Cargando…
The clinical and laboratory features of neurosyphilis in HIV-infected patients: A retrospective study in 92 patients
Neurosyphilis (NS) is an important component of central nervous system diseases among HIV-infected patients. However, its characteristics are not very clear. A retrospective analysis of clinical and laboratory findings was performed in 92 NS patients with HIV infection from a tertiary hospital in Sh...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851754/ https://www.ncbi.nlm.nih.gov/pubmed/29489672 http://dx.doi.org/10.1097/MD.0000000000010078 |
_version_ | 1783306450062278656 |
---|---|
author | Wang, Zhenyan Liu, Li Shen, Yin-Zhong Zhang, Ren-Fang Qi, Tang-Kai Tang, Yang Song, Wei Chen, Jun Lu, Hongzhou |
author_facet | Wang, Zhenyan Liu, Li Shen, Yin-Zhong Zhang, Ren-Fang Qi, Tang-Kai Tang, Yang Song, Wei Chen, Jun Lu, Hongzhou |
author_sort | Wang, Zhenyan |
collection | PubMed |
description | Neurosyphilis (NS) is an important component of central nervous system diseases among HIV-infected patients. However, its characteristics are not very clear. A retrospective analysis of clinical and laboratory findings was performed in 92 NS patients with HIV infection from a tertiary hospital in Shanghai, China. The patients had a median age of 38 years and a median CD4 count of 198 cells/μL. In all, 44.6% (41/92) were diagnosed as asymptomatic NS (ANS), 23.9% (22/92) as syphilitic meningitis, 17.4% (16/92) as cerebrovascular NS, and 14.1% (13/92) as parenchymal syphilis. A quarter of patients (23/92) complicated with ocular syphilis (OS), 60.9% (14/23) of which were ANS. The serum tolulized red unheated serum test (TRUST) titers were ≤1:8 in 15 patients (16.3%), 1:16–1:128 in 51 patients (55.4%), and ≥1:256 in 26 patients (28.3%). Sixty-nine patients (75.0%) had both cerebrospinal fluid (CSF) TRUST and Treponema pallidum particle assay reactive. CSF pleocytosis and protein elevation were found in 58.7% and 53.3% of patients, respectively. Syphilitic meningitis was more likely to present with CSF pleocytosis than ANS (P = .001), cerebrovascular NS (P < .001), and parenchymal NS (P < .001). The proportion of patients with CSF elevated protein was lower in ANS group than that in syphilitic meningitis (P = .003), cerebrovascular NS (P = .001), and parenchymal NS groups (P = .025), and was higher in sero-TRUST titers ≤1:8 group than that in 1:16–1:128 (P = .01) and 1:256–1:1024 groups (P = .005). This study revealed that ANS was the most common clinical type of NS in HIV-infected patients, which should be considered in HIV and syphilis co-infection patients without neurologic symptoms, especially in those with OS. Different patterns of NS might have different CSF features which may also vary with sero-TRUST titers. |
format | Online Article Text |
id | pubmed-5851754 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-58517542018-03-21 The clinical and laboratory features of neurosyphilis in HIV-infected patients: A retrospective study in 92 patients Wang, Zhenyan Liu, Li Shen, Yin-Zhong Zhang, Ren-Fang Qi, Tang-Kai Tang, Yang Song, Wei Chen, Jun Lu, Hongzhou Medicine (Baltimore) 4850 Neurosyphilis (NS) is an important component of central nervous system diseases among HIV-infected patients. However, its characteristics are not very clear. A retrospective analysis of clinical and laboratory findings was performed in 92 NS patients with HIV infection from a tertiary hospital in Shanghai, China. The patients had a median age of 38 years and a median CD4 count of 198 cells/μL. In all, 44.6% (41/92) were diagnosed as asymptomatic NS (ANS), 23.9% (22/92) as syphilitic meningitis, 17.4% (16/92) as cerebrovascular NS, and 14.1% (13/92) as parenchymal syphilis. A quarter of patients (23/92) complicated with ocular syphilis (OS), 60.9% (14/23) of which were ANS. The serum tolulized red unheated serum test (TRUST) titers were ≤1:8 in 15 patients (16.3%), 1:16–1:128 in 51 patients (55.4%), and ≥1:256 in 26 patients (28.3%). Sixty-nine patients (75.0%) had both cerebrospinal fluid (CSF) TRUST and Treponema pallidum particle assay reactive. CSF pleocytosis and protein elevation were found in 58.7% and 53.3% of patients, respectively. Syphilitic meningitis was more likely to present with CSF pleocytosis than ANS (P = .001), cerebrovascular NS (P < .001), and parenchymal NS (P < .001). The proportion of patients with CSF elevated protein was lower in ANS group than that in syphilitic meningitis (P = .003), cerebrovascular NS (P = .001), and parenchymal NS groups (P = .025), and was higher in sero-TRUST titers ≤1:8 group than that in 1:16–1:128 (P = .01) and 1:256–1:1024 groups (P = .005). This study revealed that ANS was the most common clinical type of NS in HIV-infected patients, which should be considered in HIV and syphilis co-infection patients without neurologic symptoms, especially in those with OS. Different patterns of NS might have different CSF features which may also vary with sero-TRUST titers. Wolters Kluwer Health 2018-03-02 /pmc/articles/PMC5851754/ /pubmed/29489672 http://dx.doi.org/10.1097/MD.0000000000010078 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 |
spellingShingle | 4850 Wang, Zhenyan Liu, Li Shen, Yin-Zhong Zhang, Ren-Fang Qi, Tang-Kai Tang, Yang Song, Wei Chen, Jun Lu, Hongzhou The clinical and laboratory features of neurosyphilis in HIV-infected patients: A retrospective study in 92 patients |
title | The clinical and laboratory features of neurosyphilis in HIV-infected patients: A retrospective study in 92 patients |
title_full | The clinical and laboratory features of neurosyphilis in HIV-infected patients: A retrospective study in 92 patients |
title_fullStr | The clinical and laboratory features of neurosyphilis in HIV-infected patients: A retrospective study in 92 patients |
title_full_unstemmed | The clinical and laboratory features of neurosyphilis in HIV-infected patients: A retrospective study in 92 patients |
title_short | The clinical and laboratory features of neurosyphilis in HIV-infected patients: A retrospective study in 92 patients |
title_sort | clinical and laboratory features of neurosyphilis in hiv-infected patients: a retrospective study in 92 patients |
topic | 4850 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851754/ https://www.ncbi.nlm.nih.gov/pubmed/29489672 http://dx.doi.org/10.1097/MD.0000000000010078 |
work_keys_str_mv | AT wangzhenyan theclinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT liuli theclinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT shenyinzhong theclinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT zhangrenfang theclinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT qitangkai theclinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT tangyang theclinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT songwei theclinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT chenjun theclinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT luhongzhou theclinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT wangzhenyan clinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT liuli clinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT shenyinzhong clinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT zhangrenfang clinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT qitangkai clinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT tangyang clinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT songwei clinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT chenjun clinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients AT luhongzhou clinicalandlaboratoryfeaturesofneurosyphilisinhivinfectedpatientsaretrospectivestudyin92patients |