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.

human immunodeficiency virus;syphilis;neurosyphilis;correlated factors

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

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

国际皮肤性病学杂志（英文）

[1]Wang Yuan-Yuan;Shi Mei;Guan Zhi-Fang;Zhang Lei;Gu Xin;Lu Hai-Kong;Qi Teng-Fei;Ni Li-Yan;Wu Juan;Zhao Wei;Peng Rui-Rui;Zhu Lin;Zhou Ping-Yu-.Clinical Features and Corrected Factors with Neurosyphilis in HIV/Syphilis Co-Infected Patients Based on Stage of Syphilis)[J].国际皮肤性病学杂志（英文）,2022(02):61-67

Neurosyphilis,neurosyphilis,serofast

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