PT  - JOURNAL ARTICLE
AU  - Andrew Tomkins
AU  - Shazaad Ahmad
AU  - Darren E Cousins
AU  - Francisco Javier Vilar
AU  - Stephen P Higgins
TI  - O32 Asymptomatic neurosyphilis is unlikely in hiv infected patients after treatment for early syphilis with benzathine penicillin g
AID  - 10.1136/sextrans-2015-052126.32
DP  - 2015 Jun 01
TA  - Sexually Transmitted Infections
PG  - A11--A12
VI  - 91
IP  - Suppl 1
4099  - http://sti.bmj.com/content/91/Suppl_1/A11.3.short
4100  - http://sti.bmj.com/content/91/Suppl_1/A11.3.full
SO  - Sex Transm Infect2015 Jun 01; 91
AB  - Background/introduction Benzathine penicillin G (BPG) does not cross the blood-brain barrier. Some experts believe that BPG may be ineffective when treating patients co-infected with HIV and syphilis. Aim(s)/objectives To establish the risk of asymptomatic neurosyphilis (ANS) after treatment of early syphilis in HIV positive patients with single dose BPG. Methods HIV patients with early syphilis were offered a post-treatment lumbar puncture if their CD4 count was <350 and/or their serum RPR >16. Patients with clinical neurosyphilis were excluded. ANS was defined as a positive CSF RPR, or CSF white blood cells >20/mm3 plus CSF TPPA >1:320. Results 64 patients participated (median CD4 417/mm3, range 84–1100). 50 of the patients were treated with single dose BPG. Only one patient had ANS (prevalence 1.56% 95 CI 0.04–8.4) with CSF RPR negative, CSF TPPA 1:1280 and lymphocytes 45/mm3. Two patients had a pleocytosis (50 and 22 white cells/mm3 respectively) with negative CSF RPR and CSF TPPA and thus did not meet diagnostic criteria for ANS per protocol. Discussion/conclusion Our study suggests that single dose BPG is effective treatment for early syphilis in HIV co-infected patients. We will present more data to support this conclusion.