To investigate the clinical characteristics, diagnosis and treatment of neurosyphilis in patients co-infected with human immunodeficiency virus (HIV).

The gender, clinical manifestation, laboratory examination, diagnosis, treatment and outcome of 37 patients identified as neurosyphilis (NS) co-infected with HIV were analyzed, retrospectively in Beijing Ditan hospital, Capital Medical University.

All 37 patients were male, among whom, 14 patients were collected as asymptomatic neurosyphilis (ANS) group, while the other 23 patients with neurological or psychiatric symptoms were taken as symptomatic neurosyphilis (SNS) group. The median count of white blood cell in cerebrospinal fluid (CSF) of patients with ANS was 10 (2, 12) cells/μl, patients of ANS group was 20 (7, 70) cells/μl, with significant difference (t = 2.39, P = 0.017). The CSF concentrations of patients in ANS group and SNS group were (42.32±23.87) mg/dl and (79.92±47.14) mg/dl, with significant difference (t =-3.21, P = 0.003). After the treatment with penicillin G, 13 patients (56.5%) showed improved clinical performance in SNS group. Among 17 patients with complete follow-up data, 14 (82.4%) paitents achieved TRUST titer decline ≥ 4 times during two years.

NS co-infected with HIV presented complex and diverse manifestations. CSF examination remained the crucial diagnostic criteria for NS. The clinical and serologic test needs to be combined to reduce the misdiagnosis. The curative effect of penicillin for NS patients co-infected with HIV was better.