Clinical Features and Corrected Factors with Neurosyphilis in HIV/Syphilis Co-Infected Patients Based on Stage of Syphilis  

作　　者：Yuan-Yuan Wang Mei Shi Zhi-Fang Guan Lei Zhang Xin Gu Hai-Kong Lu Teng-Fei Qi Li-Yan Ni Juan Wu Wei Zhao Rui-Rui Peng Lin Zhu Ping-Yu Zhou 

机构地区：[1]Sexually Transmitted Disease Institute,Shanghai Skin Disease Hospital,Clinical School of Anhui Medical University,Shanghai 200050,China [2]Sexually Transmitted Disease Institute,Shanghai Skin Disease Hospital,Tongji University,School of Medicine,Shanghai 200050,China [3]China-Australia Joint Research Center for Infectious Diseases,School of Public Health,Xi’an Jiaotong University Health Science Centre,Xi’an,Shaanxi 710049,China [4]Melbourne Sexual Health Centre,Alfred Health,Melbourne 3800,Australia [5]Central Clinical School,Faculty of Medicine,Nursing and Health Sciences,Monash University,Melbourne 3800,Australia [6]Department of Epidemiology and Biostatistics,College of Public Health,Zhengzhou University,Zhengzhou,Henan 450001,China.

出　　处：《International Journal of Dermatology and Venereology》2022年第2期61-67,共7页国际皮肤性病学杂志（英文）

基　　金：This work was supported by grants from the National Natural Science Foundation of China(Nos.81301374 and 82072322);Shanghai Municipal Commission of Health and Family Planning(No.20184Y0225);Shanghai Committee of Science and Technology(Nos.YDZX20193100002868 and 17DZ2293300);National Megaprojecton on Key Infectious Diseases(No.2017ZX10202102-001-007).

摘　　要：Objective: Neurosyphilis is challenging to diagnose, especially in patients with human immunodeficiency virus (HIV)/syphilis co-infection. The aim of this study was to profile the clinical features of neurosyphilis and evaluate the correlation between neurosyphilis and clinical or laboratory factors among patients with HIV/syphilis co-infection.Methods: We retrospectively analyzed the data of 479 HIV/syphilis co-infected patients examined between August 2009 and September 2018. A multivariate logistic regression model was used to identify factors correlated with neurosyphilis.Results: The overall prevalence of neurosyphilis was 21.7%. The prevalence of neurosyphilis differed among patients with primary (11.1%), secondary (20.1%), and latent syphilis (29.1%). The prevalences of neurosyphilis in patients with serological non-response and serofast patients were 26.1% and 6.3%, respectively, while 12.5% of patients with serological relapse had neurosyphilis. Patients with secondary and latent syphilis had serum rapid plasma reagin (RPR) titers (per unit) of 1.44-fold [95% confidence interval (CI): 1.08-1.93,P= 0.014] and 2.73-fold (95%CI: 1.49-5.00,P= 0.001), respectively, which increased the risk of confirmed neurosyphilis. Among patients with latent syphilis, a serum RPR titer of ≥1:32 and peripheral blood CD4 cell count of ≤350/mL were significantly associated with neurosyphilis, with adjusted odds ratios of 9.45 (95%CI: 1.86-48.03,P= 0.007) and 3.75 (95%CI: 1.11-12.66,P= 0.033), respectively.Conclusion: A serum RPR titer of ≥1:32 and a peripheral blood CD4 cell count of ≤350/mL have predictive value in screening for neurosyphilis among HIV-positive patients with latent syphilis.

关 键 词：human immunodeficiency virus SYPHILIS NEUROSYPHILIS correlated factors 

分 类 号：R512.91[医药卫生—内科学] R759.1[医药卫生—临床医学]