{"id":58137,"date":"2026-03-12T16:53:58","date_gmt":"2026-03-12T16:53:58","guid":{"rendered":"https:\/\/www.mediconanet.pt\/?p=58137"},"modified":"2026-03-16T09:27:40","modified_gmt":"2026-03-16T09:27:40","slug":"coinfeccao-sifilis-vih-diagnostico-tratamento","status":"publish","type":"post","link":"https:\/\/www.mediconanet.pt\/en\/coinfeccao-sifilis-vih-diagnostico-tratamento\/","title":{"rendered":"S\u00edfilis e VIH: Coinfec\u00e7\u00e3o, Intera\u00e7\u00f5es e Gest\u00e3o Integrada"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"58137\" class=\"elementor elementor-58137\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-570cfe3 e-flex e-con-boxed e-con e-parent\" data-id=\"570cfe3\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1761780 elementor-widget elementor-widget-text-editor\" data-id=\"1761780\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2><b>Introdu\u00e7\u00e3o<\/b><\/h2><p><span style=\"font-weight: 400;\">A <\/span><b>coinfec\u00e7\u00e3o s\u00edfilis VIH<\/b><span style=\"font-weight: 400;\"> \u00e9 uma realidade epidemiol\u00f3gica frequente, com at\u00e9 50 % dos casos de s\u00edfilis em homens que t\u00eam sexo com homens (HSH) ocorrendo em pessoas que vivem com VIH. A intera\u00e7\u00e3o entre as duas infe\u00e7\u00f5es \u00e9 bidirecional: a s\u00edfilis aumenta o risco de aquisi\u00e7\u00e3o e transmiss\u00e3o do VIH, e o VIH pode modificar a hist\u00f3ria natural e o diagn\u00f3stico da s\u00edfilis.<\/span><\/p><p><span style=\"font-weight: 400;\">O European Centre for Disease Prevention and Control (ECDC) documenta que os HSH VIH-positivos representam a popula\u00e7\u00e3o com maior incid\u00eancia de s\u00edfilis na Europa. A gest\u00e3o integrada da coinfec\u00e7\u00e3o requer protocolos espec\u00edficos de rastreio, tratamento e seguimento, conforme recomendado pela European AIDS Clinical Society (EACS) e pela British HIV Association (BHIVA).<\/span><\/p><h2><b>Intera\u00e7\u00e3o Epidemiol\u00f3gica e Biol\u00f3gica<\/b><\/h2><p><span style=\"font-weight: 400;\">A \u00falcera sifil\u00edtica prim\u00e1ria cria uma porta de entrada para o VIH, aumentando o risco de aquisi\u00e7\u00e3o em 2 a 5 vezes. Simultaneamente, a inflama\u00e7\u00e3o genital associada \u00e0 s\u00edfilis aumenta a excre\u00e7\u00e3o do VIH em pessoas j\u00e1 infetadas, facilitando a transmiss\u00e3o a parceiros sexuais.<\/span><\/p><p><span style=\"font-weight: 400;\">Em pessoas com VIH, a imunossupress\u00e3o pode alterar a resposta serol\u00f3gica \u00e0 s\u00edfilis, com fen\u00f3menos de prozone (falsos negativos em testes n\u00e3o trepon\u00e9micos por excesso de anticorpos), t\u00edtulos serol\u00f3gicos atipicamente elevados ou flutuantes e progress\u00e3o mais r\u00e1pida para neuross\u00edfilis.<\/span><\/p><p><span style=\"font-weight: 400;\">Estudos publicados na revista AIDS demonstram que a s\u00edfilis pode causar aumento transit\u00f3rio da carga viral do VIH e diminui\u00e7\u00e3o da contagem de CD4, mesmo em doentes sob TAR eficaz. Esta intera\u00e7\u00e3o sublinha a necessidade de monitoriza\u00e7\u00e3o virol\u00f3gica e imunol\u00f3gica durante os epis\u00f3dios de<\/span><b> coinfec\u00e7\u00e3o sif\u00edlis VIH<\/b><span style=\"font-weight: 400;\"> .<\/span><\/p><h2><b>Rastreio e Diagn\u00f3stico na Coinfec\u00e7\u00e3o<\/b><\/h2><p><span style=\"font-weight: 400;\">A EACS recomenda rastreio serol\u00f3gico de s\u00edfilis a cada 3 a 6 meses em HSH VIH-positivos sexualmente ativos, e pelo menos anualmente em todos os doentes com VIH. A BHIVA e o NICE integram o rastreio da s\u00edfilis nos cuidados de rotina do VIH.<\/span><\/p><p><span style=\"font-weight: 400;\">O diagn\u00f3stico serol\u00f3gico da s\u00edfilis em pessoas com VIH pode ser mais complexo devido a respostas at\u00edpicas. A utiliza\u00e7\u00e3o combinada de testes trepon\u00e9micos e n\u00e3o trepon\u00e9micos \u00e9 essencial. Em caso de suspeita cl\u00ednica com serologia inconclusiva, o CDC recomenda bi\u00f3psia das les\u00f5es com colora\u00e7\u00e3o especial ou PCR para Treponema pallidum.<\/span><\/p><p><span style=\"font-weight: 400;\">A avalia\u00e7\u00e3o de neuross\u00edfilis deve ser considerada em doentes VIH-positivos com s\u00edfilis tardia, fal\u00eancia serol\u00f3gica ap\u00f3s tratamento, sintomas neurol\u00f3gicos ou contagem de CD4 inferior a 350 c\u00e9lulas\/\u03bcL. A pun\u00e7\u00e3o lombar tem um limiar de indica\u00e7\u00e3o mais baixo na coinfec\u00e7\u00e3o.