Skip to main content
Erschienen in:

12.03.2024

Cerebrospinal Fluid Biomarkers of Symptomatic Neurosyphilis in People With HIV Compared with Uninfected Individuals

verfasst von: Sérgio Monteiro de Almeida, José Tresoldi Neto, Amanda Rocha, Ana Medeiros, Debora Gonçalves, Fausto Guimarães

Erschienen in: Journal of NeuroVirology | Ausgabe 2/2024

Einloggen, um Zugang zu erhalten

Abstract

We evaluated the diagnostic clinical performance characteristics (DCPC) of cerebrospinal fluid (CSF) total protein (TP), white blood cell count (WBC), and lactate (LA) with different cutoff points as adjunct biomarkers of confirmed or presumptive symptomatic neurosyphilis (NS) and the impact of HIV infection. From 5,640 participants who underwent lumbar punctures, 236 participants were included, and classified as either people with HIV (PWH) or people without HIV (PWoH) according to the CDC criteria for confirmed NS (n = 42), presumptive NS (n = 74), systemic syphilis (SS) (n = 38), serological diagnosis of syphilis (n = 18), PWH without SS and NS (n = 10), and negative control (n = 72). In PWoH, for presumptive NS, the combination of CSF TP > 45 mg/dL and/or WBC > 5.0 cells/mm3 is valuable for screening, whereas in PWH, it is not recommended for either screening or case-finding NS, however the DCPC were better in the suppressed group. In PWoH, the value of CSF TP > 45 mg/dL is adequate for both screening and confirmation of presumptive NS, subject to prevalence. For WBC count > 20 cell/mm3, the positive predictive value (PPV) of the test is almost perfect, suggesting a confirmatory test. In PWH, CSF TP is an inadequate marker of NS. The WBC count, with cutoffs of > 10 or > 20 cells/mm3, was moderately applicable for screening.
As conclusions: CSF WBC count and TP showed distinct DCPC in confirmed or presumptive NS, better in the former. These biomarkers could be included for presumptive NS diagnosis. DCPC of these biomarkers for the diagnosis of NS is greatly affected by HIV co-infection.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
Zurück zum Zitat Akobeng AK (2007a) Understanding diagnostic tests 2: likelihood ratios, pre- and post-test probabilities and their use in clinical practice. Acta Paediatr 96:487–491PubMedCrossRef Akobeng AK (2007a) Understanding diagnostic tests 2: likelihood ratios, pre- and post-test probabilities and their use in clinical practice. Acta Paediatr 96:487–491PubMedCrossRef
Zurück zum Zitat Akobeng AK (2007b) Understanding diagnostic tests 3: receiver operating characteristic curves. Acta Paediatr 96:644–647PubMedCrossRef Akobeng AK (2007b) Understanding diagnostic tests 3: receiver operating characteristic curves. Acta Paediatr 96:644–647PubMedCrossRef
Zurück zum Zitat Boog GHP, Lopes JVZ, Mahler JV, Solti M, Kawahara LT, Teng AK, Munhoz JVT, Levin AS (2021) Diagnostic tools for neurosyphilis: a systematic review. BMC Infect Dis 21:1–12CrossRef Boog GHP, Lopes JVZ, Mahler JV, Solti M, Kawahara LT, Teng AK, Munhoz JVT, Levin AS (2021) Diagnostic tools for neurosyphilis: a systematic review. BMC Infect Dis 21:1–12CrossRef
Zurück zum Zitat Brasil Ministério da Saúde (2018) Protocolo Clínico e Diretrizes Terapêuticas para Manejo da Infecção pelo HIV em Adultos / Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Vigilância, Prevenção e Controle das Infecções Sexualmente Transmissíveis. Available from: http://www.aids.gov.br/assistencia/manualdst/item12.html. (consulted 02/23/2024). Brasil Ministério da Saúde (2018) Protocolo Clínico e Diretrizes Terapêuticas para Manejo da Infecção pelo HIV em Adultos / Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Vigilância, Prevenção e Controle das Infecções Sexualmente Transmissíveis. Available from: http://​www.​aids.​gov.​br/​assistencia/​manualdst/​item12.​html. (consulted 02/23/2024).
