Syphilis Question

[srider]

On 3/19/2019 at 6:06 PM, wildbottom said:

I have Syph myself - here's what I can tell you.  If you have it, you're never cured - you'll hear about "viral load" which is not just an HIV term, when the viral load drops to a certain point it's considered in remission.  Those figures mean when blood with Syph in it is analyzed, it is still detectable after they've thinned the blood 64 times, 32 times, 16 times, 8 times, etc.  My syph was diagnosed in July of last year (along with Hep B), was latent and tested 1/64 by the time they found it, so it wasn't contagious but it had a long time in me - I was treated (3 shots of penicillin over a 2 week period) and I've been monitored every 3 months since it is now at 1/16 - I just so happened to see my doctor today and she was happy with the drop - said it will soon be undetectable and no longer a problem. She is ready to put me on a preventative dose of 100mg Doxy daily to lessen the chances of Syph, Chlam and Gono.  Hep B, by the way, is similar - you're never cured, but in 75% of all cases here in the US the liver takes care of it for you and puts it into remission.  She's checking my viral load  this week and if it's low enough she'll have me get a Hep B immunization.  FYI - she gave me an HPV immunization today and is ready to put me on PrEP when I say go.. I'm getting as bulletproof as possible little by little.

Syphilis is cured through penicillin (or another antibiotic). The bloodwork is not direct detection or culture. The screen and confirmatory is looking for antibodies. The RPR which is the titre (e.g. 1:16) is also an indirect testing method, which is measuring something released due to damage from syphilis. It's more accurate to say that the test will always be reactive if you have had syphilis in the past. 

[Guest GoneFishing]

8 hours ago, srider said:

It can take a while for your titre to drop. Some people, especially HIV+, will serofast at higher titre levels.

I’m always at 1.1 sometimes non reactive 

 

[Pigmut]

9 hours ago, srider said:

Syphilis is cured through penicillin (or another antibiotic). The bloodwork is not direct detection or culture. The screen and confirmatory is looking for antibodies. The RPR which is the titre (e.g. 1:16) is also an indirect testing method, which is measuring something released due to damage from syphilis. It's more accurate to say that the test will always be reactive if you have had syphilis in the past. 

Is HPV immunization successful if done above age 50 ?

[doitraw]

On 3/19/2019 at 6:06 PM, wildbottom said:

I have Syph myself - here's what I can tell you.  If you have it, you're never cured - you'll hear about "viral load" which is not just an HIV term, when the viral load drops to a certain point it's considered in remission.  Those figures mean when blood with Syph in it is analyzed, it is still detectable after they've thinned the blood 64 times, 32 times, 16 times, 8 times, etc.  My syph was diagnosed in July of last year (along with Hep B), was latent and tested 1/64 by the time they found it, so it wasn't contagious but it had a long time in me - I was treated (3 shots of penicillin over a 2 week period) and I've been monitored every 3 months since it is now at 1/16 - I just so happened to see my doctor today and she was happy with the drop - said it will soon be undetectable and no longer a problem. She is ready to put me on a preventative dose of 100mg Doxy daily to lessen the chances of Syph, Chlam and Gono.  Hep B, by the way, is similar - you're never cured, but in 75% of all cases here in the US the liver takes care of it for you and puts it into remission.  She's checking my viral load  this week and if it's low enough she'll have me get a Hep B immunization.  FYI - she gave me an HPV immunization today and is ready to put me on PrEP when I say go.. I'm getting as bulletproof as possible little by little.

Some people here are probably going to call you stupid for getting bulletproof. I'm not one of them.

You're still going bare, you're still having the thrill of a risk, but you're taking care of yourself.

Let's check everybody's decisions 20 years from now and see who regrets what.

[wildbottom]

6 hours ago, doitraw said:

Some people here are probably going to call you stupid for getting bulletproof. I'm not one of them.

You're still going bare, you're still having the thrill of a risk, but you're taking care of yourself.

Let's check everybody's decisions 20 years from now and see who regrets what.