<\/span><\/p><h2><b>Tratamento e Seguimento Espec\u00edfico<\/b><\/h2><p><span style=\"font-weight: 400;\">O tratamento da s\u00edfilis em pessoas com VIH segue os mesmos protocolos da popula\u00e7\u00e3o geral: penicilina benzat\u00ednica IM para s\u00edfilis precoce e penicilina IV para neuross\u00edfilis. Alguns especialistas defendem regimes mais intensivos (tr\u00eas doses semanais de penicilina benzat\u00ednica) na s\u00edfilis precoce em doentes VIH-positivos, embora a evid\u00eancia n\u00e3o seja conclusiva.<\/span><\/p><p><span style=\"font-weight: 400;\">O seguimento serol\u00f3gico na coinfec\u00e7\u00e3o \u00e9 mais intensivo: RPR\/VDRL quantitativo aos 3, 6, 9, 12 e 24 meses ap\u00f3s tratamento. A resposta serol\u00f3gica pode ser mais lenta em doentes com VIH, e a fal\u00eancia serol\u00f3gica (aus\u00eancia de queda de 4 vezes no t\u00edtulo) deve motivar avalia\u00e7\u00e3o de neuross\u00edfilis ou retratamento.<\/span><\/p><p><span style=\"font-weight: 400;\">A BHIVA recomenda manuten\u00e7\u00e3o da TAR durante o tratamento da s\u00edfilis e monitoriza\u00e7\u00e3o da carga viral do VIH, dado o risco de aumento transit\u00f3rio. A integra\u00e7\u00e3o dos cuidados de VIH e ISTs numa mesma consulta facilita o rastreio, o diagn\u00f3stico e o seguimento da <\/span><b>coinfec\u00e7\u00e3o s\u00edfilis VIH<\/b><span style=\"font-weight: 400;\">.<\/span><\/p><p><i><span style=\"font-weight: 400;\">Na<\/span><b> M\u00e9dico na Net<\/b><span style=\"font-weight: 400;\">, a <\/span><b>equipa cl\u00ednica<\/b><span style=\"font-weight: 400;\"> realiza rastreio integrado da <\/span><a href=\"https:\/\/www.mediconanet.pt\/produto\/sifilis-tratamento\/\"><b>coinfec\u00e7\u00e3o s\u00edfilis VIH<\/b><\/a><span style=\"font-weight: 400;\">, com protocolos de diagn\u00f3stico e seguimento espec\u00edficos para a coinfec\u00e7\u00e3o e uma abordagem personalizada de sa\u00fade sexual.<\/span><\/i><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-375973d elementor-widget elementor-widget-image\" data-id=\"375973d\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/www.mediconanet.pt\/wp-content\/uploads\/2026\/03\/wpimage-id893sizeSlugfulllinkDestinationnone-figure-classwp-block-image-size-fullimg-srchttpscomprarcbdonline.ptwp-contentuploads202603unnamed-3.jpg-altFrasco-de-vidro-transparente-c-14.jpg\" title=\"Consulta m\u00e9dica online para avalia\u00e7\u00e3o de coinfec\u00e7\u00e3o s\u00edfilis VIH\" alt=\"Homem em casa a realizar consulta m\u00e9dica por videochamada num tablet para esclarecimento sobre coinfec\u00e7\u00e3o s\u00edfilis VIH\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1545e08 e-flex e-con-boxed e-con e-parent\" data-id=\"1545e08\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-9ad30cf e-con-full e-flex e-con e-child\" data-id=\"9ad30cf\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-66e4f21 e-con-full e-flex e-con e-child\" data-id=\"66e4f21\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c44ae3e elementor-widget elementor-widget-heading\" data-id=\"c44ae3e\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Perguntas frequentes (FAQ)<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-439b5c3 elementor-widget elementor-widget-n-accordion\" data-id=\"439b5c3\" data-element_type=\"widget\" data-settings=\"{&quot;default_state&quot;:&quot;all_collapsed&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7080\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7080\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Ter s\u00edfilis aumenta o risco de VIH? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7080\" class=\"elementor-element elementor-element-d801294 e-con-full e-flex e-con e-child\" data-id=\"d801294\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7080\" class=\"elementor-element elementor-element-67dd609 e-flex e-con-boxed e-con e-child\" data-id=\"67dd609\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2204be5 elementor-widget elementor-widget-text-editor\" data-id=\"2204be5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Sim. A \u00falcera sifil\u00edtica aumenta o risco de aquisi\u00e7\u00e3o e transmiss\u00e3o do VIH em 2 a 5 vezes. O rastreio simult\u00e2neo de ambas as infe\u00e7\u00f5es \u00e9 mandat\u00f3rio.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7081\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"2\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7081\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> O tratamento da s\u00edfilis \u00e9 diferente se tenho VIH? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7081\" class=\"elementor-element elementor-element-f07e3ff e-con-full e-flex e-con e-child\" data-id=\"f07e3ff\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7081\" class=\"elementor-element elementor-element-ba0d7df e-flex e-con-boxed e-con e-child\" data-id=\"ba0d7df\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bd0918d elementor-widget elementor-widget-text-editor\" data-id=\"bd0918d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">O tratamento base \u00e9 o mesmo (penicilina), mas o seguimento \u00e9 mais intensivo e prolongado. Alguns especialistas preferem regimes mais intensivos na s\u00edfilis precoce em pessoas com VIH.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7082\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"3\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7082\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> A s\u00edfilis pode afetar o controlo do VIH? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7082\" class=\"elementor-element elementor-element-1948aa2 e-con-full e-flex e-con e-child\" data-id=\"1948aa2\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7082\" class=\"elementor-element elementor-element-44203e4 e-flex e-con-boxed e-con e-child\" data-id=\"44203e4\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-90363e4 elementor-widget elementor-widget-text-editor\" data-id=\"90363e4\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Sim. A s\u00edfilis pode causar aumento transit\u00f3rio da carga viral do VIH e diminui\u00e7\u00e3o dos CD4. A monitoriza\u00e7\u00e3o durante o epis\u00f3dio de s\u00edfilis \u00e9 importante.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7083\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"4\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7083\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Com que frequ\u00eancia devo rastrear s\u00edfilis se tenho VIH? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7083\" class=\"elementor-element elementor-element-e6b82d0 e-con-full e-flex e-con e-child\" data-id=\"e6b82d0\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7083\" class=\"elementor-element elementor-element-ff98332 e-flex e-con-boxed e-con e-child\" data-id=\"ff98332\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b745fb3 elementor-widget elementor-widget-text-editor\" data-id=\"b745fb3\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">O rastreio serol\u00f3gico \u00e9 recomendado a cada 3 a 6 meses em HSH sexualmente ativos e pelo menos anualmente em todos os doentes com VIH, segundo a EACS.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-7084\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"5\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-7084\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Posso ter s\u00edfilis repetidamente se tenho VIH? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7084\" class=\"elementor-element elementor-element-7547615 e-con-full e-flex e-con e-child\" data-id=\"7547615\" data-element_type=\"container\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-7084\" class=\"elementor-element elementor-element-8c9a957 e-flex e-con-boxed e-con e-child\" data-id=\"8c9a957\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2f07efa elementor-widget elementor-widget-text-editor\" data-id=\"2f07efa\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Sim. A reinfe\u00e7\u00e3o por s\u00edfilis \u00e9 frequente, especialmente em HSH. A s\u00edfilis n\u00e3o confere imunidade protetora, e o VIH pode facilitar a reinfe\u00e7\u00e3o. O uso de preservativo e o rastreio regular s\u00e3o essenciais.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<script type=\"application\/ld+json\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@type\":\"FAQPage\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"Ter s\\u00edfilis aumenta o risco de VIH?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Sim. A \\u00falcera sifil\\u00edtica aumenta o risco de aquisi\\u00e7\\u00e3o e transmiss\\u00e3o do VIH em 2 a 5 vezes. O rastreio simult\\u00e2neo de ambas as infe\\u00e7\\u00f5es \\u00e9 mandat\\u00f3rio.\"}},{\"@type\":\"Question\",\"name\":\"O tratamento da s\\u00edfilis \\u00e9 diferente se tenho VIH?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"O tratamento base \\u00e9 o mesmo (penicilina), mas o seguimento \\u00e9 mais intensivo e prolongado. Alguns especialistas preferem regimes mais intensivos na s\\u00edfilis precoce em pessoas com VIH.