Zurück zum Zitat de Almeida SM, Bhatt A, Riggs PK, Durelle J, Lazzaretto D, Marquie-Beck J, McCutchan A, Letendre S, Ellis R (2010) Cerebrospinal fluid human immunodeficiency virus viral load in patients with neurosyphilis. J Neurovirol 16:6–12PubMedPubMedCentralCrossRef de Almeida SM, Bhatt A, Riggs PK, Durelle J, Lazzaretto D, Marquie-Beck J, McCutchan A, Letendre S, Ellis R (2010) Cerebrospinal fluid human immunodeficiency virus viral load in patients with neurosyphilis. J Neurovirol 16:6–12PubMedPubMedCentralCrossRef
Zurück zum Zitat de Almeida SM, Barros N, Fernandes Dos Santos A, Custodio G, Petterle RR, Nogueira K, Nogueira MB (2020a) Clinical performance of amperometry compared with enzymatic ultra violet method for lactate quantification in cerebrospinal fluid. Diagnosis 8:510–514PubMedCrossRef de Almeida SM, Barros N, Fernandes Dos Santos A, Custodio G, Petterle RR, Nogueira K, Nogueira MB (2020a) Clinical performance of amperometry compared with enzymatic ultra violet method for lactate quantification in cerebrospinal fluid. Diagnosis 8:510–514PubMedCrossRef
Zurück zum Zitat de Almeida SM, Kussen GB, Cogo LL, Nogueira K (2022) Cerebrospinal fluid lactate as a predictive biomarker for tuberculous meningitis diagnosis. Diagnosis 10:130–139PubMedCrossRef de Almeida SM, Kussen GB, Cogo LL, Nogueira K (2022) Cerebrospinal fluid lactate as a predictive biomarker for tuberculous meningitis diagnosis. Diagnosis 10:130–139PubMedCrossRef
Zurück zum Zitat de Almeida SM, Rotta I, de Pereira AP, Tang B, Umlauf A, Ribeiro CEL, Letendre S, Ellis RJ; HIV Neurobehavioral Research Center (HNRC) Group (2020b) Cerebrospinal fluid pleocytosis as a predictive factor for CSF and plasma HIV RNA discordance and escape. J Neurovirol 26:241–251CrossRef de Almeida SM, Rotta I, de Pereira AP, Tang B, Umlauf A, Ribeiro CEL, Letendre S, Ellis RJ; HIV Neurobehavioral Research Center (HNRC) Group (2020b) Cerebrospinal fluid pleocytosis as a predictive factor for CSF and plasma HIV RNA discordance and escape. J Neurovirol 26:241–251CrossRef
Zurück zum Zitat Deisenhammer F, Bartos A, Egg R, Gilhus NE, Giovannoni G, Rauer S, Sellebjerg F (2006) Guidelines on routine cerebrospinal fluid analysis. Report from an EFNS task force. Eur J Neurol 13:913–922PubMedCrossRef Deisenhammer F, Bartos A, Egg R, Gilhus NE, Giovannoni G, Rauer S, Sellebjerg F (2006) Guidelines on routine cerebrospinal fluid analysis. Report from an EFNS task force. Eur J Neurol 13:913–922PubMedCrossRef
Zurück zum Zitat Dumaresq J, Langevin S, Gagnon S, Serhir B, Deligne B, Tremblay C, Tsang RSW, Fortin C, Coutlee F, Roger M (2013) Clinical Prediction and Diagnosis of Neurosyphilis in HIV-Infected Patients with Early Syphilis. J Clin Microbiol 51:4060–4066PubMedPubMedCentralCrossRef Dumaresq J, Langevin S, Gagnon S, Serhir B, Deligne B, Tremblay C, Tsang RSW, Fortin C, Coutlee F, Roger M (2013) Clinical Prediction and Diagnosis of Neurosyphilis in HIV-Infected Patients with Early Syphilis. J Clin Microbiol 51:4060–4066PubMedPubMedCentralCrossRef
Zurück zum Zitat Dunaway SB, Maxwell CL, Tantalo LC, Sahi SK, Marra CM (2020) Neurosyphilis Treatment Outcomes After Intravenous Penicillin G Versus Intramuscular Procaine Penicillin Plus Oral Probenecid. Clin Infect Dis 71:267–273PubMedCrossRef Dunaway SB, Maxwell CL, Tantalo LC, Sahi SK, Marra CM (2020) Neurosyphilis Treatment Outcomes After Intravenous Penicillin G Versus Intramuscular Procaine Penicillin Plus Oral Probenecid. Clin Infect Dis 71:267–273PubMedCrossRef
