Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb;46(2):80-85.
doi: 10.1097/OLQ.0000000000000910.

Ocular Syphilis and Human Immunodeficiency Virus Coinfection Among Syphilis Patients in North Carolina, 2014-2016

Anna B Cope, Victoria L Mobley  1 , Sara E Oliver, Mara Larson  1 , Nicole Dzialowy  1 , Jason Maxwell  1 , Jessica L Rinsky, Thomas A Peterman, Aaron Fleischauer, Erika Samoff  1
Affiliations

Ocular Syphilis and Human Immunodeficiency Virus Coinfection Among Syphilis Patients in North Carolina, 2014-2016

Anna B Cope et al. Sex Transm Dis. 2019 Feb.

Abstract

Background: Ocular syphilis (OS) has been associated with human immunodeficiency virus (HIV) coinfection previously. We compared demographic and clinical characteristics of syphilis patients with and without HIV to identify risk factors for developing OS.

Methods: We reviewed all syphilis cases (early and late) reported to the North Carolina Division of Public Health during 2014 to 2016 and categorized HIV status (positive, negative, unknown) and OS status based on report of ocular symptoms with no other defined etiology. We estimated prevalence ratios (PR) and 95% confidence intervals (CI) for OS by HIV status. Among syphilis patients with HIV, we compared viral loads and CD4 cell counts by OS status. We compared symptom resolution by HIV status for a subset of OS patients.

Results: 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.

Conclusions: Syphilis patients with HIV were nearly twice as likely to report OS symptoms as were patients without documented HIV. Human immunodeficiency virus-related immunodeficiency possibly increases the risk of OS development in co-infected patients.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None of the authors have any conflicts of interest to report.

References

    1. Mathew RG, Goh BT, and Westcott MC, British Ocular Syphilis Study (BOSS): 2-year national surveillance study of intraocular inflammation secondary to ocular syphilis. Invest Ophthalmol Vis Sci, 2014. 55(8): p. 5394–400. - PubMed
    1. Woolston S, et al., A Cluster of Ocular Syphilis Cases - Seattle, Washington, and San Francisco, California, 2014–2015. MMWR Morb Mortal Wkly Rep, 2015. 64(40): p. 1150–1. - PMC - PubMed
    1. Oliver SE, et al., Ocular Syphilis - Eight Jurisdictions, United States, 2014-2015. MMWR Morb Mortal Wkly Rep, 2016. 65(43): p. 1185–1188. - PubMed
    1. Oliver SE, et al., Increases in Ocular Syphilis-North Carolina, 2014–2015. Clin Infect Dis, 2017. 65(10): p. 1676–1682. - PMC - PubMed
    1. Centers for Disease Control and Prevention Sexually transmitted disease surveillance 2016. Atlanta, GA: US Department of Health and Human Services, 2017.

Publication types