Author Affiliations: Vanderbilt Institute for Global Health, Departments of Pediatrics and Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee.
In the July 23, 2012, online and September 10, 2012, print versions of Archives, an impressive French clinical surveillance system has been used to assess the impact of syphilis infection on the viral load (VL) and CD4+ cell counts of human immunodeficiency virus (HIV)–infected men.1 In France, the national health system facilitates high continuity in primary care, reduces fiscal barriers to care, and enables clinical data to be harvested readily for outcomes research. Because this system facilitates the management of sexually transmitted infections (STIs) in the context of HIV primary care, it is markedly easier to examine the impact of coinfection than in systems in which patients are evaluated for STIs in settings outside of their primary care practice.
Vermund SH. Prevention, Detection, and Treatment of Coinfections: A Priority in Human Immunodeficiency Virus–Infected Persons to Reduce Viral Load and Consequent Disease Progression and Transmission Comment on “Effect of Early Syphilis Infection on Plasma Viral Load and CD4 Cell Count in Human Immunodeficiency Virus–Infected Men”. Arch Intern Med. 2012;172(16):1243–1244. doi:10.1001/archinternmed.2012.3770