What is the prevalence of neurosyphilis?

Updated: Jul 17, 2018
  • Author: Richard P Knudsen, MD, FAAN, FAAP; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

In 1999, the World Health Organization estimated that worldwide, approximately 12 million new cases of syphilis occurred among adults. In the United States, the number of cases reported annually rose from fewer than 10,000 in 1956 to more than 50,000 in 1990. The rise in incidence has been greatest among the underprivileged, heterosexuals, blacks, and urban dwellers and has occurred in New York, California, and the Southwest. As the Center for Disease Control and Prevention states, "The burden from neurosyphilis is unknown because national reporting of the disease is incomplete." [13, 14]

The risk of neurosyphilis is 2-3 times greater in whites than in blacks and is twice as common in males as in females. It is contracted most often during earlier years of sexual activity. Sometimes, not until decades later is the disease expressed clinically, as any of the myriad signs and symptoms within the spectrum of progressive chronic infection.

In parts of Africa, the incidence may be in excess of 2300 cases per 100,000 population. In Nigeria, patients with concurrent syphilis and HIV/AIDS had unusual manifestations, responded to therapy more slowly, and died sooner than patients described in the Western literature; this was due to generally lower levels of health. [15]

Resurgence of early syphilis contemporaneously with the global epidemic of AIDS has renewed interest in syphilis pathogenesis and the host response. Syphilis infection can increase the HIV viral load and decrease CD4 cell counts in HIV-infected persons, consequently accelerating the progression of HIV disease and enhancing symptomatology. [16]


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