Maternal syphilis may increase HIV vertical transmission or it may be a marker of other risk factors. In a Brazilian historical series, HIV vertical transmission risk was higher in newborns exposed to maternal syphilis-HIV co-infection than in newborns exposed to maternal HIV infection alone. Maternal syphilis was a risk factor for HIV vertical transmission independent of education and prenatal visits but not independent of maternal elevated HIV viral loads or inadequate maternal antiretroviral treatment.
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