Co-infection of Primary Syphilis and HIV after a Single Exposure - a Case Report

Human immunodeficiency virus type 1- infected patients with syphilis are among the most important transmitters of HIV-1 infection due to biological effects of genital ulcerations, and aggravation due to their continued risky behavior. The association between primary syphilis and acute HIV-1 co-infection is not well documented, and reports on isolated cases are raising special interest and indicate that this double primary co-infection may occur. We present a case of a 31-year-old man with no past medical history who presented with fever, papular rash on the face which lasted for a few days, and a single genital ulcer. He was diagnosed with primary syphilis and primary HIV-1 infection after a single exposure with an infected female sex worker. Male-to-female HIV transmission during vaginal intercourse is significantly more likely than female-to-male HIV transmission. However, high prevalence of sexually transmitted diseases among female sex workers contributed to high HIV transmission probability, as in our case.

As far as the available world literature is concerned, this is the first case of co-infection of primary syphilis and HIV.