abacavir and Syphilis

A 26-year-old male living with human immunodeficiency virus (HIV) and who had previously been treated for ocular syphilis presented to the Emergency Department with progressive vision loss and uveitis. The efficacy of standard management for neurosyphilis in HIV and recurrence was examined.

Topics: Adult; AIDS-Related Opportunistic Infections; Dideoxynucleosides; Eye Infections, Bacterial; Heterocyclic Compounds, 3-Ring; HIV Infections; Humans; Lamivudine; Male; Neurosyphilis; Oxazines; Penicillin G; Piperazines; Pyridones; Syphilis; Syphilis Serodiagnosis; Treatment Outcome; Treponema pallidum; Uveitis; Visual Acuity

Syphilis remains a current infection in France, with an increase in cases associated with the increase in sexual practices at risk.. An HIV-seropositive homosexual male presented with a perturbed hepatic profile and roseola-like exanthema 15 days after starting treatment with Trizivir. Because of the combination of hepatitis and cutaneous eruption evoking hypersensitivity to abacavir, treatment was suspended, but no improvement was noted. The diagnosis of syphilitic hepatitis associated with roseola was made following a sero-conversion and improvement was obtained with benzathine-penicillin and the re-introduction of Trizivir without further problem.. This case report underlines the possibility of discovering syphilis when confronted with cholestatic and cytolytic hepatitis that regresses with penicillin and is isolated or associated with evocative cutaneous signs.

Topics: Adult; Anti-HIV Agents; Chemical and Drug Induced Liver Injury; Dideoxynucleosides; Drug Combinations; Drug Therapy, Combination; Ethylenediamines; HIV Seropositivity; Humans; Lamivudine; Male; Syphilis; Zidovudine