Alternative cerebrospinal fluid tests to diagnose neurosyphilis in HIV-infected individuals
- 13 July 2004
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 63 (1), 85-88
- https://doi.org/10.1212/01.wnl.0000131902.69113.34
Abstract
Objective: To identify alternatives to the CSF-Venereal Disease Research Laboratory (VDRL) test for the diagnosis of neurosyphilis in HIV-infected individuals. Methods: CSF fluorescent treponemal antibody (FTA) reactivity and % CSF lymphocytes that were B cells in fresh and frozen samples were determined for 47 HIV-infected cases with syphilis and 26 HIV-infected controls. As for serum, CSF fluorescent treponemal antibody reactivity ≥2+ was considered positive. Based on the results in controls and cases with normal CSF measures, cut-offs for elevated CSF B cells were proposed to be ≥9% in fresh and ≥20% in frozen samples. Neurosyphilis was defined as a reactive CSF-VDRL. Results: CSF-FTA-ABS (absorbed) and CSF-FTA (unabsorbed and undiluted) were 100% sensitive for the diagnosis of neurosyphilis. Elevated % CSF B cells in fresh and cryopreserved samples was specific (100%) but not sensitive (40 and 43%) in post hoc analyses. The results of CSF-FTA and assessment of % CSF B cells together allowed 16% of cases with pleocytosis but nonreactive CSF-VDRL to be diagnosed with neurosyphilis and 26% to be diagnosed as not having neurosyphilis. Conclusion: When the CSF-VDRL is nonreactive, CSF-FTA and % CSF B cells may help exclude or establish the diagnosis of neurosyphilis.This publication has 19 references indexed in Scilit:
- Cerebrospinal Fluid Abnormalities in Patients with Syphilis: Association with Clinical and Laboratory FeaturesThe Journal of Infectious Diseases, 2004
- An outbreak no longer: factors contributing to the return of syphilis in Greater ManchesterSexually Transmitted Infections, 2003
- Cerebrospinal Fluid Treponemal Antibodies in Untreated Early SyphilisArchives of Neurology, 1995
- Syphilis, Neurosyphilis, Penicillin, and AIDSThe Journal of Infectious Diseases, 1991
- Identification of mononuclear cells in CSF of patients with HIV infectionNeurology, 1989
- Clinical significance of cerebrospinal fluid tests for neurosyphilisAnnals of Neurology, 1989
- Flow cytometric quantitation of T cell phenotypes in cerebrospinal fluid and peripheral blood of homosexual men with and without antibodies to human immunodeficiency virus, type IJournal of Neuroimmunology, 1988
- Spectrum of Cerebrospinal Fluid Findings in Various Stages of Human Immunodeficiency Virus InfectionArchives of Neurology, 1988