- Origin of modern syphilis and emergence of a pandemic Treponema pallidum cluster. [Journal Article]
- NMNat Microbiol 2016 Dec 05; 2:16245
- The abrupt onslaught of the syphilis pandemic that started in the late fifteenth century established this devastating infectious disease as one of the most feared in human history(1). Surprisingly, d...
The abrupt onslaught of the syphilis pandemic that started in the late fifteenth century established this devastating infectious disease as one of the most feared in human history(1). Surprisingly, despite the availability of effective antibiotic treatment since the mid-twentieth century, this bacterial infection, which is caused by Treponema pallidum subsp. pallidum (TPA), has been re-emerging globally in the last few decades with an estimated 10.6 million cases in 2008 (ref. 2). Although resistance to penicillin has not yet been identified, an increasing number of strains fail to respond to the second-line antibiotic azithromycin(3). Little is known about the genetic patterns in current infections or the evolutionary origins of the disease due to the low quantities of treponemal DNA in clinical samples and difficulties in cultivating the pathogen(4). Here, we used DNA capture and whole-genome sequencing to successfully interrogate genome-wide variation from syphilis patient specimens, combined with laboratory samples of TPA and two other subspecies. Phylogenetic comparisons based on the sequenced genomes indicate that the TPA strains examined share a common ancestor after the fifteenth century, within the early modern era. Moreover, most contemporary strains are azithromycin-resistant and are members of a globally dominant cluster, named here as SS14-Ω. The cluster diversified from a common ancestor in the mid-twentieth century subsequent to the discovery of antibiotics. Its recent phylogenetic divergence and global presence point to the emergence of a pandemic strain cluster.
- Sexually transmitted infections and pre-exposure prophylaxis: challenges and opportunities among men who have sex with men in the US. [Review]
- ARAIDS Res Ther 2016 Jan 19; 13(1):5
- Pre-Exposure Prophylaxis (PrEP) has shown high efficacy in preventing human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) in several large clinical trials, and more rec...
Pre-Exposure Prophylaxis (PrEP) has shown high efficacy in preventing human immunodeficiency virus (HIV) infection among men who have sex with men (MSM) in several large clinical trials, and more recently in "real world" reports of clinical implementation and a PrEP demonstration project. Those studies also demonstrated high bacterial sexually transmitted infection (STI) incidence and raised the discussion of how PrEP may impact STI control efforts, especially in the setting of increasing Neisseria gonorrhoeae antimicrobial resistance and the increase in syphilis cases among MSM. Here, we discuss STIs as a driver of HIV transmission risk among MSM, and the potential opportunities and challenges for STI control afforded by expanded PrEP implementation among high-risk MSM.
- Elimination of mother-to-child transmission of human immunodeficiency virus and syphilis in Cuba: A stepping stone toward acquired immune deficiency syndrome-free generation. [Journal Article]
- JRJ Res Med Sci 2016; 21:54
- Atypical Skin Rash in Seronegative Secondary Syphilis. [Journal Article]
- IMIntern Med 2016; 55(23):3547
- [A meta-analysis of HIV seroprevalence in pregnant women with syphilis and the impact of syphilis infection on mother-to-child HIV transmission]. [Journal Article]
- ZYZhonghua Yu Fang Yi Xue Za Zhi 2016 Nov 06; 50(11):1001-1007
- Objective: To estimate HIV seroprevalence among pregnant women with syphilis and evaluate the influence of syphilis infection on mother-to-child-transmission (MTCT) of HIV by meta-analysis. Methods: ...
