Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2013 May;24(5):351-5.
doi: 10.1177/0956462412472827. Epub 2013 Jun 14.

Neurocognitive impairment in HIV-infected individuals with previous syphilis

C M Marra  1 , R Deutsch, A C Collier, S Morgello, S Letendre, D Clifford, B Gelman, J McArthur, J A McCutchan, D M Simpson, N A Duarte, R K Heaton, I Grant
Affiliations
Observational Study

Neurocognitive impairment in HIV-infected individuals with previous syphilis

C M Marra et al. Int J STD AIDS. 2013 May.

Abstract

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.

Keywords: AIDS; HIV; Treponema pallidum; central nervous system; neurocognitive impairment; neurosyphilis; sexually transmitted infection; syphilis.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: None declared.

References

    1. [last checked 30 September 2012]; See http://www.cdc.gov/std/stats10/syphilis.htm.
    1. Buchacz K, Klausner JD, Kerndt PR, et al. HIV incidence among men diagnosed with early syphilis in Atlanta, San Francisco, and Los Angeles, 2004–2005. J Acquir Immune Defic Syndr. 2008;47:234–240. - PubMed
    1. Wong W, Chaw JK, Kent CK, Klausner JD. Risk factors for early syphilis among gay and bisexual men seen in an STD clinic: San Francisco, 2002–2003. Sex Transm Dis. 2005;32:458–463. - PubMed
    1. Marra CM, Maxwell CL, Smith SL, et al. Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features. J Infect Dis. 2004;189:369–376. - PubMed
    1. Rolfs RT, Joesoef MR, Hendershot EF, et al. A randomized trial of enhanced therapy for early syphilis in patients with and without human immunodeficiency virus infection. The Syphilis and HIV Study Group. N Engl J Med. 1997;337:307–314. - PubMed

Publication types

MeSH terms

LinkOut - more resources