Due to the low incidence of concurrent human immunodeficiency virus (HIV) and syphilis infection identified during the early phase, such as window period (WP), little is known about the clinical manifestations, diagnosis, and treatment efficacy at very early stages. One longitudinal study was conducted in a 42-year-old blood donor who was concurrently infected with syphilis and HIV. This blood donor was treated with a penicillin-based regimen and early antiretroviral therapy (ART). Sequential serological and nucleic acid tests were performed and the results were comparatively analyzed. A regular male donor who had two occasions of high-risk sexual behaviors 41 and 35 days before donation donated whole blood at the Shenzhen Blood Center. ART was initiated at the 28th day after donation (DAD), and syphilis treatment was received at the 49th DAD. Microbiological analysis using a fourth-generation anti-HIV enzyme-linked immunosorbent assay (ELISA) (4th GAHE) and electro-chemiluminesent immunoassay indicated a positive signal at the 6th DAD, while a third-generation anti-HIV ELISA (3rd GAHE) showed positive at the 26th DAD. All nucleic acid testing (NAT) for HIV RNA were reactive except the minipool NAT of 6 pooled samples at 117th DAD. The HIV viral load declined more than 4-log in copies per milliliter over 3 months, until reaching nondetectable levels at 246th DAD. Nevertheless, HIV-1 DNA was still detectable at 403rd DAD. Among all methods utilized, anti-treponema pallidum ELISA detected syphilis infection at the earliest time. A successful serological response to syphilis treatment was reached around the 80th DAD. Concurrent infection with syphilis and HIV during early phases did not significantly change the sensitivity of reagents in detection nor alter the therapeutic efficacy for the treatment of both pathogens, but might result in delayed HIV serological WP.

中文翻译：

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早期梅毒和人类免疫缺陷病毒并发感染的纵向案例研究

由于在窗口期（WP）等早期发现的并发人类免疫缺陷病毒（HIV）和梅毒感染的发生率较低，因此对非常早期的临床表现、诊断和治疗效果知之甚少。一项纵向研究是在一名同时感染梅毒和 HIV 的 42 岁献血者中进行的。这位献血者接受了基于青霉素的方案和早期抗逆转录病毒疗法 (ART) 的治疗。进行了序列的血清学和核酸检测，并对结果进行了比较分析。一位在献血前41天和35天有过两次高危性行为的普通男性献血者在深圳血液中心捐献了全血。ART 在捐赠后第 28 天（DAD）开始，梅毒治疗在 DAD 第 49 天接受。使用第四代抗 HIV 酶联免疫吸附测定 (ELISA) (4th GAHE) 和电化学发光免疫测定的微生物分析表明在第 6 天 DAD 时呈阳性信号，而第三代抗 HIV ELISA (3rd GAHE) 显示在第 26 天 DAD 时呈阳性。除了第 117 个 DAD 时 6 个合并样本的小池 NAT 外，所有 HIV RNA 核酸检测 (NAT) 均具有反应性。HIV 病毒载量在 3 个月内每毫升下降超过 4 个对数拷贝数，直到在第 246 个 DAD 时达到不可检测的水平。尽管如此，在第 403 个 DAD 时仍可检测到 HIV-1 DNA。在所有使用的方法中，抗梅毒螺旋体ELISA最早检测到梅毒感染。对梅毒治疗的成功血清学反应在第 80 天左右达到。