Objective: Neurosyphilis is challenging to diagnose, especially in patients with human immunodeficiency virus (HIV)/syphilis co-infection. The aim of this study was to profile the clinical features of neurosyphilis an...Objective: Neurosyphilis is challenging to diagnose, especially in patients with human immunodeficiency virus (HIV)/syphilis co-infection. The aim of this study was to profile the clinical features of neurosyphilis and evaluate the correlation between neurosyphilis and clinical or laboratory factors among patients with HIV/syphilis co-infection.Methods: We retrospectively analyzed the data of 479 HIV/syphilis co-infected patients examined between August 2009 and September 2018. A multivariate logistic regression model was used to identify factors correlated with neurosyphilis.Results: The overall prevalence of neurosyphilis was 21.7%. The prevalence of neurosyphilis differed among patients with primary (11.1%), secondary (20.1%), and latent syphilis (29.1%). The prevalences of neurosyphilis in patients with serological non-response and serofast patients were 26.1% and 6.3%, respectively, while 12.5% of patients with serological relapse had neurosyphilis. Patients with secondary and latent syphilis had serum rapid plasma reagin (RPR) titers (per unit) of 1.44-fold [95% confidence interval (CI): 1.08-1.93,P= 0.014] and 2.73-fold (95%CI: 1.49-5.00,P= 0.001), respectively, which increased the risk of confirmed neurosyphilis. Among patients with latent syphilis, a serum RPR titer of ≥1:32 and peripheral blood CD4 cell count of ≤350/mL were significantly associated with neurosyphilis, with adjusted odds ratios of 9.45 (95%CI: 1.86-48.03,P= 0.007) and 3.75 (95%CI: 1.11-12.66,P= 0.033), respectively.Conclusion: A serum RPR titer of ≥1:32 and a peripheral blood CD4 cell count of ≤350/mL have predictive value in screening for neurosyphilis among HIV-positive patients with latent syphilis.展开更多
Introduction Syphilis is a sexually transmitted disease caused by Treponema pallidum (T.pallidum),and involves in almost all of the body.When the nervous and vision system[1] is involved,neurosyphilis occures.T.pallid...Introduction Syphilis is a sexually transmitted disease caused by Treponema pallidum (T.pallidum),and involves in almost all of the body.When the nervous and vision system[1] is involved,neurosyphilis occures.T.pallidum can invade any part of the neuraxis,and neurosyphilis can occur at any stage of syphilis.Neurosyphilis has been divided into five major categories,including asymptomatic meningeal,meningovascular,parenchymatous,and gummatous neurosyphilis[2].These entities represent a continuum and frequent overlap[4].展开更多
基金This work was supported by grants from the National Natural Science Foundation of China(Nos.81301374 and 82072322)Shanghai Municipal Commission of Health and Family Planning(No.20184Y0225)+1 种基金Shanghai Committee of Science and Technology(Nos.YDZX20193100002868 and 17DZ2293300)National Megaprojecton on Key Infectious Diseases(No.2017ZX10202102-001-007).
文摘Objective: Neurosyphilis is challenging to diagnose, especially in patients with human immunodeficiency virus (HIV)/syphilis co-infection. The aim of this study was to profile the clinical features of neurosyphilis and evaluate the correlation between neurosyphilis and clinical or laboratory factors among patients with HIV/syphilis co-infection.Methods: We retrospectively analyzed the data of 479 HIV/syphilis co-infected patients examined between August 2009 and September 2018. A multivariate logistic regression model was used to identify factors correlated with neurosyphilis.Results: The overall prevalence of neurosyphilis was 21.7%. The prevalence of neurosyphilis differed among patients with primary (11.1%), secondary (20.1%), and latent syphilis (29.1%). The prevalences of neurosyphilis in patients with serological non-response and serofast patients were 26.1% and 6.3%, respectively, while 12.5% of patients with serological relapse had neurosyphilis. Patients with secondary and latent syphilis had serum rapid plasma reagin (RPR) titers (per unit) of 1.44-fold [95% confidence interval (CI): 1.08-1.93,P= 0.014] and 2.73-fold (95%CI: 1.49-5.00,P= 0.001), respectively, which increased the risk of confirmed neurosyphilis. Among patients with latent syphilis, a serum RPR titer of ≥1:32 and peripheral blood CD4 cell count of ≤350/mL were significantly associated with neurosyphilis, with adjusted odds ratios of 9.45 (95%CI: 1.86-48.03,P= 0.007) and 3.75 (95%CI: 1.11-12.66,P= 0.033), respectively.Conclusion: A serum RPR titer of ≥1:32 and a peripheral blood CD4 cell count of ≤350/mL have predictive value in screening for neurosyphilis among HIV-positive patients with latent syphilis.
文摘Introduction Syphilis is a sexually transmitted disease caused by Treponema pallidum (T.pallidum),and involves in almost all of the body.When the nervous and vision system[1] is involved,neurosyphilis occures.T.pallidum can invade any part of the neuraxis,and neurosyphilis can occur at any stage of syphilis.Neurosyphilis has been divided into five major categories,including asymptomatic meningeal,meningovascular,parenchymatous,and gummatous neurosyphilis[2].These entities represent a continuum and frequent overlap[4].
