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The performance of rapid plasma reagin (RPR) titer in HIV-negative general paresis after neurosyphilis therapy
BACKGROUND: Repeated nontreponemal serologic test for syphilis titers is recommended to evaluate treatment response. However, it is unknown whether serum rapid plasma reagin (RPR) titer can serve as a surrogate for determining the efficacy of treatment in general paresis (GP) remains unknown. METHOD...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5879544/ https://www.ncbi.nlm.nih.gov/pubmed/29606102 http://dx.doi.org/10.1186/s12879-018-3062-4 |
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author | Jiang, Ying Weng, Ruihui Zhang, Yuefeng Fan, Rong Liu, Yulun Chen, Zhigang Peng, Fuhua Chen, Yong Chen, Xiaohong |
author_facet | Jiang, Ying Weng, Ruihui Zhang, Yuefeng Fan, Rong Liu, Yulun Chen, Zhigang Peng, Fuhua Chen, Yong Chen, Xiaohong |
author_sort | Jiang, Ying |
collection | PubMed |
description | BACKGROUND: Repeated nontreponemal serologic test for syphilis titers is recommended to evaluate treatment response. However, it is unknown whether serum rapid plasma reagin (RPR) titer can serve as a surrogate for determining the efficacy of treatment in general paresis (GP) remains unknown. METHODS: We retrospectively reviewed data from 105 GP patients, who were divided into two groups (62 CSF RPR+ patients and 43 CSF RPR- patients) according to reactive RPR test status in CSF. Clinical assessment included the Mini-Mental State Examination (MMSE) scores, CSF examinations (WBC count, protein concentration and RPR titer), and serum tests (RPR titer and TPPA). Among the 105 GP patients, 13 CSF RPR+ patients and 6 CSF RPR- patients had a 12 months follow-up of CSF, serum measures and MMSE. RESULTS: The median serum RPR titer was significantly higher in CSF RPR+ patients than that in CSF RPR- GP patients, 1:8 [IQR 1:4–1:32] vs. 1:4 [IQR 1:4–1:8] (P < 0.001). The number of CSF RPR+ patients with serum RPR titer≥1:32 was significantly higher when compared with CSF RPR- patients (P = 0.001). For CSF RPR+ patients, the MMSE scores improved or remained constantly after penicillin treatment. For CSF RPR+ patients, the CSF RPR titer declined four-fold in 85% (11/13) of the patients, whereas the serum RPR titer declined four-fold in only 46% (6/13) of the patients, the odds ratio is 6.4 (95% confidence interval 1.0–41.2). CONCLUSIONS: A four-fold decline in CSF RPR titer is a good predictor for treatment efficacy in CSF RPR+ GP patients within 12 months after the completion of therapy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12879-018-3062-4) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5879544 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-58795442018-04-04 The performance of rapid plasma reagin (RPR) titer in HIV-negative general paresis after neurosyphilis therapy Jiang, Ying Weng, Ruihui Zhang, Yuefeng Fan, Rong Liu, Yulun Chen, Zhigang Peng, Fuhua Chen, Yong Chen, Xiaohong BMC Infect Dis Research Article BACKGROUND: Repeated nontreponemal serologic test for syphilis titers is recommended to evaluate treatment response. However, it is unknown whether serum rapid plasma reagin (RPR) titer can serve as a surrogate for determining the efficacy of treatment in general paresis (GP) remains unknown. METHODS: We retrospectively reviewed data from 105 GP patients, who were divided into two groups (62 CSF RPR+ patients and 43 CSF RPR- patients) according to reactive RPR test status in CSF. Clinical assessment included the Mini-Mental State Examination (MMSE) scores, CSF examinations (WBC count, protein concentration and RPR titer), and serum tests (RPR titer and TPPA). Among the 105 GP patients, 13 CSF RPR+ patients and 6 CSF RPR- patients had a 12 months follow-up of CSF, serum measures and MMSE. RESULTS: The median serum RPR titer was significantly higher in CSF RPR+ patients than that in CSF RPR- GP patients, 1:8 [IQR 1:4–1:32] vs. 1:4 [IQR 1:4–1:8] (P < 0.001). The number of CSF RPR+ patients with serum RPR titer≥1:32 was significantly higher when compared with CSF RPR- patients (P = 0.001). For CSF RPR+ patients, the MMSE scores improved or remained constantly after penicillin treatment. For CSF RPR+ patients, the CSF RPR titer declined four-fold in 85% (11/13) of the patients, whereas the serum RPR titer declined four-fold in only 46% (6/13) of the patients, the odds ratio is 6.4 (95% confidence interval 1.0–41.2). CONCLUSIONS: A four-fold decline in CSF RPR titer is a good predictor for treatment efficacy in CSF RPR+ GP patients within 12 months after the completion of therapy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12879-018-3062-4) contains supplementary material, which is available to authorized users. BioMed Central 2018-04-02 /pmc/articles/PMC5879544/ /pubmed/29606102 http://dx.doi.org/10.1186/s12879-018-3062-4 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Jiang, Ying Weng, Ruihui Zhang, Yuefeng Fan, Rong Liu, Yulun Chen, Zhigang Peng, Fuhua Chen, Yong Chen, Xiaohong The performance of rapid plasma reagin (RPR) titer in HIV-negative general paresis after neurosyphilis therapy |
title | The performance of rapid plasma reagin (RPR) titer in HIV-negative general paresis after neurosyphilis therapy |
title_full | The performance of rapid plasma reagin (RPR) titer in HIV-negative general paresis after neurosyphilis therapy |
title_fullStr | The performance of rapid plasma reagin (RPR) titer in HIV-negative general paresis after neurosyphilis therapy |
title_full_unstemmed | The performance of rapid plasma reagin (RPR) titer in HIV-negative general paresis after neurosyphilis therapy |
title_short | The performance of rapid plasma reagin (RPR) titer in HIV-negative general paresis after neurosyphilis therapy |
title_sort | performance of rapid plasma reagin (rpr) titer in hiv-negative general paresis after neurosyphilis therapy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5879544/ https://www.ncbi.nlm.nih.gov/pubmed/29606102 http://dx.doi.org/10.1186/s12879-018-3062-4 |
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