Alicia Zalka, BA; Marc E. Grossman, MD; David N. Silvers, MD
To the Editors: Several articles have recently been published reporting what has been called "seronegative" secondary syphilis in HIV-infected persons. We question the terminology used. On close inspection of these reports, what is being labeled "seronegative" secondary syphilis might more accudvrately be termed delayed conversion to seropositivity. In the case report by Hicks and colleagues (1) and in a letter by Strobel and coworkers (2), HIV-infected patients with histologically diagnosed secondary syphilis failed to show reactive serologic results with initial VDRL testing. In each case, however, with repeated VDRL studies, seropositivity later developed. Although Hicks describes this as "seronegative" secondary
Zalka A, Grossman ME, Silvers DN. "Seronegative" Syphilis in AIDS. Ann Intern Med. ;114:521–522. doi: 10.7326/0003-4819-114-6-521_2
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Published: Ann Intern Med. 1991;114(6):521-522.
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