Treatment of latent syphilis in HIV-infected patients with 10 d of benzylpenicillin G benethamine: a prospective study in Maputo, Mozambique

Scand J Infect Dis. 2002;34(4):257-61. doi: 10.1080/00365540110077380.


Neurosyphilis has been reported in HIV-infected patients previously treated with penicillin G benzathine, which does not achieve treponemicidal levels in cerebrospinal fluid. Therapy combining benzylpenicillin G and its repository form benzylpenicillin G benethamine could be a potentially effective alternative enhanced regimen for treating latent syphilis in HIV-infected patients because peak serum and cerebrospinal fluid concentrations would be achieved early post-administration by the former molecule and sustained for 24 h due to the prolonged half-life of the latter. In this study, 23 asymptomatic HIV and Treponema pallidum co-infected patients received 10 d of combined therapy (2 M IU intramuscular once daily) and were followed up at 3, 6 and 12 months. None experienced side effects or clinical symptoms. Of the 18 patients who were evaluated 1 y later, 8 (44.4%) exhibited serological treatment failure, defined as a positive serum rapid plasma reagin test. In conclusion, a 10-d regimen combining penicillin G and penicillin G benethamine seems to be of no benefit compared to currently recommended treatment.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Drug Therapy, Combination
  • Female
  • HIV / pathogenicity
  • HIV Infections / complications*
  • HIV Infections / pathology
  • Humans
  • Male
  • Middle Aged
  • Mozambique
  • Penicillin G Benzathine / chemistry
  • Penicillin G Benzathine / metabolism
  • Penicillin G Benzathine / therapeutic use*
  • Penicillins / therapeutic use*
  • Syphilis, Latent / complications
  • Syphilis, Latent / drug therapy*
  • Time Factors
  • Treatment Outcome


  • Penicillins
  • Penicillin G Benzathine