Zurück zum Zitat Fan L, Yu A, Zhang D, Wang Z, Ma P (2021) Consequences of HIV/Syphilis Co-Infection on HIV Viral Load and Immune Response to Antiretroviral Therapy. Infect Drug Resist 14:2851–2862PubMedPubMedCentralCrossRef Fan L, Yu A, Zhang D, Wang Z, Ma P (2021) Consequences of HIV/Syphilis Co-Infection on HIV Viral Load and Immune Response to Antiretroviral Therapy. Infect Drug Resist 14:2851–2862PubMedPubMedCentralCrossRef
Zurück zum Zitat Feraru ER, Aronow HA, Lipton RB (1990) Neurosyphilis in AIDS patients: initial CSF VDRL may be negative. Neurology 40:541–543PubMedCrossRef Feraru ER, Aronow HA, Lipton RB (1990) Neurosyphilis in AIDS patients: initial CSF VDRL may be negative. Neurology 40:541–543PubMedCrossRef
Zurück zum Zitat French P, Gomberg M, Janier M, Schmidt BL, van Voorst Vader PC, Young H (2009) IUSTI: 2008 European Guidelines on the Management of Syphilis. Int J STD AIDS 20:300–309PubMedCrossRef French P, Gomberg M, Janier M, Schmidt BL, van Voorst Vader PC, Young H (2009) IUSTI: 2008 European Guidelines on the Management of Syphilis. Int J STD AIDS 20:300–309PubMedCrossRef
Zurück zum Zitat Ghanem KG, Moore RD, Rompalo AM, Erbelding EJ, Zenilman JM, Gebo KA (2008) Neurosyphilis in a clinical cohort of HIV-1-infected patients. AIDS 22:1145–1151PubMedCrossRef Ghanem KG, Moore RD, Rompalo AM, Erbelding EJ, Zenilman JM, Gebo KA (2008) Neurosyphilis in a clinical cohort of HIV-1-infected patients. AIDS 22:1145–1151PubMedCrossRef
Zurück zum Zitat Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PMM (2003) The diagnostic odds ratio: A single indicator of test performance. J Clin Epidemiol 56:1129–1135PubMedCrossRef Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PMM (2003) The diagnostic odds ratio: A single indicator of test performance. J Clin Epidemiol 56:1129–1135PubMedCrossRef
Zurück zum Zitat Guarner J, Jost H, Pillay A, Sun Y, Cox D, Notenboom R, Workowski K (2015) Evaluation of Treponemal Serum Tests Performed on Cerebrospinal Fluid for Diagnosis of Neurosyphilis. Am J Clin Pathol 143:479–484PubMedCrossRef Guarner J, Jost H, Pillay A, Sun Y, Cox D, Notenboom R, Workowski K (2015) Evaluation of Treponemal Serum Tests Performed on Cerebrospinal Fluid for Diagnosis of Neurosyphilis. Am J Clin Pathol 143:479–484PubMedCrossRef
Zurück zum Zitat He C, Kong Q, Shang X, Duan Y, Cui Y, Wang J, Ci C, Sang H (2021) Clinical, laboratory and brain Magnetic Resonance Imaging (MRI) characteristics of asymptomatic and symptomatic HIV-negative neurosyphilis patients. J Infect Chemother 27:1596–1601PubMedCrossRef He C, Kong Q, Shang X, Duan Y, Cui Y, Wang J, Ci C, Sang H (2021) Clinical, laboratory and brain Magnetic Resonance Imaging (MRI) characteristics of asymptomatic and symptomatic HIV-negative neurosyphilis patients. J Infect Chemother 27:1596–1601PubMedCrossRef
Zurück zum Zitat Izzat NN, Bartruff JK, Glicksman JM, Holder WR, Knox JM (1971) Validity of the VDRL test on cerebrospinal fluid contaminated by blood. Br J Vener Dis 47:162–164PubMedPubMedCentral Izzat NN, Bartruff JK, Glicksman JM, Holder WR, Knox JM (1971) Validity of the VDRL test on cerebrospinal fluid contaminated by blood. Br J Vener Dis 47:162–164PubMedPubMedCentral
Zurück zum Zitat Jiang Y, Weng R, Zhang Y, Fan R, Liu Y, Chen Z, Peng F, Chen Y, Chen X (2018) The performance of rapid plasma reagin (RPR) titer in HIV-negative general paresis after neurosyphilis therapy. BMC Infect Dis 18:144–149 Jiang Y, Weng R, Zhang Y, Fan R, Liu Y, Chen Z, Peng F, Chen Y, Chen X (2018) The performance of rapid plasma reagin (RPR) titer in HIV-negative general paresis after neurosyphilis therapy. BMC Infect Dis 18:144–149
