title: Cerebrospinal fluid examination may be useful in diagnosing neurosyphilis in asymptomatic HIV+ patients with syphilis.
abstract: Lumbar puncture in neurologically asymptomatic HIV+ patients is still under debate. There are different criteria for detecting neurosyphilis through cerebrospinal fluid (CSF), especially in cases that are negative through the Venereal Disease Research Laboratory (VDRL), regarding cellularity and protein content. However, a diagnosis of neurosyphilis can still exist despite negative VDRL. Treponema pallidum hemagglutination assay (TPHA) titers and application of the TPHA index in albumin and IgG improve the sensitivity, with a high degree of specificity. Thirty-two patients were selected for this study. VDRL was positive in five of them. The number of diagnoses reached 14 when the other techniques were added. It was not determined whether cellularity and increased protein levels were auxiliary tools in the diagnosis. According to our investigation, CSF analysis using the abovementioned techniques may be useful in diagnosing neurosyphilis in these patients.
authors.affiliation: Sección Neuroinfectología, Instituto de Neurología, Hospital de Clínicas, Montevideo, Uruguay.
authors.forename: Ronald
authors.initials: R
authors.lastname: Salamano
authors.affiliation: Sección Inmunología, Departamento de Laboratorio Clínico, Hospital de Clínicas, Montevideo, Uruguay.
authors.forename: Raquel
authors.initials: R
authors.lastname: Ballesté
authors.affiliation: Sección Neuroinfectología, Instituto de Neurología, Hospital de Clínicas, Montevideo, Uruguay.
authors.forename: Abayubá
authors.initials: A
authors.lastname: Perna
authors.affiliation: Sección Inmunología, Departamento de Laboratorio Clínico, Hospital de Clínicas, Montevideo, Uruguay.
authors.forename: Natalia
authors.initials: N
authors.lastname: Rodriguez
authors.affiliation: Sección Neuroinfectología, Instituto de Neurología, Hospital de Clínicas, Montevideo, Uruguay.
authors.forename: Diego
authors.initials: D
authors.lastname: Lombardo
authors.affiliation: Sección Inmunología, Departamento de Laboratorio Clínico, Hospital de Clínicas, Montevideo, Uruguay.
authors.forename: Natalia
authors.initials: N
authors.lastname: García
authors.affiliation: Sección Inmunología, Departamento de Laboratorio Clínico, Hospital de Clínicas, Montevideo, Uruguay.
authors.forename: Pablo
authors.initials: P
authors.lastname: López
authors.affiliation: Servicio de Enfermedades Infecto-Contagiosas, Hospital Pasteur, Montevideo, Uruguay.
authors.forename: Pablo
authors.initials: P
authors.lastname: Cappuccio
mesh_terms: D058345:Asymptomatic Infections; D003430:Cross-Sectional Studies; D006679:HIV Seropositivity / Q000134:cerebrospinal fluid*; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid*; D009494:Neurosyphilis / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D012680:Sensitivity and Specificity; D014210:Treponema pallidum / Q000276:immunology / Q000302:isolation & purification*
chemical_list: D007074:Immunoglobulin G