\"}},{\"@type\":\"Question\",\"name\":\"A s\\u00edfilis pode afetar o controlo do VIH?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Sim. A s\\u00edfilis pode causar aumento transit\\u00f3rio da carga viral do VIH e diminui\\u00e7\\u00e3o dos CD4. A monitoriza\\u00e7\\u00e3o durante o epis\\u00f3dio de s\\u00edfilis \\u00e9 importante.\"}},{\"@type\":\"Question\",\"name\":\"Com que frequ\\u00eancia devo rastrear s\\u00edfilis se tenho VIH?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"O rastreio serol\\u00f3gico \\u00e9 recomendado a cada 3 a 6 meses em HSH sexualmente ativos e pelo menos anualmente em todos os doentes com VIH, segundo a EACS.\"}},{\"@type\":\"Question\",\"name\":\"Posso ter s\\u00edfilis repetidamente se tenho VIH?\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Sim. A reinfe\\u00e7\\u00e3o por s\\u00edfilis \\u00e9 frequente, especialmente em HSH. A s\\u00edfilis n\\u00e3o confere imunidade protetora, e o VIH pode facilitar a reinfe\\u00e7\\u00e3o. O uso de preservativo e o rastreio regular s\\u00e3o essenciais.\"}}]}<\/script>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-02d7fba e-flex e-con-boxed e-con e-parent\" data-id=\"02d7fba\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ca91313 elementor-widget elementor-widget-text-editor\" data-id=\"ca91313\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h2><b>Conclus\u00e3o<\/b><\/h2>\n<span style=\"font-weight: 400;\">A <\/span><b>coinfec\u00e7\u00e3o s\u00edfilis VIH<\/b><span style=\"font-weight: 400;\"> \u00e9 epidemiologicamente frequente e clinicamente complexa, exigindo rastreio intensivo, diagn\u00f3stico cuidadoso e seguimento prolongado. A integra\u00e7\u00e3o dos cuidados de VIH e ISTs e a sensibiliza\u00e7\u00e3o das popula\u00e7\u00f5es de risco s\u00e3o fundamentais para o controlo simult\u00e2neo destas duas infe\u00e7\u00f5es.<\/span>\n<h2><b>Refer\u00eancias<\/b><\/h2>\n<a href=\"https:\/\/www.eacsociety.org\/guidelines\/eacs-guidelines\/\" rel=\"dofollow noopener\" target=\"_blank\">EACS Guidelines \u2014 Syphilis in People Living with HIV \u2014 European AIDS Clinical Society<\/a>\n\n<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.13420\" rel=\"dofollow noopener\" target=\"_blank\">BHIVA Guidelines for the Management of Syphilis in Adults with HIV \u2014 British HIV Association (HIV Medicine)<\/a>\n\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17443467\/\" rel=\"dofollow noopener\" target=\"_blank\">Syphilis and HIV Infection: An Update \u2014 Clinical Infectious Diseases<\/a>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Introdu\u00e7\u00e3o A coinfec\u00e7\u00e3o s\u00edfilis VIH \u00e9 uma realidade epidemiol\u00f3gica frequente, com at\u00e9 50 % dos casos de s\u00edfilis em homens que t\u00eam sexo com homens (HSH) ocorrendo em pessoas que vivem com VIH. A intera\u00e7\u00e3o entre as duas infe\u00e7\u00f5es \u00e9 bidirecional: a s\u00edfilis aumenta o risco de aquisi\u00e7\u00e3o e transmiss\u00e3o do VIH, e o VIH [&hellip;]<\/p>\n","protected":false},"author":13102,"featured_media":58245,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[59],"tags":[],"class_list":["post-58137","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-saude-sexual"],"jetpack_featured_media_url":"https:\/\/www.mediconanet.pt\/wp-content\/uploads\/2026\/03\/wpimage-id893sizeSlugfulllinkDestinationnone-figure-classwp-block-image-size-fullimg-srchttpscomprarcbdonline.ptwp-contentuploads202603unnamed-3.jpg-altFrasco-de-vidro-transparente-c-24.jpg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/posts\/58137","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/users\/13102"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/comments?post=58137"}],"version-history":[{"count":4,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/posts\/58137\/revisions"}],"predecessor-version":[{"id":58144,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/posts\/58137\/revisions\/58144"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/media\/58245"}],"wp:attachment":[{"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/media?parent=58137"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/categories?post=58137"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mediconanet.pt\/en\/wp-json\/wp\/v2\/tags?post=58137"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}