Thanks - it's the right thing to do since I have kids.  I also just got a Pneumococcal Polysaccharide immunization yesterday (prevents against meningitis, bacteremia and types of pneumonia) - why not, right?  Truth be told, for 20 years I never gave a shit what might happen to me - feeling amazing during each romp but terrible after.  Being diagnosed bipolar this past year explained a LOT so 200mg of Lamotrigine every day has given me the clarity to prepare for the types of fun I know I love.  Now to figure out if the wife understands.  

[srider]

On 3/27/2019 at 11:23 AM, Pigmut said:

Is HPV immunization successful if done above age 50 ?

For most people the benefits outweigh the risks. It hasn't really been studied in that population. Discuss with your MD, but I think it is a good idea. 

[srider]

On 3/27/2019 at 10:43 AM, Chargedup said:

I’m always at 1.1 sometimes non reactive 

 

That's not uncommon.

[PG1961Canada]

PrEP here.

I was diagnosed with Syphillis in fall 2017.  Had the ONE shot treatment and was told that is usually effective.  I had NONE of the regular symptoms at all.  I also know that my partner at the time was not being very picky about extra-curricular partners and had dosed up on Chlamydia and passed it along.

My HIV Doc said the one-shot option didn't appear to have fixed the issue and he wanted follow up to address and recommended two follow up shots.

I had the TWO shot treatment - Week 1 and Week 2.  Went for my normal HIV clinic appointment 3 months later.  Guess what? It HAD reduced, but still there.

So, they did a THREE treatment penicillin shot - Week 1, Week 2 and then Week 3.  It was (literally) a pain in the ass.... because of the fact that I had 3.

I have my regular clinic appointment next week.  Hoping that the blood work will show numbers have stabilized.

As has been mentioned by others - my clinic Doc told me I will 'never' be cured - the tests will always show 'something'. 

However, he also explained that some people have an issue with antibiotics in general, and it can slow down or impede healing.  In fact, I was treated for acne as a teen years ago and have built up a resistance to antibiotics - as this is how they treated acne 30 years ago.  It is interesting how you end up with some long term effects for EVERY drug you take!!

So yes.. it could be reinfection.  It could be resistance to antibiotics.  But you are wise to stay on top of this.... lots of good advice from others in this thread already!

Good luck!

[viking8x6]

I'm a scientist, and have gone to some effort (for reasons you can probably guess) to understand the details behind the tests. If there's some confusion in the above posts about whether Syphilis is curable and what the titers mean, that's because it's damn confusing (many health professionals don't seem to really get the details)! Here's the most accurate information I've been able to glean:

Syphilis is generally *curable* with antibiotics (penicillin), although there are some strains that are resistant (but even these are usually curable with retreatment or stronger treatment).

Entrenched syphilis (stage 2 or 3) is much more difficult to cure than early-stage syphilis. This is at least partly because the bacterium (not a virus) gets into the brain where it is difficult for most antibiotics to reach it (HIV does the same thing). Therefore, if you don't want to have long-term syphilis, it's good to be tested regularly.

The RPR test, and others like it, (the ones that involve the 1:n titer levels) don't actually test for Syphilis or for antibodies to the syphilis bacterium per se. They test for antibodies to a substance that is found in heart muscle. When a human is infected with syphilis or any of several other agents, the bacteria cause damage to the cells and some of the substance leaks out, and the immune system forms antibodies to it. Once the Syphilis is cured, the leakage stops and the immune system *may* stop making the antibodies... but no guarantees. How long this takes depends on your specific immune response, but it is at least months and may be years... or never. If that's the case, even though you are cured of Syphilis (or hope so) you will still have a reactive test.

There are more specific tests for Syphilis where they actually look for the bacteria in the blood, but these are not used as a first-line diagnostic because they require lab procedures that are more difficult, slower, and more expensive.

 

[edit] Oh, yeah... and Syphilis can be really hard to notice if you don't happen to have a chancre in an obvious place. A fact I can confirm first-hand.

