Tags

Type your tag names separated by a space and hit enter

Early syphilis: risk factors and clinical manifestations focusing on HIV-positive patients.
BMC Infect Dis. 2019 Aug 16; 19(1):727.BI

Abstract

BACKGROUND

Since 2000, substantial increases in syphilis in men who have sex with men (MSM) have been reported in many cities. Condomless anal sex (CAS) is one of the factors, along with drugs for sex and sex in group. This study identified factors and clinical manifestations as well as Treponema pallidum (T.pallidum) strains that could be related to early syphilis in Barcelona.

METHODS

This prospective study was conducted in a sexually transmitted infections unit in 2015. Epidemiological, behavioral, clinical and microbiological variables were collected in a structured form. Univariate and multivariate statistical analyses were performed focusing on HIV-positive patients.

RESULTS

Overall, 274 cases were classified as having early syphilis (27.5% primary, 51.3% secondary, and 21.2% early latent syphilis). In all, 94% of participants were MSM and 36.3% were HIV-positive. The median number of sexual contacts in the last 12 months was 10; 72.5% practiced CAS, 50.6% had sex in group, and 54.7% consumed drugs. HIV-positive cases had more anonymous sex contacts (p = 0.041), CAS (p = 0.002), sex in group (p < 0.001) and drugs for sex (p < 0.001). In the multivariate analysis, previous syphilis (adjusted odds ratio [aOR] 4.81 [2.88-8.15]), previous Neisseria gonorrhoeae infection (aOR 3.8 [2.28-6.43]), and serosorting (aOR 20.4 [7.99-60.96]) were associated with having syphilis. Clinically, multiple chancres were present in 31% of cases with no differences on serostatus, but anal chancre was most common in HIV-positive patients (p = 0.049). Molecular typing did not conclusively explain clinical presentation in relation to specific T.pallidum strains.

CONCLUSION

Control of syphilis remains a challenge. Similar to prior studies, HIV-positive patients were found to engage more often in sexual behaviors associated with syphilis than HIV-negative patients. Clinical manifestations were rather similar in both groups, although anal chancre was most common in HIV-positive patients. Various strain types of syphilis were found, but no clinical associations were identified.

Authors+Show Affiliations

STI Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Hospital Vall d'Hebron, Av Drassanes 17-21 STI Unit Vall d'Hebron-Drassanes, Barcelona, Spain. marando@vhebron.net. Medicine Department, Autonomous University of Barcelona, Barcelona, Spain. marando@vhebron.net.Vall d'Hebron Institute of Research, Barcelona, Spain. Genetics and Microbiology Department, Autonomous University of Barcelona, Barcelona, Spain.Statistics and Bioinformatics Unit, Vall d'Hebron Institute of Research, Barcelona, Spain.STI Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Hospital Vall d'Hebron, Av Drassanes 17-21 STI Unit Vall d'Hebron-Drassanes, Barcelona, Spain.STI Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Hospital Vall d'Hebron, Av Drassanes 17-21 STI Unit Vall d'Hebron-Drassanes, Barcelona, Spain.STI Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Hospital Vall d'Hebron, Av Drassanes 17-21 STI Unit Vall d'Hebron-Drassanes, Barcelona, Spain.Microbiology Department, Hospital Vall d'Hebron, Barcelona, Spain.STI Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Hospital Vall d'Hebron, Av Drassanes 17-21 STI Unit Vall d'Hebron-Drassanes, Barcelona, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31420018

Citation

Arando, Maider, et al. "Early Syphilis: Risk Factors and Clinical Manifestations Focusing On HIV-positive Patients." BMC Infectious Diseases, vol. 19, no. 1, 2019, p. 727.
Arando M, Fernandez-Naval C, Mota-Foix M, et al. Early syphilis: risk factors and clinical manifestations focusing on HIV-positive patients. BMC Infect Dis. 2019;19(1):727.
Arando, M., Fernandez-Naval, C., Mota-Foix, M., Martinez, D., Armengol, P., Barberá, M. J., Esperalba, J., & Vall-Mayans, M. (2019). Early syphilis: risk factors and clinical manifestations focusing on HIV-positive patients. BMC Infectious Diseases, 19(1), 727. https://doi.org/10.1186/s12879-019-4269-8
Arando M, et al. Early Syphilis: Risk Factors and Clinical Manifestations Focusing On HIV-positive Patients. BMC Infect Dis. 2019 Aug 16;19(1):727. PubMed PMID: 31420018.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early syphilis: risk factors and clinical manifestations focusing on HIV-positive patients. AU - Arando,Maider, AU - Fernandez-Naval,Candela, AU - Mota-Foix,Miriam, AU - Martinez,Desi, AU - Armengol,Pere, AU - Barberá,Maria Jesús, AU - Esperalba,Juliana, AU - Vall-Mayans,Martí, Y1 - 2019/08/16/ PY - 2019/04/11/received PY - 2019/07/08/accepted PY - 2019/8/18/entrez PY - 2019/8/20/pubmed PY - 2019/11/19/medline KW - Condomless anal sex KW - HIV KW - Men who have sex with men KW - Syphilis SP - 727 EP - 727 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 19 IS - 1 N2 - BACKGROUND: Since 2000, substantial increases in syphilis in men who have sex with men (MSM) have been reported in many cities. Condomless anal sex (CAS) is one of the factors, along with drugs for sex and sex in group. This study identified factors and clinical manifestations as well as Treponema pallidum (T.pallidum) strains that could be related to early syphilis in Barcelona. METHODS: This prospective study was conducted in a sexually transmitted infections unit in 2015. Epidemiological, behavioral, clinical and microbiological variables were collected in a structured form. Univariate and multivariate statistical analyses were performed focusing on HIV-positive patients. RESULTS: Overall, 274 cases were classified as having early syphilis (27.5% primary, 51.3% secondary, and 21.2% early latent syphilis). In all, 94% of participants were MSM and 36.3% were HIV-positive. The median number of sexual contacts in the last 12 months was 10; 72.5% practiced CAS, 50.6% had sex in group, and 54.7% consumed drugs. HIV-positive cases had more anonymous sex contacts (p = 0.041), CAS (p = 0.002), sex in group (p < 0.001) and drugs for sex (p < 0.001). In the multivariate analysis, previous syphilis (adjusted odds ratio [aOR] 4.81 [2.88-8.15]), previous Neisseria gonorrhoeae infection (aOR 3.8 [2.28-6.43]), and serosorting (aOR 20.4 [7.99-60.96]) were associated with having syphilis. Clinically, multiple chancres were present in 31% of cases with no differences on serostatus, but anal chancre was most common in HIV-positive patients (p = 0.049). Molecular typing did not conclusively explain clinical presentation in relation to specific T.pallidum strains. CONCLUSION: Control of syphilis remains a challenge. Similar to prior studies, HIV-positive patients were found to engage more often in sexual behaviors associated with syphilis than HIV-negative patients. Clinical manifestations were rather similar in both groups, although anal chancre was most common in HIV-positive patients. Various strain types of syphilis were found, but no clinical associations were identified. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/31420018/Early_syphilis:_risk_factors_and_clinical_manifestations_focusing_on_HIV-positive_patients L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4269-8 DB - PRIME DP - Unbound Medicine ER -