Previous Syphilis Not Associated With Neurocognitive Outcomes in People Living With Human Immunodeficiency Virus in Ontario, Canada
Bibliographic record
Abstract
Background About 40% to 60% of people living with human immunodeficiency virus (HIV) experience neurocognitive impairments, irrespective of antiretroviral status. We hypothesized that a history of syphilis or neurosyphilis would be associated with worse neurocognitive outcomes in this population. Methods Among health care–engaged people living with HIV in Ontario older than 16 years enrolled in the OHTN Cohort Study, neurocognitive outcomes were as follows: (1) self-reported Medical Outcome Study–HIV Health Survey 4-item cognitive scale; (2) average T score summary scores based on objective neuropsychological testing of complex attention, speed of processing, and learning/memory; and (3) global deficit score dichotomized into impaired/unimpaired neurocognitive status. Syphilis history was determined by laboratory data or chart review. Univariable and multivariable generalized linear mixed models assessed the association between each of: syphilis, number of episodes of syphilis, and years since syphilis diagnosis with these neurocognitive outcomes controlling for age, sex, race, education, income, years of HIV, nadir and most recent CD4 count, most recent HIV viral load, substance use, depression, and number of prior neurocognitive tests. Results Of 1288 eligible participants, 218 (16.9%) had a history of syphilis at baseline and an additional 53 were diagnosed during follow up for a total of 271 (21.0%) at the most recent visit. Of those with past infection at baseline, 179 (82.1%) had 1 and 39 (17.9%) had 2 or more episodes of syphilis. In longitudinal multivariable models, we observed no relationship between syphilis diagnosis or years since syphilis diagnosis and any of the neurocognitive outcomes. Conclusions In this sample, prior syphilis was not associated with worse neurocognitive outcomes over time according to self-reported scales or objective neuropsychological testing.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".