Skip to main content Skip to main navigation menu Skip to site footer

Sifilis pada spektrum Human Immunodeficiency Virus (HIV) yang melibatkan roseola sifilitika, kondiloma akuminata, dan kondiloma lata: sebuah laporan kasus langka

Abstract

Introduction: Human Immunodeficiency Virus (HIV) infection often coincides with syphilis, thereby increasing the risk of HIV transmission 3-5 times higher than in patients without syphilis. HIV infection, syphilis, and condyloma acuminata have overlapping risk factors, and the co-occurrence of these three diseases can cause difficulties in diagnosis and management. This case report reports a case of secondary syphilis with typical characteristics of syphilis roseola and condyloma lata accompanied by perianal condyloma acuminata in a male patient who has sex with men (LSL) with stage I HIV infection who experienced significant improvement after therapy.

Case report: The patient, a 24-year-old man, complained of reddish spots appearing on the palms of the hands and feet, stomach, thighs, calves, feet, and warts appearing around the anus. The patient was diagnosed with HIV infection one month before the examination. Complaints of lumps on the buttocks were still there but had reduced and become smaller on the second observation. The patient was diagnosed on follow-up with condyloma acuminata (improved) with secondary syphilis and stage I HIV infection on HAART. Monitoring the success of syphilis therapy will be carried out with a quantitative VDRL examination plan 1 month after the last injection, then carried out periodically during the 3rd, 6th, 9th, and 12th months.

Conclusion: Clinical outcomes should remain suspicious of the occurrence of other sexually transmitted diseases in LSL patients and can differentiate clinically between secondary syphilis and condyloma lata in patients with HIV. So, we can provide earlier treatment to reduce morbidity rates in LSL patients.

 

Pendahuluan: Infeksi Human Immunodeficiency Virus (HIV) seringkali beriringan dengan sifilis yang meningkatkan risiko penularan HIV 3-5 kali lebih tinggi dibandingkan dengan pasien tanpa sifilis. Infeksi HIV, sifilis, dan kondiloma akuminata memiliki faktor risiko yang tumpang tindih dan koinsiden dari ketiga penyakit ini dapat menyebabkan kesulitan untuk mendiagnosis dan tatalaksana. Laporan kasus ini melaporkan kasus sifilis sekunder dengan gambaran tipikal roseola sifilitika dan kondiloma lata disertai kondiloma akuminata perianal pada pasien lelaki seks dengan lelaki (LSL) dengan infeksi HIV stadium I yang mengalami perbaikan signifikan setelah terapi.

Laporan kasus: Pasien merupakan seorang laki-laki usia 24 tahun mengeluhkan muncul bercak kemerahan pada telapak tangan dan kaki, perut, paha, betis dan kaki serta muncul kutil pada sekitar anus. Pasien terdiagnosis infeksi HIV satu bulan sebelum pemeriksaan. Keluhan benjolan pada pantat masih ada namun sudah berkurang dan mengecil pada pengamatan ke dua. Pasien didiagnosis dengan follow up kondiloma akuminata (membaik) dengan sifilis sekunder dan infeksi HIV stadium I on HAART. Pemantauan keberhasilan terapi sifilis akan dilakukan dengan rencana pemeriksaan VDRL kuantitatif pada 1 bulan pasca injeksi terakhir, kemudian dilakukan berkala pada bulan ke -3, -6, -9, dan -12
Simpulan: Luaran klinis sebaiknya tetap mencurigai adanya koinsiden penyakit menular seksual lain pada pasien LSL dan dapat membedakan klinis sifilis sekunder dan kondiloma lata pada pasien dengan HIV. Sehingga, dapat memberikan tatalaksana lebih awal agar mengurangi angka morbiditas pada pasien LSL.

