{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T08:57:13Z","timestamp":1769849833169,"version":"3.49.0"},"reference-count":37,"publisher":"American Society for Microbiology","issue":"12","license":[{"start":{"date-parts":[[2013,12,1]],"date-time":"2013-12-01T00:00:00Z","timestamp":1385856000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The diagnosis of neurosyphilis (NS) is a challenge, especially in HIV-infected patients, and the criteria for deciding when to perform a lumbar puncture (LP) in HIV-infected patients with syphilis are controversial. We retrospectively reviewed demographic, clinical, and laboratory data from 122 cases of HIV-infected patients with documented early syphilis who underwent an LP to rule out NS, and we evaluated 3 laboratory-developed validated real-time PCR assays, the\n            <jats:named-content content-type=\"genus-species\">Treponema pallidum<\/jats:named-content>\n            particle agglutination (TPPA) assay, the fluorescent treponemal antibody absorption (FTA-ABS) assay, and the line immunoassay INNO-LIA Syphilis, for the diagnosis of NS from cerebrospinal fluid (CSF) samples of these patients. NS was defined by a reactive CSF-VDRL test result and\/or a CSF white blood cell (WBC) count of &gt;20 cells\/\u03bcl. Thirty of the 122 patients (24.6%) had early NS. Headache, visual symptoms, a CD4 cell count of &lt;500 cells\/\u03bcl, and viremia, as defined by an HIV-1 RNA count of \u226550 copies\/ml, were associated with NS in multivariate analysis (\n            <jats:italic>P<\/jats:italic>\n            = &lt;0.001 for each factor). Blood serum rapid plasma reagin (RPR) titers were not associated with early NS (\n            <jats:italic>P<\/jats:italic>\n            = 0.575). For the diagnosis of NS, the PCR, FTA-ABS, TPPA, and INNO-LIA assays had sensitivities of 58%, 100%, 68%, and 100%, specificities of 67%, 12%, 49%, and 13%, and negative predictive values of 85%, 100%, 84%, and 100%, respectively. Visual disturbances, headache, uncontrolled HIV-1 viremia, and a CD4 cell count of &lt;500 cells\/\u03bcl were predictors of NS in HIV-infected patients with early syphilis, while blood serum RPR titers were not; therefore, RPR titers should not be used as the sole criterion for deciding whether to perform an LP in early syphilis. When applied to CSF samples, the INNO-LIA Syphilis assay easily helped rule out NS.\n          <\/jats:p>","DOI":"10.1128\/jcm.01989-13","type":"journal-article","created":{"date-parts":[[2013,10,3]],"date-time":"2013-10-03T01:00:40Z","timestamp":1380762040000},"page":"4060-4066","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":62,"title":["Clinical Prediction and Diagnosis of Neurosyphilis in HIV-Infected Patients with Early Syphilis"],"prefix":"10.1128","volume":"51","author":[{"given":"Jeannot","family":"Dumaresq","sequence":"first","affiliation":[{"name":"D\u00e9partement de Microbiologie et d'Infectiologie, Centre Hospitalier Affili\u00e9 Universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phanie","family":"Langevin","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Microbiologie et d'Infectiologie, Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Gagnon","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Microbiologie et d'Infectiologie, Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bouchra","family":"Serhir","sequence":"additional","affiliation":[{"name":"Laboratoire de Sant\u00e9 Publique du Qu\u00e9bec, Sainte-Anne-de-Bellevue, Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beno\u00eet","family":"Deligne","sequence":"additional","affiliation":[{"name":"D\u00e9partement de M\u00e9decine Interne et Vasculaire, Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9cile","family":"Tremblay","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Microbiologie et d'Infectiologie, Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Laboratoire de Sant\u00e9 Publique du Qu\u00e9bec, Sainte-Anne-de-Bellevue, Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond S. W.","family":"Tsang","sequence":"additional","affiliation":[{"name":"Division of Syphilis Diagnostics and Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claude","family":"Fortin","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Microbiologie et d'Infectiologie, Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"D\u00e9partement de Microbiologie et d'Immunologie de l'Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Coutl\u00e9e","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Microbiologie et d'Infectiologie, Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"D\u00e9partement de Microbiologie et d'Immunologie de l'Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Roger","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Microbiologie et d'Infectiologie, Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"D\u00e9partement de Microbiologie et d'Immunologie de l'Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Laboratoire d'Immunog\u00e9n\u00e9tique, Centre de Recherche du Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","unstructured":"MarraCM. 2012. 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