OBJECTIVE: In a prospective study we evaluated longitudinal changes in serum- and CSF-antibody production against treponema pallidum following high dose antibiotic treatment in HIV seropositive homosexuals (HIVs) with neurosyphilis. METHODS: Nine HIVs were treated with high dose Penicillin for active neurosyphilis. Serologic tests in serum and CSF (VDRL, FTA-ABS-IgG, 19-S-IgM-FTA-ABS) were performed before and after antibiotic treatment. The data were correlated to clinical response and concurrent changes of CSF parameters (Cell count, protein, IgG-index and oligoclonal bands). RESULTS: Penicillin therapy induced transitory elevation of the VDRL in 4 of 9 patients. In another patient the CSF FTA-ABS-IgG became positive. All 5 patients improved clinically and pretreatment CSF pleocytosis (4 of 5) decreased (one normal CSF cell count remained unchanged). CONCLUSION: Transitory enhancement of treponemal antibody production can result from antibiotic therapy and may not represent treatment failure.

*Antibodies, Bacterial/BLOOD *HIV Infections/COMPLICATIONS *HIV Seropositivity/COMPLICATIONS *IgG/BLOOD *IgM/BLOOD *Neurosyphilis/DRUG THERAPY *Neurosyphilis/IMMUNOLOGY *Penicillins/THERAPEUTIC USE

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