aidsВИЧ-инфекция и иммуносупрессииHIV Infection and Immunosuppressive Disorders2077-9828Baltic Medical Education Center10.22328/2077-9828-2018-10-2-43-53aids-346Research ArticleАНАЛИТИЧЕСКИЙ ОБЗОРПРОБЛЕМЫ ДИАГНОСТИКИ И ЛЕЧЕНИЯ СИФИЛИСА ПРИ КОИНФЕКЦИИ ВИРУСОМ ИММУНОДЕФИЦИТА ЧЕЛОВЕКАDIAGNOSIS AND TREATMENT OF SYPHILIS IN PATIENTS COINFECTED WITH HUMAN IMMUNODEFICIENCYКрасносельскихТ. В.KrasnoselskikhT. V.

Красносельских Татьяна Валерьевна — доктор медицинских наук, профессор кафедры дерматовенерологии с клиникой 

197022, Санкт-Петербург, ул. Льва Толстого, 6–8, корп. 4

krasnoselskikh@gmail.comМанашеваЕ. Б.ManashevaE. B.

Манашева Елизавета Борисовна — старший лаборант кафедры дерматовенерологии с клиникой 

197022, Санкт-Петербург, ул. Льва Толстого, 6–8, корп. 4

volf8989@mail.ruГезейМ. А.GezeiM. A.

Гезей Мария Александровна — врач 

190103, СанктПетербург, наб. Обводного канала, 179

mariya-gezej@yandex.ruФГБОУ ВО ПСПбГМУ им. И.П.Павлова Минздрава РоссииРоссияFSBEI HE I.P.Pavlov SPbMU MOH RussiaRussian FederationСПб ГБУЗ «Центр СПИД и инфекционными заболеваний»РоссияCenter for AIDS and Other Infectious DiseasesRussian Federation2018080720181024353Copyright © Красносельских Т.В., Манашева Е.Б., Гезей М.А., 20182018Красносельских Т.В., Манашева Е.Б., Гезей М.А.Krasnoselskikh T.V., Manasheva E.B., Gezei M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hiv.bmoc-spb.ru/jour/article/view/346

Обзорная статья посвящена особенностям диагностики и лечения сифилиса, развивающегося на фоне ВИЧ-инфекции. У небольшого числа ВИЧ-инфицированных больных могут отмечаться ложноотрицательные и ложноположительные результаты серологических реакций на сифилис. Пациенты с коинфекцией подвержены более высокому риску возникновения специфических поражений нервной системы, органов зрения и слуха, у них выше вероятность неудач в лечении сифилиса и возникновения нейрорецидивов. Эффективность терапии нейросифилиса на фоне коинфекции трудно оценить, так как нормализация состава СМЖ у ВИЧ-позитивных пациентов происходит медленнее, чем у ВИЧ-негативных. В ближайшие годы число случаев сочетанных заражений сифилисом и ВИЧ-инфекцией будет неминуемо увеличиваться. В связи с этим необходимо всестороннее изучение проблемы коинфекции и совершенствование подходов к ведению больных на основе принципов доказательной медицины.

A review article is addressed the issue of the diagnosis and treatment of syphilis that is developing against the background of HIV infection. A small number of HIV-infected patients may have false-negative or false-positive serological tests for syphilis. Patients with co-infection are at higher risk of the nervous system involvement as well as ocular and otological syphilis. The cases of treatment failure and neurorelapses are also more frequent in HIV-positive patients with syphilis. The effectiveness of neurosyphilis treatment in co-infected patients is difficult to assess, as the normalization of the CSF in HIV-positives is going slower comparing to HIV-negatives. The inevitable increase in incidence of syphilis and HIV co-infection is anticipated in the coming years. In this regard, a comprehensive study of the co-infection problem and improvement of approaches to managing patients based on the principles of evidence-based medicine is required.

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The authors declare that there are no conflicts of interest present.