Syphilis clinical最新文献

O06.1 Oral and anal Treponema pallidum detection in men who have sex with men with early infectious syphilis: a cross-sectional study 与早期传染性梅毒男性发生性行为的男性口腔和肛门梅毒螺旋体检测:一项横断面研究

Syphilis clinical Pub Date : 2021-07-01 DOI: 10.1136/SEXTRANS-2021-STI.80

Janet M. Towns, D. Leslie, I. Denham, Rebecca Wigan, F. Azzato, D. Williamson, D. Lee, E. Chow, C. Fairley, S. Graves, Lei Zhang, Marcus Y. Chen

引用次数: 0

O06.5 Expanding syphilis test uptake using rapid dual self-testing for syphilis and HIV among MSM: a randomized controlled trial in China 在中国的一项随机对照试验中，使用梅毒和艾滋病毒快速双重自我检测扩大男男性行为者梅毒检测的接受程度

Syphilis clinical Pub Date : 2021-07-01 DOI: 10.1136/SEXTRANS-2021-STI.84

Cheng Wang, J. Ong, P. Zhao, W. Tang, M. Smith, Michael Marks, Hongyun Fu, Weibin Cheng, F. Terris-Prestholt, Heping Zheng, J. Tucker, Bin Yang

引用次数: 0

O06.2 Syphilis not associated with neurocognitive outcomes in people living with HIV in Ontario Canada O06.2加拿大安大略省艾滋病毒感染者的梅毒与神经认知结果无关

Syphilis clinical Pub Date : 2021-07-01 DOI: 10.1136/SEXTRANS-2021-STI.81

B. Christensen, F. Tavangar, A. Kroch, A. Burchell, S. Rourke, Rodney K. Rousseau, L. Light, T. Bekele, D. Tan

{"title":"O06.2 Syphilis not associated with neurocognitive outcomes in people living with HIV in Ontario Canada","authors":"B. Christensen, F. Tavangar, A. Kroch, A. Burchell, S. Rourke, Rodney K. Rousseau, L. Light, T. Bekele, D. Tan","doi":"10.1136/SEXTRANS-2021-STI.81","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.81","url":null,"abstract":"Background About 40–60% of people living with HIV (PLWH) experience neurocognitive impairments, irrespective of antiretroviral status. We hypothesized that a history of syphilis would be associated with worse neurocognitive outcomes in this population. Methods We conducted a retrospective study of PLWH enrolled between 2008–2017 in an Ontarian HIV cohort. Cognitive outcomes were the most recent measurements of: 1) self-reported MOS-HIV 4-item cognitive scale; 2) average T-score (ATS) based on formal neuropsychological testing of complex attention, speed of processing, and learning/memory; and 3) global deficit score (GDS) dichotomized into impaired/unimpaired. Syphilis history was based on chart review or lab data. We compared median MOS-HIV and ATS using Wilcoxon rank-sum tests, and proportion impaired on GDS using Chi-square/Fisher test. Multivariable models were fitted to estimate the association between syphilis and each outcome, adjusted for age, education, race, income, years of HIV, nadir and most recent CD4 count, most recent viral load, methamphetamine use, depression, and number of prior neurocognitive tests. Results Of 1434 participants, 76.4% were male at birth and 50.6% were white. At the time of the most recent MOS-HIV, median age was 47 (IQR: 37,54), median CD4 count was 517.5 (IQR: 360,678) cells/mm3 and 80.2% had HIV viral load Conclusion Among PLWH in care in Ontario, prior syphilis was not associated with worse neurocognitive outcomes according to self-reported scales or formal neuropsychological testing. Continued study into the etiology of neurocognitive impairments in PLWH is required.","PeriodicalId":330607,"journal":{"name":"Syphilis clinical","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133041326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

O06.3 Developing a symptom-based risk score for infectious syphilis among men who have sex with men 06.3为男男性行为者制定基于症状的传染性梅毒风险评分

