Neurosyphilis Increases Human Immunodeficiency Virus (HIV)-associated Central Nervous System Inflammation but Does Not Explain Cognitive Impairment in HIV-infected Individuals With Syphilis

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Emily L HoC M Marra

Abstract

Individuals infected with human immunodeficiency virus (HIV) who have previously had syphilis may have cognitive impairment. We tested the hypothesis that neurosyphilis causes cognitive impairment in HIV by amplifying HIV-related central nervous system (CNS) inflammation. HIV-infected participants enrolled in a study of cerebrospinal fluid (CSF) abnormalities in syphilis underwent the mental alternation test (MAT), venipuncture, and lumbar puncture. CSF concentrations of chemokine (C-X-C motif) ligand 10 (CXCL10), chemokine (C-C motif) ligand 2 (CCL2), and neurofilament light (NFL) were determined by commercial assays. The proportion of peripheral blood mononuclear cells (PBMCs) and of CSF white blood cells (WBCs) that were activated monocytes (CD14+CD16+) was determined by flow cytometry. Neurosyphilis was defined as detection of Treponema pallidum 16S RNA in CSF or CSF white blood cells (WBCs) >20/uL or a reactive CSF-Venereal Disease Research Laboratory (VDRL) test; uncomplicated syphilis was defined as undetectable CSF T. pallidum, CSF WBCs ≤5/uL and nonreactive CSF-VDRL. MAT <18 was considered low. Median proportion of PBMCs that were activated monocytes (16.6 vs. 5.3), and median CSF CXCL10 (10658 vs. 2530 units), CCL2 (5...Continue Reading

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Citations

Aug 1, 2018·Sexually Transmitted Infections·Michael MarksDavid Mabey
Mar 30, 2019·Sexually Transmitted Infections·Kirsten Salado-RasmussenTerese Lea Katzenstein
Jun 11, 2019·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Phillip ChanSerena Spudich
Feb 27, 2018·Practical Neurology·Emily HobbsDavid Lawrence
Jul 11, 2020·Sexually Transmitted Diseases·Dong-Mei XuWen-Hui Lun

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