The performance of rapid plasma reagin (RPR) titer in HIV-negative general paresis after neurosyphilis therapy.

Abstract

BACKGROUND:

Repeated nontreponemal serologic test for syphilis titers is recommended to evaluate treatment response. However, it is unknown whether serum rapid plasma reagin (RPR) titer can serve as a surrogate for determining the efficacy of treatment in general paresis (GP) remains unknown.

METHODS:

We retrospectively reviewed data from 105 GP patients, who were divided into two groups (62 CSF RPR+ patients and 43 CSF RPR- patients) according to reactive RPR test status in CSF. Clinical assessment included the Mini-Mental State Examination (MMSE) scores, CSF examinations (WBC count, protein concentration and RPR titer), and serum tests (RPR titer and TPPA). Among the 105 GP patients, 13 CSF RPR+ patients and 6 CSF RPR- patients had a 12 months follow-up of CSF, serum measures and MMSE.

RESULTS:

The median serum RPR titer was significantly higher in CSF RPR+ patients than that in CSF RPR- GP patients, 1:8 [IQR 1:4-1:32] vs. 1:4 [IQR 1:4-1:8] (P < 0.001). The number of CSF RPR+ patients with serum RPR titer≥1:32 was significantly higher when compared with CSF RPR- patients (P = 0.001). For CSF RPR+ patients, the MMSE scores improved or remained constantly after penicillin treatment. For CSF RPR+ patients, the CSF RPR titer declined four-fold in 85% (11/13) of the patients, whereas the serum RPR titer declined four-fold in only 46% (6/13) of the patients, the odds ratio is 6.4 (95% confidence interval 1.0-41.2).

CONCLUSIONS:

A four-fold decline in CSF RPR titer is a good predictor for treatment efficacy in CSF RPR+ GP patients within 12 months after the completion of therapy.

• Authors: Ying Jiang, Ruihui Weng, Yuefeng Zhang, Rong Fan, Yulun Liu, Zhigang Chen, Fuhua Peng, Yong Chen, Xiaohong Chen
• Journal: BMC infectious diseases (BMC Infect Dis) Vol. 18 Issue 1 Pg. 144 (04 02 2018) ISSN: 1471-2334 [Electronic] England
• PMID: 29606102 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Reagins

Topics

• Adult
• Biomarkers (blood)
• Female
• HIV Seronegativity
• Humans
• Male
• Middle Aged
• Neurosyphilis (blood, diagnosis, therapy)
• Predictive Value of Tests
• Prognosis
• Reagins (analysis, blood)
• Retrospective Studies
• Serologic Tests
• Syphilis Serodiagnosis
• Treatment Outcome