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Treatment of latent syphilis in HIV-infected patients with 10 d of benzylpenicillin G benethamine: a prospective study in Maputo, Mozambique.

Abstract
Neurosyphilis has been reported in HIV-infected patients previously treated with penicillin G benzathine, which does not achieve treponemicidal levels in cerebrospinal fluid. Therapy combining benzylpenicillin G and its repository form benzylpenicillin G benethamine could be a potentially effective alternative enhanced regimen for treating latent syphilis in HIV-infected patients because peak serum and cerebrospinal fluid concentrations would be achieved early post-administration by the former molecule and sustained for 24 h due to the prolonged half-life of the latter. In this study, 23 asymptomatic HIV and Treponema pallidum co-infected patients received 10 d of combined therapy (2 M IU intramuscular once daily) and were followed up at 3, 6 and 12 months. None experienced side effects or clinical symptoms. Of the 18 patients who were evaluated 1 y later, 8 (44.4%) exhibited serological treatment failure, defined as a positive serum rapid plasma reagin test. In conclusion, a 10-d regimen combining penicillin G and penicillin G benethamine seems to be of no benefit compared to currently recommended treatment.
AuthorsPierre Tattevin, Patrick Renault, Véronique Joly, Rui Bastos, Elisabeth Coelho, Christian Adda, Anne Ebel, Patrick Yeni
JournalScandinavian journal of infectious diseases (Scand J Infect Dis) Vol. 34 Issue 4 Pg. 257-61 ( 2002) ISSN: 0036-5548 [Print] England
PMID12064687 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Penicillins
  • Penicillin G Benzathine
Topics
  • Adult
  • Drug Therapy, Combination
  • Female
  • HIV (pathogenicity)
  • HIV Infections (complications, pathology)
  • Humans
  • Male
  • Middle Aged
  • Mozambique
  • Penicillin G Benzathine (chemistry, metabolism, therapeutic use)
  • Penicillins (therapeutic use)
  • Syphilis, Latent (complications, drug therapy)
  • Time Factors
  • Treatment Outcome

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