Neurosyphilis among people with and without HIV infection: A Danish nationwide prospective, population-based cohort study 2015-2021.


Journal

The Journal of infection
ISSN: 1532-2742
Titre abrégé: J Infect
Pays: England
ID NLM: 7908424

Informations de publication

Date de publication:
05 2023
Historique:
received: 04 01 2023
revised: 15 03 2023
accepted: 22 03 2023
medline: 1 5 2023
pubmed: 27 3 2023
entrez: 26 3 2023
Statut: ppublish

Résumé

Comparative data on clinical presentation, laboratory characteristics, treatment, and outcome of neurosyphilis (NS) in people living with HIV (PLWH) and NS patients without HIV are scarce. Nationwide, population-based, prospective cohort study on all adults with NS diagnosed between 2015 and 2021 at departments of infectious diseases in Denmark. We identified 108 patients with NS, which equals a yearly incidence of 0.3/100,000 adults. The median age was 49 years, 85 (79%) were male, 43 (40%) were men having sex with men and 20 (22%) were PLWH. Ninety-five (88%) had early NS, 37 (34%) had ocular or ocular and otogenic NS, and 27 (25%) had symptomatic meningitis. Most common symptoms were visual disturbance (44%), skin rash (40%), fatigue (26%) and chancre (17%). Median CSF leukocyte count was 27 × 10 PLWH with NS have better outcomes than NS patients without HIV infection.

Sections du résumé

BACKGROUND
Comparative data on clinical presentation, laboratory characteristics, treatment, and outcome of neurosyphilis (NS) in people living with HIV (PLWH) and NS patients without HIV are scarce.
METHODS
Nationwide, population-based, prospective cohort study on all adults with NS diagnosed between 2015 and 2021 at departments of infectious diseases in Denmark.
RESULTS
We identified 108 patients with NS, which equals a yearly incidence of 0.3/100,000 adults. The median age was 49 years, 85 (79%) were male, 43 (40%) were men having sex with men and 20 (22%) were PLWH. Ninety-five (88%) had early NS, 37 (34%) had ocular or ocular and otogenic NS, and 27 (25%) had symptomatic meningitis. Most common symptoms were visual disturbance (44%), skin rash (40%), fatigue (26%) and chancre (17%). Median CSF leukocyte count was 27 × 10
CONCLUSIONS
PLWH with NS have better outcomes than NS patients without HIV infection.

Identifiants

pubmed: 36967087
pii: S0163-4453(23)00148-2
doi: 10.1016/j.jinf.2023.03.019
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

439-445

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of interests All authors declare no competing interests.

Auteurs

Christina Carolina Steenberg Schnohr (CCS)

Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

Fie Welling Paulsen (FW)

Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

Lykke Larsen (L)

Department of Infectious Diseases, Odense University Hospital, Denmark.

Merete Storgaard (M)

Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.

Micha Phill Grønholm Jepsen (MPG)

Department of Pulmonary and Infectious Diseases, Nordsjællands University Hospital, Hillerød, Denmark.

Hans Rudolf Lüttichau (HR)

Department of Infectious Diseases, Herlev Gentofte Hospital, Copenhagen, Denmark.

Lothar Wiese (L)

Department of Infectious Diseases, Sjællands University Hospital, Roskilde, Denmark.

Birgitte Rønde Hansen (BR)

Department of Infectious Diseases, Hvidovre University Hospital, Copenhagen, Denmark.

Jacob Bodilsen (J)

Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

Henrik Nielsen (H)

Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

Anne-Mette Lebech (AM)

Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Lars Haukali Omland (LH)

Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. Electronic address: lars.haukali.hoej.omland@regionh.dk.

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Classifications MeSH