Managing Syphilis in HIV Co-infected Patients: A Case-Based Approach

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Presentation transcript:

Managing Syphilis in HIV Co-infected Patients: A Case-Based Approach

Managing Syphilis in HIV-Coinfected Patients: A Case-Based Approach

CME Information

Nursing and Pharmacy Credits

Evaluations will be available in your IAS-USA “My Activities” page by 5 pm PT today. See the IAS–USA website for instructions on claiming CME, pharmacy, nursing, or pharmacotherapy credits, or a certificate of participation.

Grant Support for this Webinar

Navigating the Webinar

Poll 1

Poll 2

Poll 3

Managing Syphilis in HIV-Coinfected Patients: A Case-Based Approach

Financial Relationships With Commercial Entities

Learning Objectives

Pretest Question 1

Pretest Question 2

Epidemiology: Who’s at risk?

Where we were in 1999…

Syphilis: The MSM epidemic

Syphilis: The heterosexual epidemic

The intersection of epidemics: Drug use and heterosexual syphilis transmission

Congenital syphilis: A failure of public health

The Solution

So why are we failing?

So why are we failing?

PLWH: Syphilis Screening Recommendations

Epidemiology: Implications

Management

The Natural History of Syphilis

RJ

RJ

RJ: Laboratory Results

RJ: What is the clinical diagnosis?

Clinical Manifestations of Syphilis

Syphilitic Hepatitis

Serological tests for syphilis

Testing: The Reverse Sequence Algorithm

Management: Antimicrobial therapy

But what about a pregnant woman with penicillin allergy?

Summary: Treatment Recommendations

RJ: Need for CSF examination

CSF Examination in Neurologically Asymptomatic HIV+ Persons with Syphilis?

RJ

Patient NN

Patient NN

NN: Diagnoses

Neurosyphilis

FYI- Ocular Syphilis

FYI- Otosyphilis

Need for a CSF Examination: A Summary

Neurosyphilis: Questions to Ask

Ocular Syphilis: Questions to Ask

Otic Syphilis: Questions to Ask

Patient NN: CSF Examination

Are follow-up CSF Exams Necessary in Persons Treated Appropriately for Neurosyphilis?

Patient NN: Summary

Let’s go back to our patient RJ…

RJ

What is the appropriate response to RJ’s RPR titers that have not declined appropriately?

Does the serofast state predict poor clinical outcomes?

Patient RJ

Does additional antimicrobial therapy improve serological outcomes?

Summary: What I do with asymptomatic patients who experience an inadequate serological response:

RJ

Would you restart treatment over again?

RJ

Syphilis Control: Doxycycline?

Syphilis PrEP & PEP: Pros & Cons

Syphilis PrEP/PEP

Syphilis: Take-Home Messages

Thank you

https://www.stdccn.org/

Additional Resources

Posttest Question #1

Posttest Question #2

Question-and-Answer

Evaluations will be available in your IAS-USA “My Activities” page by 5 pm PT today. See the IAS–USA website for instructions on claiming CME, pharmacy, nursing, or pharmacotherapy credits, or a certificate of participation.

Final Poll

Thank You