Syphilis clinical Pub Date : 2021-07-01 DOI: 10.1136/SEXTRANS-2021-STI.82

S. Nieuwenburg, H. Vries, M. S. Loeff

{"title":"O06.3 Developing a symptom-based risk score for infectious syphilis among men who have sex with men","authors":"S. Nieuwenburg, H. Vries, M. S. Loeff","doi":"10.1136/SEXTRANS-2021-STI.82","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.82","url":null,"abstract":"Background Syphilis incidence is rising among men who have sex with men (MSM). An online tool based on a risk score identifying men with higher likelihood of infectious syphilis could motivate MSM to seek help. We aimed to develop a symptoms-based risk score for infectious syphilis. Methods We included data from all consultations by MSM attending the Amsterdam STI clinic, in 2018–2019. Infectious syphilis (i.e. primary, secondary or early latent syphilis) was diagnosed according to the clinic’s routine protocol. The associations between symptoms and infectious syphilis were expressed as odds ratios (OR), with 95% confidence intervals (CI). Based on multivariable logistic regression models we created several risk scores. We assessed the area under the curve (AUC) and cutoff based on the Youden index. We estimated which percentage of men should be tested based on a positive risk score and which percentage of infectious syphilis cases would then be missed. Results 21,646 consultations with 11,594 unique persons were conducted. The median age was 34 years (interquartile range 27–45), and 14% were HIV-positive (93% on antiretroviral treatment). 538 cases of infectious syphilis were diagnosed. Associations with textbook syphilis symptoms or signs were strong and highly significant, e.g. OR for a painless penile ulcer was 35.0 (CI 24.9–49.2) and OR for a non-itching rash 57.8 (CI 36.8–90.9). None of the individual symptoms or signs had an AUC >0.55, and the AUC of risk scores varied from 0.68 to 0.69; weighting for size of coefficient did not affect AUC. Using cutoffs based on Youden index, syphilis screening would be recommended in 6% of MSM, and 59% of infectious syphilis cases would be missed. Conclusion Symptom-based risk-scores for infectious syphilis perform poorly and cannot be recommended to select MSM for syphilis screening. All MSM with relevant sexual exposure should be regularly tested for syphilis.","PeriodicalId":330607,"journal":{"name":"Syphilis clinical","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122689181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

O06.6 Refreshing the British Columbia Syphilis Control Strategy: Thematic Analysis of a Multi-Stakeholder Consultation Process 06.6刷新不列颠哥伦比亚省梅毒控制战略:多方利益相关者咨询过程的专题分析

Syphilis clinical Pub Date : 2021-07-01 DOI: 10.1136/SEXTRANS-2021-STI.85

J. Wong, V. Ryan, A. Bharmal, M. Morshed, G. Ford, K. Mooder, E. Giesbrecht, A. Pederson, T. Grennan, M. Gilbert

引用次数: 3

O06.4 Detection of Treponema pallidum DNA at various body locations as a proxy for infectiousness O06.4梅毒螺旋体DNA在不同身体部位的检测作为传染性的代表

Syphilis clinical Pub Date : 2021-07-01 DOI: 10.1136/SEXTRANS-2021-STI.83

S. Nieuwenburg, H. Zondag, S. Bruisten, M. S. Loeff, A. V. Dam, H. D. Vries

{"title":"O06.4 Detection of Treponema pallidum DNA at various body locations as a proxy for infectiousness","authors":"S. Nieuwenburg, H. Zondag, S. Bruisten, M. S. Loeff, A. V. Dam, H. D. Vries","doi":"10.1136/SEXTRANS-2021-STI.83","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.83","url":null,"abstract":"Background Syphilis is highly infectious, but it is unknown whether other anatomical sites than the primary infection site contribute to onward transmission. We aimed to evaluate the presence of Treponema pallidum ssp pallidum (TP) at various body locations of syphilis patients to elucidate transmissibility during various syphilis stages. Methods This study was performed at the Sexually transmitted infections( STI) clinic of the Public Health Services in Amsterdam. Eligible were: men who have sex with men (MSM), 18 years or older with clinical signs or symptoms suggestive of syphilis stage 1 or stage 2, and asymptomatic men with a positive syphilis serology. Besides routine diagnostics, anorectal and oropharyngeal swabs, urine samples, and venous blood samples were tested using an in-house polymerase chain reaction targeting the polA gene of Treponema pallidum (Tp-PCR). Results From 2018 to 2019 we included 293 MSM. Seventy patients had primary syphilis, 73 secondary syphilis, 86 early latent syphilis, 14 late latent syphilis, 23 treated syphilis and 27 had no syphilis. Outside of the primary ulcus, TP-DNA was detected in 35/70 among the primary syphilis patients in at least one site (2/70 blood, 7/70 oro-pharynx, 13/70 ano-rectum and 24/70 urine); in 62/73 secondary syphilis patients in at least one site (15/73 blood, 47/73 oro-pharynx, 37/73 ano-rectum and 26/73 urine); and 29/86 early latent syphilis patients in at least one site (5/86 blood, 21/86 oro-pharynx, 11/86 ano-rectum and 6/86 urine ). No TP-DNA was detected among the late latent syphilis, treated syphilis or in the no syphilis group. Conclusion DNA of T.pallidum was frequently detected in various body locations of MSM with primary or secondary syphilis. This is in agreement with the high transmissibility of syphilis.","PeriodicalId":330607,"journal":{"name":"Syphilis clinical","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127078903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1