1. Clinical features associated with neurosyphilis in people living with HIV and late latent syphilis.
- Author
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Martínez-Ayala P, Quiñonez-Flores A, González-Hernández LA, Ruíz-Herrera VV, Zúñiga-Quiñones S, Alanis-Sánchez GA, Cabrera-Silva RI, Amador-Lara F, Sánchez-Reyes K, Álvarez-Zavala M, Vázquez-Limón JC, Sánchez-Navarro JP, and Andrade-Villanueva JF
- Subjects
- Humans, Retrospective Studies, Syphilis Serodiagnosis, HIV Infections complications, HIV Infections epidemiology, Neurosyphilis complications, Neurosyphilis diagnosis, Neurosyphilis epidemiology, Syphilis complications, Syphilis diagnosis, Syphilis epidemiology, Syphilis, Latent
- 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 1:32 ( p <0.01), 1:64 ( p = 0.055), and ≥1:128 ( p < 0.001) were associated with neurosyphilis. Furthermore, serum VDRL ≥1:32 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 ≤1:16 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 ≥1:32 increased the risk of neurosyphilis in patients with or without any symptoms.- Published
- 2022
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