Bidirectional Association within HIV and Syphilis Coinfection: A Pathophysiological and Clinical Review

HIV and syphilis coinfection were a major public health problem worldwide due to similar modes of transmission and pathophysiological interactions. HIV facilitates syphilis transmission by suppressing immunity, while syphilis enhances HIV replication and transmission through mucosal damage and immunological changes. The clinical manifestations of coinfection may differ from the usual course of the disease, complicating diagnosis and treatment. Coinfection increases the likelihood of treatment failure, immunological suppression, and serious sequelae such as neurosyphilis. Controlling this dual epidemic requires comprehensive policies that prioritize early detection, ongoing monitoring, and targeted therapy, especially among high-risk groups such as men who have sex with men and commercial sex workers. This review examines the epidemiology, immunopathogenesis, and clinical aspects of HIV and syphilis coinfection, emphasizing the importance of integrated prevention and treatment strategies