Seek Neurosyphilis Aggressively in HIV Patients

High rates of symptomatic neurosyphilis have been reported in patients with HIV infection, even after standard treatment for primary or secondary syphilis, but experts disagree . . .

High rates of symptomatic neurosyphilis have been reported in patients with HIV infection, even after standard treatment for primary or secondary syphilis, but experts disagree on the criteria that should prompt a proactive search for neurologic disease in patients with both infections.

A national consortium of researchers enrolled 326 patients with syphilis and a high clinical probability of neurosyphilis in a prospective trial of treatment efficacy. Most subjects were male and HIV-positive, which reflects current U.S. patterns of disease. We now have baseline data from the study, in which neurosyphilis was defined as white blood cell count >20/mm³ in cerebrospinal fluid or reactive CSF-VDRL result.

Neurosyphilis was found in about 16% of HI…

Reviewing Author

Abigail Zuger, MD