 

Edited April 28, 2019 by vnaught8x6

[Rubberbanned]

So much learnings from this thread, which I appreciate because I've had syphilis twice. The first time, I had a few red spots over my palms. Had three shots of penicillin at one-week intervals. The second time, I had very, very bad headaches that won't go away. No red spots whatsoever. An ex said it could be neurosyphilis. The doctor confirmed it wasn't (which was one hell of a relief), and gave me a penicillin shot. However, I seem to have had an allergic reaction of some sort this time from penicillin. My face swelled for a day or so. After that, I felt perfectly fine.

I've been told by friends to take Doxycycline twice a day in the next 14 days after bareback sex to lessen my chances of having syphilis again. Have you heard of this advice? Is this wise to do?

[Caliente]

've been told by friends to take Doxycycline twice a day in the next 14 days after bareback sex to lessen my chances of having syphilis again. Have you heard of this advice? Is this wise to do?

 

I’m also curious about this 

[Spunkinmyarse]

On 3/28/2020 at 8:12 PM, Caliente said:

've been told by friends to take Doxycycline twice a day in the next 14 days after bareback sex to lessen my chances of having syphilis again. Have you heard of this advice? Is this wise to do?

 

 

NO!  There is some anecdotal evidence (and one or two small studies) that show that taking 200mg of doxycycline in one go up to 72 hours after unprotected sex may REDUCE the chance of getting syphilis, as well as chlamydia (but not gonnorhea).  Based on my own experience, I think this is probably true.

But taking doxycycline twice a day for 14 days after unprotected sex would be overkill: that kind of dosage is usually used to treat a confirmed case of chlamydia.

Anyway, I’m no expert.  But there is more info on this topic in another thread in this section (same page at the moment) called ‘Prophylactic Doxycycline’.

[srider]

I also agree that I wouldn't take doxycycline for 14 days after each exposure. There is some evidence of smaller doses of doxy post-sex as prophylaxis for syphilis and chlamydia (not gonorrhea) but this may drive antibiotic resistance which would fuck everyone over. If you are engaging in activities where you are at risk of contracting STIs, testing is the best strategy. 

[Guest MattDillan]

On 4/28/2019 at 3:24 PM, viking8x6 said:

I'm a scientist, and have gone to some effort (for reasons you can probably guess) to understand the details behind the tests. If there's some confusion in the above posts about whether Syphilis is curable and what the titers mean, that's because it's damn confusing (many health professionals don't seem to really get the details)! Here's the most accurate information I've been able to glean:

Syphilis is generally *curable* with antibiotics (penicillin), although there are some strains that are resistant (but even these are usually curable with retreatment or stronger treatment).

Entrenched syphilis (stage 2 or 3) is much more difficult to cure than early-stage syphilis. This is at least partly because the bacterium (not a virus) gets into the brain where it is difficult for most antibiotics to reach it (HIV does the same thing). Therefore, if you don't want to have long-term syphilis, it's good to be tested regularly.

The RPR test, and others like it, (the ones that involve the 1:n titer levels) don't actually test for Syphilis or for antibodies to the syphilis bacterium per se. They test for antibodies to a substance that is found in heart muscle. When a human is infected with syphilis or any of several other agents, the bacteria cause damage to the cells and some of the substance leaks out, and the immune system forms antibodies to it. Once the Syphilis is cured, the leakage stops and the immune system *may* stop making the antibodies... but no guarantees. How long this takes depends on your specific immune response, but it is at least months and may be years... or never. If that's the case, even though you are cured of Syphilis (or hope so) you will still have a reactive test.

There are more specific tests for Syphilis where they actually look for the bacteria in the blood, but these are not used as a first-line diagnostic because they require lab procedures that are more difficult, slower, and more expensive.

 

[edit] Oh, yeah... and Syphilis can be really hard to notice if you don't happen to have a chancre in an obvious place. A fact I can confirm first-hand.

 

 

[Guest MattDillan]

For me I had no symptoms of syphilis until my ears started ringing, and had vision problems (spots in my right eye).  I tested negative in Jan 2017 during my routine 90 day tests.  By April I had neurosyphilis,  guessing I skipped some stages.  I had dizzy spells, memory/concentration problems, ears ringing, eye problems, headache and fever.  Rashes didn’t appear until I started treatment  (2 shots, pills AND 2 weeks taking antibiotics on an IV).