| Title | Alternative cerebrospinal fluid tests to diagnose neurosyphilis in HIV-infected individuals. | | Author(s) | Marra CM, Tantalo LC, Maxwell CL, Dougherty K, Wood B | | Institution | Department of Neurology, University of Washington School of Medicine, Seattle, USA. cmarra@u.washington.edu | | Source | Neurology 2004 Jul 13; 63(1):85-8. | | MeSH | Absorption
Adult
Animals
Antibodies, Protozoan
B-Lymphocytes
Cardiolipins
Cerebrospinal Fluid
Cholesterol
Comparative Study
False Negative Reactions
Female
Flow Cytometry
Fluorescent Antibody Technique, Indirect
HIV Infections
Humans
Leukocytosis
Lymphocyte Count
Male
Middle Aged
Neurosyphilis
Phosphatidylcholines
Research Support, U.S. Gov't, P.H.S.
Sensitivity and Specificity
Single-Blind Method
Syphilis Serodiagnosis
Treponema pallidum
| | 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 > or =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 > or =9% in fresh and > or =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. | | Language | eng | | Pub Type(s) | Evaluation Studies
Journal Article
Multicenter Study
| | PubMed ID | 15249615 |
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