Date Published:
2013 May
Publication Type:
Journal Article
Authors:
Secondary:
Int J STD AIDS
Volume:
24
Pagination:
351-5
Issue:
5
PMID:
23970701
URL:
https://pubmed.ncbi.nlm.nih.gov/23970701
Keywords:
Adult;Case-Control Studies;CHARTER;Cognition Disorders;Female;Fluorescent Treponemal Antibody-Absorption Test;HIV Infections;Humans;Internal;Male;Middle Aged;Neuropsychological Tests;Neurosyphilis;Prospective Studies;Syphilis;Syphilis Serodiagnosis;Treponema pallidum
Abstract:
<p>Cognitive impairment is common in HIV-infected individuals, as is syphilis. Treponema pallidum, the bacterium that causes syphilis, invades the central nervous system early in disease. We hypothesized that HIV-infected patients with a history of syphilis or neurosyphilis would have more cognitive impairment than HIV-infected individuals without these infections. Eighty-two of 1574 enrollees in CHARTER, a prospective, observational study, had reactive serum rapid plasma reagin (RPR) tests. They were matched to 84 controls with non-reactive RPR by age, gender, ethnicity and HIV risk factor. Participants underwent comprehensive neuropsychological (NP) evaluations. RPR results were confirmed and serum fluorescent treponemal antibody absorption (FTA-ABS) test reactivity determined at a central laboratory. Sera from 101 of 166 participants were FTA-ABS reactive, indicating past or current syphilis. Among the 136 individuals without confounding conditions, compared with patients who had never had syphilis, those with prior syphilis had a greater number of impaired NP test domains (1.90 SD [1.77] versus 1.25 [1.52], P = 0.03), a higher global deficit score (0.47 [0.46] versus 0.31 [0.33], P = 0.03), and more were impaired in the NP learning domain (36 [42.9%] of 84 versus 13 [25.0%] of 52, P = 0.04). These effects of prior syphilis remained after controlling for education and premorbid intelligence.</p>