Clinical features associated with neurosyphilis in people living with HIV and late latent syphilis.
Int J STD AIDS
; 33(4): 330-336, 2022 03.
Article
in En
| MEDLINE
| ID: mdl-34978502
ABSTRACT
BACKGROUND:
The diagnosis of neurosyphilis is a challenge, and the criteria for deciding when to perform a lumbar puncture are still controversial, especially in people living with HIV with a late latent syphilis diagnosis.METHODS:
Retrospective analysis of demographic, clinical, and laboratory data of people with HIV and documented late latent syphilis or syphilis of unknown duration with a cerebrospinal fluid VDRL test.RESULTS:
122 patients were evaluated, of whom 52 had the diagnosis of neurosyphilis. Patients with and without neurosyphilis presented a similar viral load and lymphocyte CD4+ T-cell count. Neurological symptoms (OR 6.4, 95% CI 2.1-22.4; p < 0.01), serum VDRL titers of 132 (p<0.01), 164 (p = 0.055), and ≥1128 (p < 0.001) were associated with neurosyphilis. Furthermore, serum VDRL ≥132 were associated with (OR 24.9, 95% CI 5.45-154.9; p < 0.001) or without (OR 6.5, 95% CI 2.0-29.2; p = 0.004) neurological symptoms with neurosyphilis; however, VDRL ≤116 with neurological symptoms can be associated with neurosyphilis (OR 7.6, 95% CI 1.03-64.3; p = 0.046).CONCLUSION:
Neurological symptoms, particularly headache, were predictors of neurosyphilis in people with HIV irrespective of their viral load and lymphocyte CD4+ T-cell count in late latent syphilis. A serum VDRL ≥132 increased the risk of neurosyphilis in patients with or without any symptoms.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Syphilis, Latent
/
Syphilis
/
HIV Infections
/
Neurosyphilis
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Int J STD AIDS
Journal subject:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Year:
2022
Document type:
Article
Affiliation country:
Mexico