{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:25:20Z","timestamp":1792783520398,"version":"4.5.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Johann Wolfgang Goethe-Universit\u00e4t, Frankfurt am Main","id":[{"id":"https:\/\/ror.org\/04cvxnb49","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Syphilis and neurosyphilis remain significant comorbidities among people living with human immunodeficiency virus (HIV). Data on cerebrospinal fluid (CSF) findings in co-infected individuals are limited. This study aimed to determine which CSF parameters and HIV-related immunologic and virologic markers are associated with neurosyphilis in people living with HIV (PLWH), and to assess the impact of antiretroviral therapy (ART) on these relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective analysis of 211 people living with HIV undergoing syphilis serology and CSF testing at a tertiary care center between 2011 and 2017. Patients were stratified by syphilis stage and ART status. CSF parameters, CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      cell counts, HIV viral load, and syphilis diagnostic parameters were analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Neurosyphilis was diagnosed in 10% (n\u2009=\u200921) of the study population.\n                      <jats:italic>Treponema pallidum<\/jats:italic>\n                      particle agglutination (TPPA) titers\u2009\u2265\u20091024 in CSF were significantly associated with neurosyphilis (p\u2009=\u20090.001). No significant association was observed between neurosyphilis and CD4\n                      <jats:sup>+<\/jats:sup>\n                      count\u2009&lt;\u2009200\/\u03bcL (p\u2009=\u20090.67) or detectable CSF HIV viral load (p\u2009=\u20090.83). ART success was associated with lower CSF viral loads (p\u2009&lt;\u20090.001), higher CD4\n                      <jats:sup>+<\/jats:sup>\n                      counts (p\u2009&lt;\u20090.001), and CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratios (p\u2009=\u20090.001). CSF immunoglobulin levels (IgA, IgG, IgM) differed significantly between patients on ART and those not receiving ART, whereas leukocyte counts and protein levels showed no differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      High CSF TPPA titers, particularly\u2009\u2265\u20091024, are strong indicators of neurosyphilis among PLWH. CD4\n                      <jats:sup>+<\/jats:sup>\n                      count and CSF HIV RNA were not predictive of neurosyphilis, underscoring the diagnostic challenge posed by HIV co-infection. ART success influences CSF immunological parameters but not neurosyphilis risk directly.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02871-2","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T10:10:40Z","timestamp":1783678240000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Syphilis and neurosyphilis in people living with HIV: analysis of cerebrospinal fluid findings"],"prefix":"10.1007","author":[{"given":"Tobias","family":"Weirauch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Plano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Bickel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavel","family":"Khaykin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anette","family":"Haberl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gundolf","family":"Sch\u00fcttfort","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Marx","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Besier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Wichelhaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Stephan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"issue":"9","key":"2871_CR1","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1056\/NEJMra1901593","volume":"382","author":"KG Ghanem","year":"2020","unstructured":"Ghanem KG, Ram S, Rice PA. 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P.K. received honoraria from Gilead, Abbvie, ViiV, Camurus, Roche, and Sanofi, all unrelated to the submitted work. A.H. has received honoraria for scientific lectures and sponsored contributions to medical conferences from Gilead Sciences, MSD, and ViiV Healthcare; additionally, she has received travel support and conference registration fees from Gilead Sciences, as well as honoraria for participation in scientific advisory boards from Gilead Sciences and MSD. G.S. reports that all potential conflicts of interest are unrelated to the submitted work. G.S. has received funding from Gilead Sciences and honoraria from ViiV Healthcare, Gilead Sciences, Bristol Myers Squibb, MSD, and Hormosan for advisory board participation, data safety and monitoring board service, development of educational materials, and lectures. G.S. has also received support for meeting attendance and travel from ViiV Healthcare, Gilead Sciences, Bristol Myers Squibb, and MSD. S.B. received payments for scientific advice from Pfizer, unrelated to the submitted work. C.S. received payments for lectures\/scientific advice from the following pharmaceutical companies: Gilead Sciences, Janssen-Cilag, MSD Sharp & Dohme, Shionogi, Theratechnologies and ViiV Healthcare, and travel grants for scientific conferences from AbbVie, Gilead Sciences, MSD Sharp & Dohme and Janssen-Cilag. S.P., M.B., T.Wo., B.M. and T.Wi. have nothing to disclose.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}