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Because the HIV and syphilis epidemics are intertwined, patients with one of these diseases are usually routinely tested for the other. In Switzerland, however, routine syphilis screening for HIV-infected patients was stopped in 1998 because of declining national rates; it was not reintroduced until 2004.
During the first 33 months after routine screening was resumed, 7244 HIV-infected patients in that country were tested for syphilis. Most had early-stage HIV infection (mean CD4 count, 439 cells/mm3). Overall, 218 (3%) were found to have untreated syphilis. Among these patients, 130 (60%) were asymptomatic, including 3 of the 4 who subsequently proved to have central nervous system involvement, and 106 (49%) had latent syphilis. Newly detec…