Zurück zum Zitat Klein M, Angstwurm K, Esser S, Hahn K, Maschke M, Scheithauer S, Schoefer H, Sturzenegger M, Wildemann B, Weber J (2020) German guidelines on the diagnosis and treatment of neurosyphilis. Neurol Res Pract 2:1–9CrossRef Klein M, Angstwurm K, Esser S, Hahn K, Maschke M, Scheithauer S, Schoefer H, Sturzenegger M, Wildemann B, Weber J (2020) German guidelines on the diagnosis and treatment of neurosyphilis. Neurol Res Pract 2:1–9CrossRef
Zurück zum Zitat Lee SY, Cheng V, Rodger D, Rao N (2015) Clinical and laboratory characteristics of ocular syphilis: a new face in the era of HIV co-infection. J Ophthalmic Inflamm Infect 5:56PubMedCrossRef Lee SY, Cheng V, Rodger D, Rao N (2015) Clinical and laboratory characteristics of ocular syphilis: a new face in the era of HIV co-infection. J Ophthalmic Inflamm Infect 5:56PubMedCrossRef
Zurück zum Zitat Li W, Jiang M, Xu D, Kou C, Zhang L, Gao J, Qin K, Wu W, Zhang X (2019) Clinical and Laboratory Characteristics of Symptomatic and Asymptomatic Neurosyphilis in HIV-Negative Patients: A Retrospective Study of 264 Cases. Biomed Res Int 2019:2426313PubMedPubMedCentral Li W, Jiang M, Xu D, Kou C, Zhang L, Gao J, Qin K, Wu W, Zhang X (2019) Clinical and Laboratory Characteristics of Symptomatic and Asymptomatic Neurosyphilis in HIV-Negative Patients: A Retrospective Study of 264 Cases. Biomed Res Int 2019:2426313PubMedPubMedCentral
Zurück zum Zitat Lin LR, Zhang HL, Huang SJ, Zeng YL, Xi Y, Guo XJ, Liu GL, Tong ML, Zheng WH, Liu LL, Yang TC (2014) Psychiatric manifestations as primary symptom of neurosyphilis among HIV-negative patients. J Neuropsychiatry Clin Neurosci 26:233–240PubMedCrossRef Lin LR, Zhang HL, Huang SJ, Zeng YL, Xi Y, Guo XJ, Liu GL, Tong ML, Zheng WH, Liu LL, Yang TC (2014) Psychiatric manifestations as primary symptom of neurosyphilis among HIV-negative patients. J Neuropsychiatry Clin Neurosci 26:233–240PubMedCrossRef
Zurück zum Zitat Lin LR, Lin DH, Tong ML, Liu LL, Fan JY, Zhu XZ, Gao K, Chen MJ, Zheng WH, Zhang HL, Li SL, Lin HL, Lin ZF, Niu JJ, Yang TC (2016) Macrophage migration inhibitory factor as a novel cerebrospinal fluid marker for neurosyphilis among HIV-negative patients. Clin Chim Acta 463:103–108PubMedCrossRef Lin LR, Lin DH, Tong ML, Liu LL, Fan JY, Zhu XZ, Gao K, Chen MJ, Zheng WH, Zhang HL, Li SL, Lin HL, Lin ZF, Niu JJ, Yang TC (2016) Macrophage migration inhibitory factor as a novel cerebrospinal fluid marker for neurosyphilis among HIV-negative patients. Clin Chim Acta 463:103–108PubMedCrossRef
Zurück zum Zitat Liu LL, Zhang HL, Huang SJ, Liu L, Tong ML, Lin LR, Chen YY, Xi Y, Guo XJ, Zhang YF, Zhang Q, Zheng WH, Chen FY, Jiang J, Yang TC (2013) Assessing cerebrospinal fluid abnormalities in neurosyphilis patients without human immunodeficiency virus infection. Int Immunopharmacol 17:1120–1124PubMedCrossRef Liu LL, Zhang HL, Huang SJ, Liu L, Tong ML, Lin LR, Chen YY, Xi Y, Guo XJ, Zhang YF, Zhang Q, Zheng WH, Chen FY, Jiang J, Yang TC (2013) Assessing cerebrospinal fluid abnormalities in neurosyphilis patients without human immunodeficiency virus infection. Int Immunopharmacol 17:1120–1124PubMedCrossRef
Zurück zum Zitat Marks M, Lawrence D, Kositz C, Mabey D (2018) Diagnostic performance of PCR assays for the diagnosis of neurosyphilis: a systematic review. Sex Transm Infect 94:585–588PubMedCrossRef Marks M, Lawrence D, Kositz C, Mabey D (2018) Diagnostic performance of PCR assays for the diagnosis of neurosyphilis: a systematic review. Sex Transm Infect 94:585–588PubMedCrossRef
Zurück zum Zitat Marra CM (2007) Déjà Vu all over again: When to perform a lumbar puncture in HIV-infected patients with syphilis. Sex Transm Dis 34:145–146PubMedCrossRef Marra CM (2007) Déjà Vu all over again: When to perform a lumbar puncture in HIV-infected patients with syphilis. Sex Transm Dis 34:145–146PubMedCrossRef