Objective: To estimate HIV seroprevalence among pregnant women with syphilis and evaluate the influence of syphilis infection on mother-to-child-transmission (MTCT) of HIV by meta-analysis. Methods: We conducted a systematic literature search for 1 678 articles related to maternal syphilis and HIV infection published until October 1(st) 2015 using the PubMed, Web of Science, Chinese Web of Knowledge, Wanfang, Weipu, and SinoMed databases and evaluated the quality of each papers using the STROBE checklist, and the keywords were " pregnant women/maternal/pregnancy" , "syphilis/AIDS" , "HIV/human immunodeficiency virus" , "mother- to-child transimission/vertical transmission" . Excluding studies with the special subgroups of HIV-positive pregnant women as the research objects, review or meeting abstract, impossibility of full-text acquisition, sample size <50, duplication or impossibility of data extraction, finally, 16 studies were included. Random-effects meta-analysis was used to estimate HIV seroprevalence among pregnant women with syphilis and the RR of MTCT for women infected with both syphilis and HIV. Subgroup analyses were undertaken by study location, sample size, use of anti-retroviral therapy and study quality. Results: Sixteen studies with a combined sample of 110 573 pregnant women were included in the analysis. Of these, ten reported HIV seroprevalences among pregnant women with syphilis and six studies evaluated the influence of syphilis infection on MTCT of HIV. Pooled estimates yielded a HIV seroprevalence of 11.6% (95% CI: 6.7%-19.5%) among pregnant women with syphilis. We estimated that the risk of MTCT of HIV was 1.86 times (RR=1.86, 95% CI: 0.89%-3.89%) higher among pregnant women with syphilis compared with those only infected with HIV-although this effect was not statistically significant. Cochran's Q test showed a high degree of heterogeneity in estimates of HIV seroprevalence and the effect of syphilis infection on MTCT of HIV across studies (I(2)=89.4% and 86.2%, respectively, P<0.10). Subgroup analysis estimated HIV seroprevalences of 24.9% (95%CI: 17.4%-34.3%) in Africa, 2.8% (95% CI: 1.4%-5.6%) in Asia and 2.2% (95% CI: 0.7%-6.7%) in South America. While studies with a large sample size (≥100) or of higher quality estimated overall seroprevalence at 15.2% (95%CI: 9.0%-24.7%), this was 2.2% (95%CI: 0.7%-6.7%) for lower-quality or smaller studies. Meanwhile, subgroup analyses of the RR of MTCT of HIV in pregnant women infected both with HIV and syphilis gave estimates of 1.19 (0.62-2.29) for the higher quality studies, 4.76 (2.65-8.53) for the lower-quality studies, 1.47 (0.77-2.81) for studies with a large sample size, 5.82 (3.16-10.74) for studies with a small sample size, 4.76 (2.65-8.53) for studies in which participants received antiretroviral treatment and 1.19 (0.62-2.29) for studies in which they did not. While Begg's test showed evidence of publication bias in studies of HIV seroprevalence estimates in pregnant women with syphilis (t=-2.48, P=0.038), no evidence of publication bias was found in studies on the influence of syphilis infection on MTCT of HIV (t=-0.22, P=0.835). Conclusion: HIV seroprevalence is higher among pregnant women with syphilis than uninfected women. Further research is warranted to verify whether syphilis infection can increase the risk of MTCT of HIV.
- [Factors associated with commercial sexual behavior among men who have sex with men in Shenzhen, China, in 2011-2015]. [Journal Article]
- ZYZhonghua Yu Fang Yi Xue Za Zhi 2016 Nov 06; 50(11):943-948
- Objective: To investigate the status and factors associated with commercial sexual behavior among men who have sex with men (MSM) in Shenzhen. Methods: A convenience sampling method was used to recru...
