Clinical characteristics of HIV positive and HIV negative syphilis complicated with cerebral infarction
Objective To compare and analyze the clinical characteristics of HIV-positive and HIV-negative syphilis complicated with cerebral infarction patients to provide a basis for improving the diagnosis.Methods We retrospectively analyzed the data of patients with syphilis complicated with cerebral infarction treated in Zhongnan Hospital of Wuhan University between January 2017 and May 2022.We then used the data to divide them into the HIV-positive group and the HIV-negative group,which were interpreted for their clinical characteristics and prognosis.Results The median age in the HIV-positive group was significantly lower than that in the HIV-negative group(26 vs.67 years),P＜0.05,Z=3.653;the diagnosis rate of neurosyphilis was much higher(90.91％,10/11)than that in the HIV-negative group(9.09％,1/11),P＜0.001;The average titer of RPR at 1:18 was higher than that at 1:4 in the HIV-negative group(P＜0.001,t=25.791);the number of hospitalization days(21±9)was significantly longer than that of the negative group 9±3(P＜0.05,t=4.160).The proportion of treatment improvement in HIV-positive group was higher than that in HIV-negative group,but the difference was not statistically significant(P＞0.05).The differences between the two groups in terms of the number of imaging lesions and vessels involved were not statistically significant.Conclusion When syphilis combined with cerebral infarction,neurosyphilis needs to be excluded;when HIV-positive syphilis combined with cerebral infarction,neurosyphilis should be considered first,and treatment of syphilis expulsion as soon as possible can effectively avoid sequelae.
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