Zurück zum Zitat Marra CM (2015) Neurosyphilis Continuum (minneap Minn) 21:1714–1728PubMed Marra CM (2015) Neurosyphilis Continuum (minneap Minn) 21:1714–1728PubMed
Zurück zum Zitat Marra CM, Gary DW, Kuypers J, Jacobson MA (1996) Diagnosis of Neurosyphilis in Patients Infected with Human Immunodeficiency Virus Type 1. J Infect Dis 174:219–221PubMedCrossRef Marra CM, Gary DW, Kuypers J, Jacobson MA (1996) Diagnosis of Neurosyphilis in Patients Infected with Human Immunodeficiency Virus Type 1. J Infect Dis 174:219–221PubMedCrossRef
Zurück zum Zitat Marshall DW, Brey RL, Cahill WT, Houk RW, Zajac RA, Boswell RN (1988) Spectrum of cerebrospinal fluid findings in various stages of human immunodeficiency virus infection. Arch Neurol 45:954–958 Marshall DW, Brey RL, Cahill WT, Houk RW, Zajac RA, Boswell RN (1988) Spectrum of cerebrospinal fluid findings in various stages of human immunodeficiency virus infection. Arch Neurol 45:954–958
Zurück zum Zitat Matthews BW (1975) Comparison of the predicted and observed secondary structure of T4 phage lysozyme. Biochim Biophys Acta 405:442–451PubMedCrossRef Matthews BW (1975) Comparison of the predicted and observed secondary structure of T4 phage lysozyme. Biochim Biophys Acta 405:442–451PubMedCrossRef
Zurück zum Zitat Mitchell AJ (2008) The clinical significance of subjective memory complaints in the diagnosis of mild cognitive impairment and dementia: a meta-analysis. Int J Geriatr Psychiatry 23:1191–1202PubMedCrossRef Mitchell AJ (2008) The clinical significance of subjective memory complaints in the diagnosis of mild cognitive impairment and dementia: a meta-analysis. Int J Geriatr Psychiatry 23:1191–1202PubMedCrossRef
Zurück zum Zitat Mitchell AJ (2011) Sensitivity × PPV is a recognized test called the clinical utility index (CUI+). Eur J Epidemiol 26:251–252PubMedCrossRef Mitchell AJ (2011) Sensitivity × PPV is a recognized test called the clinical utility index (CUI+). Eur J Epidemiol 26:251–252PubMedCrossRef
Zurück zum Zitat Palacios R, Jiménez-Oñate F, Aguilar M, Galindo MJ, Rivas P, Ocampo A, Berenguer J, Arranz JA, Ríos MJ, Knobel H, Moreno F, Ena J, Santos J (2007) Impact of syphilis infection on HIV viral load and CD4 cell counts in HIV-infected patients. J Acquir Immune Defic Syndr 44:356–359PubMedCrossRef Palacios R, Jiménez-Oñate F, Aguilar M, Galindo MJ, Rivas P, Ocampo A, Berenguer J, Arranz JA, Ríos MJ, Knobel H, Moreno F, Ena J, Santos J (2007) Impact of syphilis infection on HIV viral load and CD4 cell counts in HIV-infected patients. J Acquir Immune Defic Syndr 44:356–359PubMedCrossRef
Zurück zum Zitat Pastuszczak M, Zeman J, Jaworek AK, Wojas-Pelc A (2013) Cerebrospinal Fluid Abnormalities in HIV-Negative Patients with Secondary and Early Latent Syphilis and Serum VDRL ≥ 1:32. Indian J Dermatol 58:325PubMedPubMedCentralCrossRef Pastuszczak M, Zeman J, Jaworek AK, Wojas-Pelc A (2013) Cerebrospinal Fluid Abnormalities in HIV-Negative Patients with Secondary and Early Latent Syphilis and Serum VDRL ≥ 1:32. Indian J Dermatol 58:325PubMedPubMedCentralCrossRef
Zurück zum Zitat Rotta O (2005) Serological diagnosis of syphilis. An Bras Dermatol 80:299–302CrossRef Rotta O (2005) Serological diagnosis of syphilis. An Bras Dermatol 80:299–302CrossRef
Zurück zum Zitat Salamano R, Ballesté R, Perna A, Rodriguez N, Lombardo D, García N, López P, Cappuccio P (2016) Cerebrospinal fluid examination may be useful in diagnosing neurosyphilis in asymptomatic HIV+ patients with syphilis. Arq Neuropsiquiatr 74:128–132PubMedCrossRef Salamano R, Ballesté R, Perna A, Rodriguez N, Lombardo D, García N, López P, Cappuccio P (2016) Cerebrospinal fluid examination may be useful in diagnosing neurosyphilis in asymptomatic HIV+ patients with syphilis. Arq Neuropsiquiatr 74:128–132PubMedCrossRef
