Neurocognitive impairment in HIV-infected individuals with previous syphilis

C. M. Marra, R. Deutsch, A. C. Collier, S. Morgello, S. Letendre, D. Clifford, B. Gelman, J. McArthur, J. A. McCutchan, D. M. Simpson, N. A. Duarte, R. K. Heaton, I. Grant

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32 Scopus citations


Cognitive impairment is common in HIV-infected individuals, as is syphilis. Treponema pallidum, the bacterium that causes syphilis, invades the central nervous system early in disease. We hypothesized that HIV-infected patients with a history of syphilis or neurosyphilis would have more cognitive impairment than HIV-infected individuals without these infections. Eighty-two of 1574 enrollees in CHARTER, a prospective, observational study, had reactive serum rapid plasma reagin (RPR) tests. They were matched to 84 controls with non-reactive RPR by age, gender, ethnicity and HIV risk factor. Participants underwent comprehensive neuropsychological (NP) evaluations. RPR results were confirmed and serum fluorescent treponemal antibody absorption (FTA-ABS) test reactivity determined at a central laboratory. Sera from 101 of 166 participants were FTA-ABS reactive, indicating past or current syphilis. Among the 136 individuals without confounding conditions, compared with patients who had never had syphilis, those with prior syphilis had a greater number of impaired NP test domains (1.90 SD [1.77] versus 1.25 [1.52], P = 0.03), a higher global deficit score (0.47 [0.46] versus 0.31 [0.33], P = 0.03), and more were impaired in the NP learning domain (36 [42.9%] of 84 versus 13 [25.0%] of 52, P = 0.04). These effects of prior syphilis remained after controlling for education and premorbid intelligence.

Original languageEnglish
Pages (from-to)351-355
Number of pages5
JournalInternational Journal of STD and AIDS
Issue number5
StatePublished - Nov 2013


  • AIDS
  • HIV
  • Treponema pallidum
  • central nervous system
  • neurocognitive impairment
  • neurosyphilis
  • sexually transmitted infection
  • syphilis


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