In a study of patients with HIV and syphilis, greater immunosuppression at syphilis diagnosis was associated with the development of neurosyphilis and with serologic failure after adequate syphilis treatment. Conversely, potent ART reduced the likelihood of both outcomes.
Previous studies of HIV-infected patients with syphilis have shown that greater immunosuppression at the time of syphilis diagnosis increases both the risk for serologic failure after syphilis treatment and the risk for neurosyphilis. Now, investigators have corroborated these findings in an analysis of 180 patients in the Johns Hopkins HIV Clinical Cohort Study who contracted syphilis between 1990 and 2006 (251 cases total). Median follow-up was 5.3 years.
Forty patients developed neurosyphilis. Most were symptomatic at presentation (66%) and developed the neurosyphilis within 1 year of syphilis diagnosis (63%). Uveitis was the most common clinical presentation. Symptomatic patients tended to have lower CD4 counts at presentation than did a…
Reviewing Authors
DisclosuresGrant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; NIH/National Institute on Drug Abuse
Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes; Vaccines
Leadership Positions in Professional SocietiesInternational Antiviral Society–USA (Board of Directors); Infectious Diseases Society of America (Past President)
DisclosuresGrant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; NIH/National Institute on Drug Abuse
Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes; Vaccines
Leadership Positions in Professional SocietiesInternational Antiviral Society–USA (Board of Directors); Infectious Diseases Society of America (Past President)