 3.9\u2003months\u2003\u00b1\u20031.4 and lesions of greatest concern occurred mainly on the genitalia. The glans penis was affected in 10 (32.3%) cases, the penile shaft in seven (22.6%), the oral cavity in five (16.1%), the rectum in six (19.4%) and the vulva in three (0.9%) cases. Nine (29.1%) patients had a history of primary syphilitic chancre, 19 (61.3%) had a past history of sexually transmitted disease (STD) \u2013 particularly genital ulcers \u2013 while three (9.7%) could not recall any past history of STD. Eighteen (59.3%) had a history of unprotected sex, 16 (51.7%) had multiple sexual partners, four (13.3%) had had oral sex, and one anal sex (3.3%); none admitted to being bisexual. Other relevant risk factors for HIV transmission were blood transfusion within 5\u2003years for three (9.7%) and intravenous drug use in two (6.5%). Some patients had more than one condition as a potential source of exposure. Serological tests were weakly reactive in 17 (48.4%), strongly reactive in nine (29%) and non\u2010reactive in five (16.1%) patients. Three patients exhibited prozone phenomenon. Treatment comprised the syndromic approach, which currently is advocated for use in primary healthcare centres without facilities for aetiological diagnosis of sexually transmitted infections.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion\u2002<\/jats:bold>\n                    Our cases with concurrent syphilis and HIV\/AIDS had unusual manifestations, responded to treatment more slowly and died sooner than cases described in Western literature due to generally lower levels of health.\n                  <\/jats:p>","DOI":"10.1111\/j.1365-3156.2004.01344.x","type":"journal-article","created":{"date-parts":[[2005,1,12]],"date-time":"2005-01-12T06:45:41Z","timestamp":1105512341000},"page":"58-64","source":"Crossref","is-referenced-by-count":34,"title":["Evaluation of syphilis in patients with HIV infection in Nigeria"],"prefix":"10.1111","volume":"10","author":[{"given":"E. N.","family":"Nnoruka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. C. J.","family":"Ezeoke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,1,12]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-103-5-704"},{"key":"e_1_2_14_3_1","first-page":"3S","article-title":"Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome","volume":"36","author":"Centers for Disease Control","year":"1987","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"e_1_2_14_4_1","first-page":"40","article-title":"Sexually transmitted diseases treatment guidelines","volume":"42","author":"Centers for Disease Control","year":"1993","journal-title":"Morbidity and Mortality Weekly Report"},{"issue":"12","key":"e_1_2_14_5_1","first-page":"1","article-title":"HIV prevention through early detection and treatment of other sexually transmitted diseases \u2013 United States","volume":"47","author":"Centers for Disease Control and Prevention","year":"1998","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"e_1_2_14_6_1","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/S0891-5520(20)30558-4","article-title":"Sexually transmitted diseases and human immunodeficiency virus, epidemiologic synergy","volume":"7","author":"Clottey C","year":"1993","journal-title":"Infectious Disease Clinics of North America"},{"key":"e_1_2_14_7_1","unstructured":"Federal Ministry of Health Nigeria(2001) STD\/HIV Technical Report 1\u20133."},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.75.1.3"},{"key":"e_1_2_14_9_1","first-page":"2408","volume-title":"Dermatology in General Medicine","author":"Gonzalez E","year":"1987"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(90)70153-9"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-107-4-492"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198706183162503"},{"key":"e_1_2_14_13_1","first-page":"17","article-title":"AIDS and syphilis","author":"Leishman K","year":"1988","journal-title":"Atlantic Monthly"},{"key":"e_1_2_14_14_1","first-page":"3","volume-title":"Syndromic Management of Sexually Transmitted Infections for Nigeria: Manual for Health Workers","author":"MoHW","year":"2001"},{"key":"e_1_2_14_15_1","first-page":"445","volume-title":"Disease Control Priorities in Developing Countries","author":"Over M","year":"1993"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198801283180401"},{"key":"e_1_2_14_17_1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.2340\/0001555575153154","article-title":"The prozone phenomenon in secondary syphilis","volume":"75","author":"Taniguchi S","year":"1995","journal-title":"Acta Dermato-Venereologica"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198706183162510"},{"key":"e_1_2_14_19_1","first-page":"61","article-title":"Epidemiology synergy: interrelationships between HIV and other STDs","volume":"19","author":"Wasserheit JN","year":"1992","journal-title":"Sexually Transmitted Diseases"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-3156.2004.01344.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-3156.2004.01344.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T03:12:13Z","timestamp":1696907533000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-3156.2004.01344.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,1]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2005,1]]}},"alternative-id":["10.1111\/j.1365-3156.2004.01344.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-3156.2004.01344.x","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,1]]}}}