{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T07:37:56Z","timestamp":1771486676568,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,3,27]],"date-time":"2022-03-27T00:00:00Z","timestamp":1648339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Our objective was to describe and compare the occurrence of neurological outcomes and neurosyphilis in people living with HIV with incident syphilis and no neurological symptoms who underwent early screening for asymptomatic neurosyphilis (ANS) or regular clinical management without a lumbar puncture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study in a single referral centre of Sao Paulo, Brazil. Patients with incident syphilis diagnosed between January 2000 and August 2016 and meeting the adapted criteria for ANS investigation suggested by Marra et al. (CD4<jats:sup>+<\/jats:sup> T\u2010cell counts \u2264350 cells\/mm\u00b3 and\/or venereal disease research laboratory test results \u22651:16) were identified. Those with no neurological symptoms and immediately referred for lumbar puncture were categorized as group 1, and those not referred for cerebrospinal fluid collection were categorized as group 2. We compared the occurrence of neurological symptoms and neurosyphilis diagnoses between the groups using incidence rates and Kaplan\u2013Meier curves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 425 participants with a median follow\u2010up of 6\u00a0years. The incidence rate of neurological symptoms was 36.5\/1000 person\u2010years in group 1 and 40.6\/1000 person\u2010years in group 2 (incidence rate ratio [IRR] 0.90; 95% confidence interval [CI] 0.57\u20131.39; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.62). The incidence rate of neurosyphilis was 15.0 cases\/1000 person\u2010years in group 1 and 6.7 cases\/1000 person\u2010years in group 2 (IRR 2.26; 95% CI 0.93\u20135.68; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found no statistically significant differences between groups in the incidence rates of neurological symptoms and neurosyphilis. Our findings support the current guidelines, which suggest a less invasive approach regarding ANS investigation among people living with HIV with incident syphilis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13306","type":"journal-article","created":{"date-parts":[[2022,3,27]],"date-time":"2022-03-27T23:48:25Z","timestamp":1648424905000},"page":"1041-1050","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical outcomes of HIV\u2013syphilis coinfection among patients with no neurological symptoms: a retrospective cohort study"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0297-1762","authenticated-orcid":false,"given":"Barbara L.","family":"Henriques","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Faculdade de Medicina da Universidade de S\u00e3o Paulo (FMUSP)  Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4748-6226","authenticated-orcid":false,"given":"Andr\u00e9 L.","family":"Cortez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Faculdade de Medicina da Universidade de S\u00e3o Paulo (FMUSP)  Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7525-3238","authenticated-orcid":false,"given":"Nath\u00e1lia N.","family":"Nunes","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Faculdade de Medicina da Universidade de S\u00e3o Paulo (FMUSP)  Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7830-8716","authenticated-orcid":false,"given":"Jos\u00e9 E.","family":"Vidal","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Faculdade de Medicina da Universidade de S\u00e3o Paulo (FMUSP)  Sao Paulo Brazil"},{"name":"Departament of Neurology Instituto de Infectologia Emilio Ribas  Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6660-3088","authenticated-orcid":false,"given":"Vivian I.","family":"Avelino\u2010Silva","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Faculdade de Medicina da Universidade de S\u00e3o Paulo (FMUSP)  Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,27]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Minist\u00e9rio da Sa\u00fade.Secretaria de Vigil\u00e2ncia em Sa\u00fade. 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