<![CDATA[Syphilis is treatable sexually transmitted infection caused by Treponema pallidum. "Late latent syphilis" is a term used to describe syphilis that shows serologic reactivity without any symptoms >1 year's duration. Both treponemal and non-treponemal laboratory serological tests are necessary for the diagnosis of syphilis. Hepatitis B and Hepatitis C share the same transmission routes as syphilis. The coinfection of HIV and HBV infection is a critical clinical concern, affect the choice of appropriate medications to minimize side effects and prevent severe complications due to the high rate of serological failure. A case was reported in 22-year-old male with RPR titer at 1:128 and reactive rapid TP test, who had history of a painless genital ulcer that healed spontaneously about a year ago. The patient also complained yellowing of the eyes and tea-colored urine, ocular examination showed icteric sclera. Laboratory tests indicated elevated transaminase levels, hyperbilirubinemia, reactive HBsAg result, and reactive anti-HIV test with CD4 count of 363. Consequently, the patient was diagnosed with late latent syphilis, newly diagnosed HIV stage I, and hepatitis B. Following treatment, the serological results showed a decrease in the VDRL titer. While both VDRL and RPR tests are valid, their quantitative results cannot be directly compared due to methodological differences and RPR titers slightly higher than VDRL titers.]]>
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