Neurosyphilis in the patients with and without HIV infection. Description and comparison of two historical cohorts Neurosyphilis follows a more aggressive and different clinical course in HIV-infected patients compared to patients with normal immunity. Two historical series of patients with a diagnosis of neurosyphilis between 1995 and 2008 were compared: they included a group of 15 patients with y and 28 patients without HIV infection. Probability of neurosyphilis in patients with positive serum VDRL (+) was increased in patients infected with HIV comparedto HIV (-) negative patients (OR: 62.37 IC:95% (32.1-119.1) p value:< 0,001). Predominant clinical manifestations in neurosyphilis in the HIV (-) group were ocular abnormality, vascular encephalic and spinal cord lesions. In the HIV (+) positive group, they were fever, ocular abnormalities and headache. There were no differences in cerebrospinal fluid characteristics between both groups. Neurosyphilis was diagnosed even in patients with blood VDRL of < 1:32: 17,8% of HIV (+) and 60% of HIV (-) patients. Penicillin sodium at dose > than 18.000.000 IU/day IV during 14 days was the most common treatment. In patients with clinical neurosyphilis, 93% of HIV (-) group, and 54,2% of HIV (+) group had persistent neurological sequels. Three HIV (+) patients died due to causes not related to neurosyphilis.

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