Human immunodeficiency virus (HIV) and syphilis co-infection is a major health concern due to similar transmission routes and pathophysiology interactions. HIV promotes syphilis transmission by decreasing immunity, whereas syphilis exacerbates HIV replication and transmission via mucosal damage and immunological changes. The clinical manifestations of co-infection may differ from conventional illness development, complicating the diagnosis and management. Co-infection raises the risk of treatment failure, immunological suppression, and serious consequences such as neurosyphilis. Addressing this dual epidemic requires integrated policies that prioritize early detection, persistent monitoring, and targeted therapies, particularly among high-risk groups like men who have sex with men (MSM) and commercial sex workers. This review examines the epidemiology, immunopathogenesis, and clinical implications of HIV and syphilis co-infection, emphasizing the importance of comprehensive preventive and treatment strategies.
Keywords: bidirectional relationship, coinfection, HIV, syphilis.
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Address for correspondence:
Ni Made Dwi PUSPAWATI
Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia
E-mail: dwi.puspawati@yahoo.com
