Neurocognitive impairment in HIV-infected individuals with previous syphilis.

TitleNeurocognitive impairment in HIV-infected individuals with previous syphilis.
Publication TypeJournal Article
Year of Publication2013
AuthorsMarra, CM, Deutsch, R, Collier, AC, Morgello, S, Letendre, S, Clifford, D, Gelman, B, McArthur, J, McCutchan, JA, Simpson, DM, Duarte, NA, Heaton, RK, Grant, I
JournalInt J STD AIDS
Volume24
Issue5
Pagination351-5
Date Published2013 May
ISSN1758-1052
KeywordsAdult, Case-Control Studies, Cognition Disorders, Female, Fluorescent Treponemal Antibody-Absorption Test, HIV Infections, Humans, Male, Middle Aged, Neuropsychological Tests, Neurosyphilis, Prospective Studies, Syphilis, Syphilis Serodiagnosis, Treponema pallidum
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.

DOI10.1177/0956462412472827
Alternate JournalInt J STD AIDS
PubMed ID23970701
PubMed Central IDPMC4560461
Grant ListHHSN271201000036C / MH / NIMH NIH HHS / United States
K24 MH097673 / MH / NIMH NIH HHS / United States
N01 MH22005 / MH / NIMH NIH HHS / United States
P30 MH062512 / MH / NIMH NIH HHS / United States
R01 NS34235 / NS / NINDS NIH HHS / United States