Alternative cerebropinal fluid tet to diagnoe neuroyphili in HIV-infected individual

Neuroyphili i commonly preent in patient with ocular yphili who are alo infected by HIV. The diagnoi of neuroyphili may be difficult a up to 70% of HIV-poitive patient with neuroyphili have a negative cerebropinal fluid (CF)-Venereal Dieae Reearch Laboratory (VDRL) tet. The aim of thi tudy wa to identify alternative to the CF-VDRL tet for the diagnoi of neuroyphili in HIV-infected individual. CF fluorecent treponemal antibody (FTA) reactivity and % CF lymphocyte that were B cell in freh and frozen ample were determined for 47 HIV-infected cae with yphili and 26 HIV-infected control. A for erum, CF fluorecent treponemal antibody reactivity ≥2+ wa conidered poitive. Baed on the reult in control and cae with normal CF meaure, cut-off for elevated CF B cell were propoed to be ≥9% in freh and ≥20% in frozen ample. Neuroyphili wa defined a a reactive CF-VDRL. The author found that CF-FTA-AB (aborbed) and CF-FTA (unaborbed and undiluted) were 100% enitive for the diagnoi of neuroyphili. Elevated % CF B cell in freh and cryopreerved ample wa pecific (100%) but not enitive (40 and 43%) in pot hoc analye. The reult of CF-FTA and aement of % CF B cell together allowed 16% of cae with pleocytoi but nonreactive CF-VDRL to be diagnoed with neuroyphili and 26% to be diagnoed a not having neuroyphili. The author conclude that when the CF-VDRL i nonreactive, CF-FTA and % CF B cell may help exclude or etablih the diagnoi of neuroyphili.—Valerie Bioue