Abstract
We aimed to investigate the CXCL13 concentration of the serum and cerebral spinal fluid (CSF) in human immunodeficiency virus (HIV)-negative latent syphilis patients with treatment failure and explore the change in CXCL13 after treatment. Sixty-eight latent syphilis patients with treatment failure (failure group), 68 syphilis patients with successful treatment (seroconversion group) and 18 patients with non-inflammatory diseases of the nervous system (control group) were included and serum and CSF were collected. Enzyme-linked immunosorbent assay was employed to detect the CXCL13 in the serum and CSF. Results showed that the serum CXCL13 concentration was comparable among three groups, and the CSF leukocyte count, IgG index and CXCL13 concentration in the failure group were significantly higher than those in the seroconversion group and control group (P < 0.05, P < 0.01). CSF CXCL13 concentration in the failure group was positively related to the CSF leukocyte count (r = 0.3594, P < 0.001). Of the 68 patients in the treatment failure group, neurosyphilis was found in 17 (25.0%). In conclusion, involvement of nervous system is one of the reasons for the treatment failure in patients with latent syphilis. Detection of CSF CXCL13 concentration is helpful for the diagnosis and therapeutic evaluation of HIV-negative latent syphilis patients with treatment failure and neurosyphilis.
Highlights
Syphilis is a sexually transmitted disease due to treponema pallidum infection and may cause damage to multiplePrevious studies have shown that the CXCL13 concentration of the cerebral spinal fluid (CSF) in human immunodeficiency virus (HIV)-negative/positive patients with neurosyphilis is significantly higher than in patients without neurosyphilis and CSF CXCL13 may serve as a marker in the diagnosis of neurosyphilis [7,8,9]
Latent syphilis diagnosis criteria: (1) blood TRUST and treponema pallidum particle agglutination (TPPA) assay showed positive; patients were negative for HIV; (2) patients had no history of rash, the course of disease was unclear, and latent syphilis was diagnosed at blood donation, premarital examination, preoperative examination or routine examination during hospitalization; (3) latent syphilis at unknown stage was diagnosed, and serum TRUST titer was ≥1:4 at initial examination; and (4) patients were never diagnosed as having syphilis or received any anti-syphilis treatment
The initial serum TRUST titer ≤1:32 at baseline was comparable between the treatment failure group and seroconversion group (P > 0.05)
Summary
Syphilis is a sexually transmitted disease due to treponema pallidum infection and may cause damage to multiple. Previous studies have shown that the CXCL13 concentration of the cerebral spinal fluid (CSF) in human immunodeficiency virus (HIV)-negative/positive patients with neurosyphilis is significantly higher than in patients without neurosyphilis and CSF CXCL13 may serve as a marker in the diagnosis of neurosyphilis [7,8,9]. The relationship between CXCL13 concentration and latent syphilis is still poorly understood. In this retrospective study, the relationship of CXCL13 concentration of CSF and serum with latent syphilis was assessed in patients with treatment failure and the change in CXCL13 concentration of CSF and serum after standard treatment in these patients investigated
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