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

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Presentation on theme: "Managing Syphilis in HIV Co-infected Patients: A Case-Based Approach"— Presentation transcript:

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

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

3

4 CME Information

5 Nursing and Pharmacy Credits

6 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.

7 Grant Support for this Webinar

8 Navigating the Webinar

9 Poll 1

10 Poll 2

11 Poll 3

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

13 Financial Relationships With Commercial Entities

14 Learning Objectives

15 Pretest Question 1

16 Pretest Question 2

17 Epidemiology: Who’s at risk?

18 Where we were in 1999…

19 Syphilis: The MSM epidemic

20 Syphilis: The heterosexual epidemic

21 The intersection of epidemics: Drug use and heterosexual syphilis transmission

22 Congenital syphilis: A failure of public health

23 The Solution

24 So why are we failing?

25 So why are we failing?

26 PLWH: Syphilis Screening Recommendations

27 Epidemiology: Implications

28 Management

29 The Natural History of Syphilis

30 RJ

31 RJ

32 RJ: Laboratory Results

33 RJ: What is the clinical diagnosis?

34 Clinical Manifestations of Syphilis

35 Syphilitic Hepatitis

36 Serological tests for syphilis

37 Testing: The Reverse Sequence Algorithm

38 Management: Antimicrobial therapy

39 But what about a pregnant woman with penicillin allergy?

40 Summary: Treatment Recommendations

41

42 RJ: Need for CSF examination

43 CSF Examination in Neurologically Asymptomatic HIV+ Persons with Syphilis?

44 RJ

45 Patient NN

46 Patient NN

47 NN: Diagnoses

48

49 Neurosyphilis

50 FYI- Ocular Syphilis

51 FYI- Otosyphilis

52 Need for a CSF Examination: A Summary

53 Neurosyphilis: Questions to Ask

54 Ocular Syphilis: Questions to Ask

55 Otic Syphilis: Questions to Ask

56 Patient NN: CSF Examination

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

58 Patient NN: Summary

59 Let’s go back to our patient RJ…

60 RJ

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

62 Does the serofast state predict poor clinical outcomes?

63 Patient RJ

64 Does additional antimicrobial therapy improve serological outcomes?

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

66 RJ

67 Would you restart treatment over again?

68 RJ

69

70 Syphilis Control: Doxycycline?

71 Syphilis PrEP & PEP: Pros & Cons

72 Syphilis PrEP/PEP

73 Syphilis: Take-Home Messages

74 Thank you

75

76

77 Additional Resources

78 Posttest Question #1

79 Posttest Question #2

80 Question-and-Answer

81

82 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.

83 Final Poll

84

85

86 Thank You


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