New approaches to laboratory diagnosis of neurosyphilis

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BACKGROUND

Syphilis is a systemic infection caused by T. pallidum. It continues to be reported around the world, with severe consequences. In the early 2000s, a significant increase in the incidence of neurosyphilis (NS) in Russia was reported. Its diagnosis remains challenging in scientific and practice ways.

OBJECTIVE

To compare the effectiveness of two current approaches to laboratory diagnosis of NS: ITPA index (Intrathecal T. pallidum assay index), or serum-liquor ratio, vs. multivariate discriminant analysis (MDA).

RESULTS AND DISCUSSION

Sixty-five paired biosamples (blood serum and cerebrospinal fluid) obtained from patients diagnosed with NS, including 43 from asymptomatic NS patients and 22 from symptomatic NS patients, were examined. The ITPA index was positive in 95.4% of patients, including 97.7% of asymptomatic NS patients and 90.9% of symptomatic NS patients. MDA showed 98.5% positive results, including 100% of asymptomatic NS patients and 95.5% of symptomatic NS patients. The same results of these methods were observed in 93.8% of cases.

CONCLUSION

The high efficacy of the ITPA index and MDA in the NS diagnosis and high agreement of the two methods were demonstrated, suggesting the prospects for their use in clinical practice.

Keywords:

neurosyphilis

diagnosis

ITPA index

multivariate discriminant analysis

Authors:

Dmitriev G.A.

Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology

Frigo N.V.

Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology

ORCID: 0000-0001-6231-971X

Negasheva E.S.

Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology

ORCID: 0000-0001-5613-6482

Kitaeva N.V.

Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology

Dolya O.V.

Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology;
Peoples’ Friendship University of Russia

ORCID: 0000-0001-5019-4593

Received:

19.10.2021

Accepted:

17.01.2022

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