To the Editor: The reports by Gordon et al. and Horowitz et al. (Dec. 1 issue)1,2 appropriately question the effectiveness of high-dose penicillin as a treatment for syphilis in persons infected with the human immunodeficiency virus (HIV). However, these reports do not prove that such treatment is ineffective. The polymerase-chain-reaction (PCR) tests used do not necessarily indicate the presence of replicating organisms. In addition, an immunologic marker, especially a nonspecific one such as the Venereal Disease Research Laboratory (VDRL) or rapid plasma reagin titer, cannot be relied on to indicate successful treatment in persons who are immunologically dysfunctional. Patients.
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