To provide information on the response of HIV infected, neurosyphilis patients to the
currently recommended treatment for neurosyphilis; to determine whether possible
co-infection with both HIV and syphilis makes more difficult the diagnosis of syphilis; to
explore the usefulness of an alternative treatment which, if effective, would permit
outpatient treatment for neurosyphilis that until now required prolonged hospitalization.
Studies suggest that syphilis treatment failures may be more common in HIV infected patients
than in patients without HIV infection and that treatment failures occur due to and/or are
displayed as central nervous system (CNS) involvement. Very little is known about the best
treatment course for neurosyphilis in patients who are also infected with HIV.
Inclusion Criteria
Concurrent Medication:
Allowed:
- Antiretroviral drugs.
- Concurrent treatment for opportunistic infections with non-antisyphilitic drugs.
- Metronidazole, aminoglycosides, trimethoprim / sulfamethoxazole (TMP / SMX),
polymyxin, vancomycin, dapsone, pentamidine, acyclovir, antifungals, clindamycin,
immunomodulators, and quinolones.
Patients must:
- Have HIV infection.
- Have presumable or documented neurosyphilis.
- Be capable of giving informed consent.
- Have life expectancy of at least 52 weeks.
Exclusion Criteria
Co-existing Condition:
Patients with the following conditions or symptoms are excluded:
- History of penicillin or cephalosporin immediate hypersensitivity reaction
characterized by angioneurotic edema, hyperemia, urticaria, bronchospasm, and/or
anaphylaxis.
- History of mucosal or blistering rash in response to related treatment.
Concurrent Medication:
Excluded:
- Antitreponemal therapy (amoxicillin, doxycycline, tetracycline hydrochloride,
erythromycin, procaine penicillin, any beta lactam, or chloramphenicol).
Patients with the following are excluded:
- Other etiology of cerebrospinal (CSF) abnormalities other than HIV and syphilis
infection in patients who present with clinical symptoms (this is not required in
asymptomatic patients).
Prior Medication:
Excluded:
- Treatment for syphilis within 1 year prior to study entry.
- Antitreponemal therapy (amoxicillin, doxycycline, tetracycline hydrochloride,
erythromycin, procaine penicillin, any beta lactam, or chloramphenicol) within 45
days prior to study entry.
Unwilling or unable to comply with follow-up schedule, including repeat lumbar punctures.
Univ of Alabama at Birmingham, Birmingham, Alabama 35294, United States
Univ of California / San Diego Treatment Ctr, San Diego, California 921036325, United States
San Francisco Veterans Administration Med Ctr, San Francisco, California 94121, United States
Harbor UCLA Med Ctr, Torrance, California 90502, United States
Yale Univ / New Haven, New Haven, Connecticut 065102483, United States
Florida Keys Memorial Hosp, Key West, Florida 33040, United States
Med Service, Miami, Florida 33125, United States
Miami Veterans Administration Med Ctr, Miami, Florida 33125, United States
Univ of Miami School of Medicine, Miami, Florida 33136, United States
Northwestern Univ Med School, Chicago, Illinois 60611, United States
Rush Presbyterian - Saint Luke's Med Ctr, Chicago, Illinois 60612, United States
Indiana Univ Hosp, Indianapolis, Indiana 462025250, United States
Methodist Hosp of Indiana / Life Care Clinic, Indianapolis, Indiana 46202, United States
Johns Hopkins Hosp, Baltimore, Maryland 21287, United States
Beth Israel Deaconess Med Ctr, Boston, Massachusetts 02215, United States
Baystate Med Ctr of Springfield, Springfield, Massachusetts 01199, United States
Robert Wood Johnson Med School/UMDNJ, New Brunswick, New Jersey 089030019, United States
Bronx Municipal Hosp Ctr/Jacobi Med Ctr, Bronx, New York 10461, United States
Jack Weiler Hosp / Bronx Municipal Hosp, Bronx, New York 10465, United States
Montefiore Drug Treatment Ctr / Bronx Municipal Hosp, Bronx, New York 10461, United States
Montefiore Family Health Ctr / Bronx Municipal Hosp, Bronx, New York 10461, United States
Montefiore Med Ctr / Bronx Municipal Hosp, Bronx, New York 10467, United States
Montefiore Med Ctr Adolescent AIDS Program, Bronx, New York 10467, United States
North Central Bronx Hosp / Bronx Municipal Hosp, Bronx, New York 10467, United States
Samaritan Village Inc / Bronx Municipal Hosp, Bronx, New York 10461, United States
SUNY / Health Sciences Ctr at Brooklyn, Brooklyn, New York 112032098, United States
SUNY / Erie County Med Ctr at Buffalo, Buffalo, New York 14215, United States
Nassau County Med Ctr, East Meadow, New York 11554, United States
Bellevue Hosp / New York Univ Med Ctr, New York, New York 10016, United States
Columbia Presbyterian Med Ctr, New York, New York 100323784, United States
Saint Luke's - Roosevelt Hosp Ctr, New York, New York 10025, United States
Univ of Rochester Medical Center, Rochester, New York 14642, United States
SUNY / State Univ of New York, Syracuse, New York 13210, United States
Univ of North Carolina, Chapel Hill, North Carolina 275997215, United States
Wake Med Ctr / Univ of North Carolina, Chapel Hill, North Carolina 275997215, United States
Carolinas Med Ctr, Charlotte, North Carolina 28203, United States
Univ of Cincinnati, Cincinnati, Ohio 452670405, United States
Thomas Jefferson Univ Hosp, Philadelphia, Pennsylvania 191075098, United States
Univ of Pennsylvania at Philadelphia, Philadelphia, Pennsylvania 19104, United States
Med Univ of South Carolina / UNC, Charleston, South Carolina 29425, United States
Northwest Family Ctr at the Harbor View Med Ctr, Seattle, Washington 98104, United States
Univ of Washington, Seattle, Washington 981224304, United States
Silva MG, Cruz ML, Lopes GB, Leite CG, Menezes JA. Neurosyphilis in HIV patients. Int Conf AIDS. 1996 Jul 7-12;11(2):280 (abstract no ThB4170)
