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Directory >> Christina M. Marra, MD


Contact Information

Christina M. Marra, MD

  • Professor, Department of Neurology
  • Adjunct Professor of Medicine, Division of Allergy and Infectious Diseases
  • University of Washington

I am Board Certified in Neurology. After my Neurology training, I completed a fellowship in Infectious Diseases. The focus of my research is on clinically relevant problems that relate to infections of the nervous system. My laboratory-based work centers on syphilis and neurosyphilis. We began a study of cerebrospinal fluid abnormalities in patients with syphilis in 1996. Broadly stated, the goal of the project is to identify which patients with syphilis are at increased risk for neurosyphilis, to identify means to better diagnose neurosyphilis in HIV-infected patients, and to determine the best ways to assess the success of neurosyphilis treatment.

Part of our work has focused on identifying molecular differences in strains of Treponema pallidum (the bacterium that causes syphilis). As we are able to identify individual syphilis strains, we can examine changes in circulating organisms over time in Seattle. We are also studying whether there is an association between the clinical manifestations of syphilis, including central nervous system (CNS) disease, and strain type.

I participate in clinical research studies on neurological complications of HIV conducted by the UW AIDS Clinical Trials Unit, which is part of the national AIDS Clinical Trials Group. These studies address the pathophysiology of HIV-associated neurological diseases, as well as treatment and prognosis. I have been particularly interested in the role of CNS penetration of antiretrovirals in treatment of HIV-associated cognitive impairment. With Dr. Ann Collier, I am local co-PI of the UW CHARTER (CNS HIV Antiretroviral Therapy Effects Research) site. CHARTER is a multicenter, longitudinal prospective study of neurological, neuropsychological and neuroimaging abnormalities in HIV-infected individuals.

Clinically, I have cared for HIV-infected people with neurological problems since 1988. I also attend on the Neurology in-patient service and in Neurology clinic at Harborview.

Selected Publications

Scheld WM, Whitley RJ, Marra CM, eds. Infections of the Central Nervous System, 3rd ed. Philadelphia, PA: Lippincott, Williams and Wilkins; 2004.

Marra CM, Maxwell CL, Smith SL, et al. Cerebrospinal fluid abnormalities in patients with syphilis: association with clinical and laboratory features. J Infect Dis. 2004; 189: 369-76.
PubMed Abstract

Marra CM, Maxwell CL, Tantalo L, et al. Normalization of CSF abnormalities after neurosyphilis therapy: does HIV status matter? Clin Infect Dis. 2004; 38: 1001-6.
PubMed Abstract

Marra CM, Tantalo LC, Maxwell CL, Dougherty K, Wood B. Alternative cerebrospinal fluid tests to diagnose neurosyphilis in HIV-infected individuals. Neurology. 2004; 63(1): 85-8.
• PubMed Abstract

Marra CM, Colina AP, Godornes C, et al. Antibiotic selection may contribute to increases in macrolide-resistant Treponema pallidum. J Infect Dis. 2006;194(12): 1771-3.
PubMed Abstract

Marra CM, Maxwell CL, Collier AC, Robertson K, Imrie A. Interpreting cerebrospinal fluid pleocytosis in HIV in the era of potent antiretroviral therapy. BMC Infect Dis. 2007; 7: 37.
PubMed Abstract

Marra CM, Maxwell CL, Tantalo LC, Sahi SK, Lukehart SA. Normalization of serum RPR predicts normalization of cerebrospinal fluid and clinical abnormalities after treatment for neurosyphilis. Clin Infect Dis. 2008; 47: 893-9.
• PubMed Abstract

Tunkel AR, Glaser CA, Bloch KC, Sejvar JJ, Marra CM, et al for the Infectious Diseases Society of America. The management of encephalitis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2008; 47: 303-27.
PubMed Abstract

Marra CM, Zhao Y, Clifford DB, et al. Impact of combination antiretroviral therapy on cerebrospinal fluid HIV RNA and neurocognitive performance. AIDS. 2009; 23(11): 1359-66.
PubMed Abstract

Marra CM, Tantalo LC, Sahi SK, Maxwell CL, Lukehart SA. CXCL13 as a cerebrospinal fluid marker for neurosyphilis in HIV-infected patients with syphilis. Sex Transm Dis. 2010; 37: 283-7. PMCID: PMC2884158
• PubMed Abstract

Marra CM, Sahi SK, Tantalo LC, Godornes C, Reid T, Behets F, et al. Enhanced molecular typing of Treponema pallidum: geographical distribution of strain types and association with neurosyphilis. J Infect Dis. 2010; 202: 1380-8. PMCID: PMC3114648.
PubMed Abstract

Heaton RK, Clifford DB, Franklin DR Jr, Woods SP, Ake C, Vaida F, Ellis RJ, Letendre SL, Marcotte TD, Atkinson JH, Rivera-Mindt M, Vigil OR, Taylor MJ, Collier AC, Marra CM, et al. HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER Study. Neurology. 2010; 75: 2087-96. PMC2995535.
• PubMed Abstract

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