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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...

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Autores principales: Jiang, Ying, Weng, Ruihui, Zhang, Yuefeng, Fan, Rong, Liu, Yulun, Chen, Zhigang, Peng, Fuhua, Chen, Yong, Chen, Xiaohong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
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.
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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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