The Diagnosis and Management of Syphilis in the HIV-Infected Patient.

In the 1980s, the number of cases of syphilis in the United States increased concurrently with the onset of the HIV epidemic. Within a short time, clinicians began to note unusual presentations of syphilis and inappropriate responses to standard therapy for syphilis in dually infected patients. Whether these cases collectively represented a new aspect of the natural history of syphilis remains to be elucidated. In recent years, only a few prospective studies have addressed this issue, and the results of these studies have been inconclusive.