References

  1. Luppi CG, Gomes SEC, Silva RJC da, Ueno AM, Santos AMK Dos, Tayra Â, et al. Factors associated with HIV co-infection in cases of acquired syphilis reported in a Reference Center for Sexually Transmitted Diseases and AIDS in the municipality of São Paulo, Brazil, 2014. Epidemiol e Serv saude Rev do Sist Unico Saude do Bras. 2018;27(1):e20171678.
  2. Afriana N, Luhukay L, Mulyani PS, Irmawati, Romauli, Pratono, et al. Laporan Tahunan HIV AIDS 2022 Kemenkes. 2022;1–91.
  3. Primasari PY, Elis Indira IGAA, Indah Jayanthi AA. Kondiloma Akuminata Perianal Disertai Sifilis Sekunder Dan Infeksi HIV Stadium II Pada Remaja Laki-Laki Yang Berhubungan Seksual Dengan Laki-Laki: Laporan Kasus. Intisari Sains Medis. 2022;13(3):764–70. Available from: http://dx.doi.org/10.15562/ism.v13i3.1534
  4. Weng R-X, Hong F-C, Yu W-Y, Cai Y-M. Compare HIV/syphilis infections between age groups and explore associated factors of HIV/syphilis co-infections among men who have sex with men in Shenzhen, China, from 2009 to 2017. PLoS One. 2019;14(10):e0223377–e0223377. Available from: https://pubmed.ncbi.nlm.nih.gov/31581277
  5. Tuddenham, Susan A; Zenilman JM. Syphilis. In: Kang, Sewon, Craddock, Lauren N, Schieke SM, editor. Fitzpatrick’s Dermatology, 9e. 9th ed. New York, NY: McGraw-Hill Education; 2019. p. 3145–72.
  6. Devi M, Purwoko IH, Nugroho SA, Aryani IA, Budiamal S, Karim PL. Diagnosis, Treatment, and Prognosis of Syphilis in HIV Patient. Biosci Med J Biomed Transl Res. 2021;5(11):1153–64. Available from: http://dx.doi.org/10.32539/bsm.v5i11.416
  7. Anonim. Register Poliklinik VCT RSUP Prof. Dr. I G.N.G Ngoerah Denpasar. Denpasar; 2023.
  8. Anonim. Register Poliklinik Kulit dan Kelamin Divisi Infeksi Menular Seksual Rumah Sakit Umum Pusat Prof. Dr. I G.N.G. Ngoerah Denpasar. Denpasar; 2023.
  9. Kidd S, Torrone E, Su J, Weinstock H. Reported Primary and Secondary Syphilis Cases in the United States: Implications for HIV Infection. Sex Transm Dis. 2018;45(9S Suppl 1):S42–7. Available from: https://pubmed.ncbi.nlm.nih.gov/29465633
  10. Firdaus S, Agustin H. Faktor Risiko Kejadian HIV pada Komunitas LSL (Lelaki Seks dengan Lelaki) Mitra Yayasan Lantera Minangkabau Sumatera Barat. J Kesehat Komunitas. 2013;2(2):94–9. Available from: http://dx.doi.org/10.25311/jkk.vol2.iss2.52
  11. Pachauri S, Pachauri A, Mittal K. Men Who Have Sex with Men [Internet]. SpringerBriefs in Public Health. Springer Singapore; 2021. p. 9–25. Available from: http://dx.doi.org/10.1007/978-981-16-4578-5_2
  12. Mawardi P, Yuliarto D. Susceptibility of Male who Have Sex with Male to High-Risk Type Human Papillomavirus (HPV) 16 and 18 with Condyloma Acuminata. Berk Ilmu Kesehat Kulit dan Kelamin. 2022;34(3):197–202. Available from: http://dx.doi.org/10.20473/bikk.v34.3.2022.197-202
  13. California HIV/AIDS Policy & Research Centre. HIV and Syphilis: Rising Rates for Men who have Sex with Men (MSM). 2018;3;1-3.
  14. Cherneskie T, Augenbraun M, Blank S, Dunn A, Friedenberg E, Hermoso A. An Update and Review of the Diagnosis and Management of Syphilis. NYC Heal. 2010;15–7.
