Syphilis reinfection?

Question

About a year ago I was diagnosed with neuro syphilis, and I spent two weeks in the hospital getting a penicillin drip. At the time my titer was about 500. I was also diagnosed with having AIDS at that time. After getting out of the hospital I was in denial and didn't start treatment with medication until a year later. My CD4 count was 12, and my viral load was 450,000. I also tested positive for syphylis again with my titer being 100. Is it likely that I got infected again (even though I didn't have the same partners), or has it not decreased further because my immune system was so weak? Just to be on the safe side, the doctor suggested I get a penicillin shot in my butt once a week for three weeks - to which I had no response. Getting Syphillis once was bad enough, getting it twice (possibly) was horrible. Is it likely that I got reinfected? Or the numbers just haven't gone down fast enough?

Answer

Hello and thanks for posting.

Positives are at greater risk of having poor response to syphilis treatment and/or recurrence. It's also possible that you could have been reinfected. Unfortunately, the current tests don't discriminate between all of these possibilities, but what is clear that especially with a history of neurosyphilis, that monitoring of your RPR titers is important.

Hope that helps, BY