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The mean CD4+T-lymphocyte count was not predictive of relapse.Patients with reactive cerebrospinal fluid(CSF)Veneral Disease Research Laboratory (VDRL)test titers(4 of 7 patients[57%])or the rash of secondary syphilis(4 of 14 patients[29%])were at highest risk of subsequent relapse or treatment failure when monitored for an average of 2 years.Standard penicillin regimens,including high-dose intravenous penicillin,transiently lowered serum VDRL titers in nearly all cases,but were sometimes inadequate in preventing serologic and clinical relapse in patients infected with HIV type-1,especially among those with secondary syphilis and reactive CSF VDRL titers.Careful long-term follow-up is essential,and repeated courses of therapy may be needed for patients infected with HIV type-1 who have syphilis. |
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