Natl Conf Hum Retroviruses Relat Infect (1st). 1993 Dec 12-16;:141.
There is a lack of data on the response to treatment of syphilis in
HIV-infected individuals. We retrospectively reviewed all medical
records of HIV-infected patients evaluated for neurosyphilis from August
1987 to October 1992 at the West Los Angeles VAMC. Twelve cases of
neurosyphilis (four symptomatic and eight asymptomatic) and seventeen
cases of late syphilis were found. Seven patients had a positive CSF
VDRL and five had presumed neurosyphilis based upon CSF pleocytosis and
elevated protein concentrations. Patients with symptomatic neurosyphilis
had higher peripheral RPR titers, lower CD4 cell counts, greater CSF
pleocytosis and protein concentrations than asymptomatic patients.
Patients with neurosyphilis had higher peripheral RPR titers and lower
CD4 cell counts than patients with late latent syphilis. All patients
with neurosyphilis had treatment with high-dose IV penicillin.
Post-treatment evaluation was performed on eleven of twelve patients
with neurosyphilis. All seven patients with neurosyphilis in whom
follow-up spinal fluid analysis was performed (10-36 months after
treatment) had resolution of their CSF abnormalities. Six of eleven
patients with neurosyphilis had at least a four-fold drop in peripheral
RPR titer. Follow-up evaluation was performed on thirteen of seventeen
patients with late latent syphilis. Seven of thirteen patients with late
latent syphilis had at least a four-fold drop in RPR titer, and five
became RPR nonreactive. However, six of thirteen with late syphilis
showed no change in RPR titer despite at least three doses of IM
benzathine penicillin (6-48 months after treatment).
Comparative Study Human HIV Infections/*COMPLICATIONS *Spinal
Puncture Syphilis/CEREBROSPINAL FLUID/COMPLICATIONS/*DRUG THERAPY
Syphilis Serodiagnosis ABSTRACT