Neurosyphilis in the age of AIDS: clinical and laboratory features

Neurosyphilis remains to be a challenging diagnostic possibility worldwide. The aim of our study was to identify and report the clinical and laboratory profile of neurosyphilis, comparing features of HIV-infected and HIV-negative patients. A retrospective investigation of all cases of neurosyphilis, defined as positive VDRL test on cerebrospinal fluid, diagnosed at Hospital das Clínicas, Ribeirão Preto School of Medicine between January 1988 and December 2005, was carried out. We identified 35 patients with a mean age of 42.1 years, 28.6% of them HIV infected and 74.3% of them were male. HIV-infected patients were younger (34.6 years), presented with a higher frequency of the early forms of neurosyphilis, higher titers of serum VDRL and higher mean proteinorrachia at the suboccipital level. Neurosyphilis is still characterized by clinical polymorphism and there are significant differences in its epidemiological, clinical and laboratory profile when HIV-infected patients are compared with HIV-negative patients.