Objective: To investigate the status and factors associated with commercial sexual behavior among men who have sex with men (MSM) in Shenzhen. Methods: A convenience sampling method was used to recruit MSM in Shenzhen from 2011 to 2015. Questionnaire-based interviews were conducted on a one-on-one basis. Data were collected, including socio-demographic information, HIV testing history, history of blood donation and drug abuse in the last 2 years, self-reported sexual orientation, role in homosexual behavior, and experience serving as a male sex worker and/or as a client of male sex workers. Blood samples (5 ml) were taken and tested for treponema pallidum and HIV antibodies. The rate of MSM serving as male sex workers among different age groups was analyzed using the Cochran-Armitage trend test. Factors associated with commercial sexual behavior were analyzed by univariate logistic regression and multivariate unconditional logistic regression. Results: Among the 3 040 MSM recruited, 341 (11.2%) reported having served as male sex worker. The prevalence rates of syphilis, HIV, and syphilis-HIV co-infection among all recruited MSM were 18.3% (556/3 040), 9.8% (297/3 040), and 5.1% (154/3 040), respectively. The prevalence rates of syphilis, HIV, and syphilis-HIV co-infection among those who served as male sex worker were 27.0% (92/341), 16.4% (56/341), and 8.8% (30/341), respectively, and the prevalence rates among MSM with no experience as male sex worker were 17.2% (464/2 699), 8.9% (241/2 699), and 4.6% (124/2 699), respectively. Compared with non-male sex worker MSM, male sex worker had a significantly higher prevalence rates of syphilis, HIV, and syphilis-HIV co-infection (with χ(2) values of 19.41, 19.28, and 11.12, and P-values of <0.001,<0.001, 0.001, respectively). The results of the multivariate logistic regression analysis indicate that>30-year-old MSM or education level of college or above, reside in Shenzhen for 0.5-3.0 years or the living years above 3.0 years are less likely to serve as male sex worker compared with<30-year-old MSM, education level of high school or below, who reside in Shenzhen for less than 0.5 years; the OR (95%CI) values were 0.55 (0.42-0.71), 0.10 (0.06-0.14), 0.46 (0.31-0.68), and 0.23 (0.16-0.33), respectively. MSM having a monthly income of >5 000 yuan, drug abuse history, experience as male sex worker clients, and self-reported insertive and receptive anal sex behaviors were more likely to have experience serving as male sex worker compared with those having a monthly income of <3 000 yuan (OR=2.57, 95%CI: 1.85-3.57), no drug abuse history (OR=3.23, 95% CI: 2.14-4.87), no experience as male sex worker clients (OR =1.50, 95% CI: 1.04-2.15) and who engage in predominantly insertive anal sex behaviors (OR=1.77, 95% CI: 1.34-2.35). Conclusion: Age, education level, duration of residence in Shenzhen, monthly income, history of drug abuse, role in homosexual activity, and had experience commercial sex activity were associated with serving as a male sex worker among MSM. These factors need to be considered when designing syphilis/HIV prevention programs for MSM.
- TLR-2 Recognizes Propionibacterium acnes CAMP Factor 1 from Highly Inflammatory Strains. [Journal Article]
- PlosPLoS One 2016; 11(11):e0167237
- CONCLUSIONS: Our findings indicate that CAMP factor 1 may contribute to P. acnes virulence, by amplifying the inflammation reaction through direct interaction with TLR2.
- Rate of Decline in Nontreponemal Antibody Titers and Seroreversion After Treatment of Early Syphilis. [Journal Article]
- STSex Transm Dis 2016 Nov 28
- CONCLUSIONS: Despite a ≥ 4-fold RPR titer decline after treatment, the majority of HIV-negative patients with early syphilis failed to have seroreversion at 12 months. Nontreponemal antibody titers often persist despite an appropriate treatment response.
- Sexually Transmitted Infections and Associated Risk Factors Among Street-Based and Residence-Based Female Sex Workers in Dhaka, Bangladesh. [Journal Article]
- STSex Transm Dis 2016 Nov 28
- CONCLUSIONS: Despite receiving HIV/STI prevention services, bacterial STIs remain prevalent among FSWs suggesting the need for more effective management of STIs. The guidelines for management of STIs need revision in view of the emerging resistance.
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- Elimination of Mother-To-Child Transmission of Syphilis in the Americas-A Goal That Must Not Slip Away. [Journal Article]
- STSex Transm Dis 2016 Nov 28