Zurück zum Zitat Spudich SS, Nilsson AC, Lollo ND, Liegler TJ, Petropoulos CJ, Deeks SG, Paxinos EE, Price RW (2005) Cerebrospinal fluid HIV infection and pleocytosis: relation to systemic infection and antiretroviral treatment. BMC Infect Dis 5:98PubMedPubMedCentralCrossRef Spudich SS, Nilsson AC, Lollo ND, Liegler TJ, Petropoulos CJ, Deeks SG, Paxinos EE, Price RW (2005) Cerebrospinal fluid HIV infection and pleocytosis: relation to systemic infection and antiretroviral treatment. BMC Infect Dis 5:98PubMedPubMedCentralCrossRef
Zurück zum Zitat Tong ML, Liu LL, Zeng YL, Zhang HL, Liu GL, Zheng WH, Dong J, Wu JY, Su YH, Lin LR, Yang TC (2013) Laboratory findings in neurosyphilis patients with epileptic seizures alone as the initial presenting symptom. Diagn Microbiol Infect Dis 75:377–380PubMedCrossRef Tong ML, Liu LL, Zeng YL, Zhang HL, Liu GL, Zheng WH, Dong J, Wu JY, Su YH, Lin LR, Yang TC (2013) Laboratory findings in neurosyphilis patients with epileptic seizures alone as the initial presenting symptom. Diagn Microbiol Infect Dis 75:377–380PubMedCrossRef
Zurück zum Zitat Wharton M, Chorba TL, Vogt RL, Morse DL, Buehler JW (1990) Case definitions for public health surveillance. MMWR Recomm Rep 39:1–43PubMed Wharton M, Chorba TL, Vogt RL, Morse DL, Buehler JW (1990) Case definitions for public health surveillance. MMWR Recomm Rep 39:1–43PubMed
Zurück zum Zitat Workowski KA, Bolan GA (2015) Sexually Transmitted Diseases Treatment Guidelines, 2015. MMWR Recomm Rep 64:1–137PubMed Workowski KA, Bolan GA (2015) Sexually Transmitted Diseases Treatment Guidelines, 2015. MMWR Recomm Rep 64:1–137PubMed
Zurück zum Zitat Yu J, Shi JC, Wan H, Li J, Shao Y, Ye J, Dai L, Wang X, Liu A (2021) Clinical characteristics, diagnosis, and predictors of neurosyphilis patients with human immunodeficiency virus co-infection: A retrospective study at infectious diseases hospitals in two cities of China. Medicine 100:e27430PubMedPubMedCentralCrossRef Yu J, Shi JC, Wan H, Li J, Shao Y, Ye J, Dai L, Wang X, Liu A (2021) Clinical characteristics, diagnosis, and predictors of neurosyphilis patients with human immunodeficiency virus co-infection: A retrospective study at infectious diseases hospitals in two cities of China. Medicine 100:e27430PubMedPubMedCentralCrossRef
Zurück zum Zitat Zhu L, Gu X, Peng RR, Wang C, Gao Z, Zhou P, Gao Y, Shi M, Guan Z, Señac AC (2014) Comparison of the cerebrospinal fluid (CSF) toluidine red unheated serum test and the CSF rapid plasma reagin test with the CSF Venereal Disease Research Laboratory test for diagnosis of neurosyphilis among HIV-negative syphilis patients in China. J Clin Microbiol 52:736–740PubMedPubMedCentralCrossRef Zhu L, Gu X, Peng RR, Wang C, Gao Z, Zhou P, Gao Y, Shi M, Guan Z, Señac AC (2014) Comparison of the cerebrospinal fluid (CSF) toluidine red unheated serum test and the CSF rapid plasma reagin test with the CSF Venereal Disease Research Laboratory test for diagnosis of neurosyphilis among HIV-negative syphilis patients in China. J Clin Microbiol 52:736–740PubMedPubMedCentralCrossRef
Metadaten
Titel
Cerebrospinal Fluid Biomarkers of Symptomatic Neurosyphilis in People With HIV Compared with Uninfected Individuals
verfasst von
Sérgio Monteiro de Almeida
José Tresoldi Neto
Amanda Rocha
Ana Medeiros
Debora Gonçalves
Fausto Guimarães
Publikationsdatum
12.03.2024
Verlag
Springer International Publishing
Erschienen in
Journal of NeuroVirology / Ausgabe 2/2024
Print ISSN: 1355-0284
Elektronische ISSN: 1538-2443
DOI
https://doi.org/10.1007/s13365-024-01199-7