  15. Menaldi SLS. Ilmu Penyakit Kulit Dan Kelamin.Edisi Ketujuh.Fakultas Kedokteran Universitas Indonesia. 7th ed. Fakultas Kedokteran Universitas Indonesia. Jakarta; 2017.
  16. Haule A, Msemwa B, Mgaya E, Masikini P, Kalluvya S. Prevalence of syphilis, neurosyphilis and associated factors in a cross-sectional analysis of HIV infected patients attending Bugando Medical Centre, Mwanza, Tanzania. BMC Public Health. 2020;20(1):1862.
  17. Dhaliwal S, Patel M, Menter A. Secondary syphilis and HIV. Proc (Bayl Univ Med Cent). 2012;25(1):87–9. Available from: https://pubmed.ncbi.nlm.nih.gov/22275795
  18. Carvalho RX da C, de Araújo TME. Knowledge, attitudes and practices of university adolescents about syphilis: a cross-sectional study in the Northeast. Rev Saude Publica. 2020;54(120):1–13.
  19. Tudor M, Al Aboud A, Leslie S. Syphilis. StatPearls. 2023.
  20. Indriatmi W. Pedoman Nasional Infeksi Menular Seksual. 2020.
  21. Sudharshan S, Menia NK, Selvamuthu P, Tyagi M, Kumarasamy N, Biswas J. Ocular syphilis in patients with human immunodeficiency virus/acquired immunodeficiency syndrome in the era of highly active antiretroviral therapy. Indian J Ophthalmol. 2020;17(1):1.
  22. Kojima N, Klausner JD. An Update on the Global Epidemiology of Syphilis. Curr Epidemiol reports. 2018/02/19. 2018;5(1):24–38. Available from: https://pubmed.ncbi.nlm.nih.gov/30116697
  23. Wresti I, Farida Z. Infeksi Menular Seksual. 5th ed. Sjaiful DF, Hanny N, Maker WIB, Farida Z, Rasmia R, Retno PS, editors. Fakultas Kedokteran Universitas Indonesia; 2017. 161–175 p.
  24. Lowell A. Goldsmith , Stephen I. Katz , Barbara A. Gilchrest , Amy S. Paller , David J.Leffelll KW. Fitzpatrick’s Dermatology. Fitzpatrick’s Dermatology. 2012.
  25. Kusumaningsih E, Setyowatie L. Reccurent Giant Condylomata Acuminata Caused by Human Papilloma Virus in HIV with Homosexual Male. Indones J Trop Infect Dis. 2020;8(2):131. Available from: http://dx.doi.org/10.20473/ijtid.v8i2.8375
  26. World Health Organization. Consolidated Guidelines on Hiv Prevention, Testing, Treatment, Service Delivery and Monitoring: Recommendations for A Public Health Approach. Creative Commons Attribution- NonCommercial-ShareAlike. 2021.
  27. Hazra A, Collison MW, Davis AM. CDC Sexually Transmitted Infections Treatment Guidelines, 2021. JAMA. 2022;327(9):870. Available from: http://dx.doi.org/10.1001/jama.2022.1246

How to Cite

Wiratha, T., Sudarsa, P. S. S. ., Indry Salonika Sutiawan, Adelia Martalova A.J., Alfred Setyono, Putu Akopita Devi, & Putu Dewita Ganeswari. (2024). Sifilis pada spektrum Human Immunodeficiency Virus (HIV) yang melibatkan roseola sifilitika, kondiloma akuminata, dan kondiloma lata: sebuah laporan kasus langka. Intisari Sains Medis, 15(1), 378–386. https://doi.org/10.15562/ism.v15i1.1984

HTML
0

Total
0

Share

Search Panel

Tya Wiratha
Google Scholar
Pubmed
ISM Journal


Prima Sanjiwani Sarasawati Sudarsa
Google Scholar
Pubmed
ISM Journal


Indry Salonika Sutiawan
Google Scholar
Pubmed
ISM Journal


Adelia Martalova A.J.
Google Scholar
Pubmed
ISM Journal


Alfred Setyono
Google Scholar
Pubmed
ISM Journal


Putu Akopita Devi
Google Scholar
Pubmed
ISM Journal


Putu Dewita Ganeswari
Google Scholar
Pubmed
ISM Journal