Document 0924
 DOCN  M9470924
 TI    Evaluation of neurosyphilis in human immunodeficiency virus-infected
       individuals.
 DT    9409
 AU    Tomberlin MG; Holtom PD; Owens JL; Larsen RA; Department of Medicine,
       Los Angeles County-University of Southern; California Medical Center.
 SO    Clin Infect Dis. 1994 Mar;18(3):288-94. Unique Identifier : AIDSLINE
       MED/94281403
 AB    The diagnosis of neurosyphilis in patients infected with the human
       immunodeficiency virus (HIV) remains problematic. We examined the use of
       the Treponema pallidum hemagglutination (TPHA) index and quantitative
       tests of CSF by means of microhemagglutination-T. pallidum for diagnosis
       of neurosyphilis in 58 HIV-infected persons with latent syphilis who had
       not recently received therapy for syphilis. Five patients (9%) had
       reactive CSF VDRL tests and thus had proven neurosyphilis. For 13
       patients (22%), CSF findings were normal and revealed no evidence of
       neurosyphilis. For 40 patients (69%), abnormal CSF findings were
       characteristic of neurosyphilis, but their CSF VDRL tests were
       nonreactive. Twenty-five of the 40 patients with possible neurosyphilis
       had pleocytosis and elevated CSF levels of protein and/or IgG. Five
       (12.5%) of these 40 patients had positive TPHA indices that indicated
       intrathecal antitreponemal antibody production, a finding that provided
       greater support for the diagnosis of active neurosyphilis. With use of
       the TPHA index, patients with CSF abnormalities can be better classified
       in regard to their need for therapy for neurosyphilis.
 DE    Adult  Aged  Albumins/CEREBROSPINAL FLUID  Animal  Antibodies,
       Bacterial/CEREBROSPINAL FLUID  Cerebrospinal Fluid Proteins/METABOLISM
       Female  Hemagglutination Tests  Human  HIV Infections/*COMPLICATIONS
       IgG/CEREBROSPINAL FLUID  Male  Middle Age  Neurosyphilis/CEREBROSPINAL
       FLUID/*COMPLICATIONS/*DIAGNOSIS  Rabbits  Sensitivity and Specificity
       Support, Non-U.S. Gov't  Syphilis Serodiagnosis/*METHODS/STATISTICS &
       NUMER DATA  Treponema pallidum/IMMUNOLOGY  CLINICAL TRIAL  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).