Kompaktes Leitlinien-Wissen Neurologie (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Neu im Fachgebiet Neurologie

Ehe schützt nicht vor Demenz

  • 25.04.2025
  • Demenz
  • Nachrichten

Eigentlich leben Verheiratete länger und gesünder. Eine aktuelle Untersuchung kommt jedoch zu dem überraschenden Schluss, dass sie eher an Demenz erkranken als nie Verheiratete, Geschiedene oder Verwitwete.

Lohnt sich die Karotis-Revaskularisation?

Die medikamentöse Therapie für Menschen mit Karotisstenosen hat sich in den vergangenen Dekaden verbessert. Braucht es also noch einen invasiven Eingriff zur Revaskularisation der Halsschlagader bei geringem bis moderatem Risiko für einen ipsilateralen Schlaganfall?

Neuartige Antikörpertherapie bremst MS über zwei Jahre hinweg

Eine Therapie mit dem C40-Ligand-Blocker Frexalimab kann MS-Schübe und neue MRT-Läsionen über zwei Jahre hinweg verhindern. Dafür spricht die Auswertung einer offen fortgeführten Phase-2-Studie.

Therapiestopp bei älteren MS-Kranken kann sich lohnen

Eine Analyse aus Kanada bestätigt: Setzen ältere MS-Kranke die Behandlung mit Basistherapeutika ab, müssen sie kaum mit neuen Schüben und MRT-Auffälligkeiten rechnen.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.