Abstract:The impact of increasingly efficient antiretroviral therapy (ART) on survival and general well-being has contributed to a "business as usual" attitude to sex among men who have sex with men (MSM). There has been a recent marked increase of sexually transmitted infections (STI) including syphilis, LGV and Hepatits C among MSM. STIs located in the oral cavity or rectum are asymptomatic in over 80% and 50%, respectively and these sites must be seen as important reservoirs. On the other hand severe proctitis may be mistreated as inflammatory bowel disease without adequate medical history and testing. Due to the reappearance of syphilis, all genital ulcers, non-itching exanthema and severe disease symptoms (e.g. fever, fatigue, lymphadenopathy, hepato-splenomegaly, increased liver enzymes, neurological and ophthalmologic symptoms without other explanations) should lead to testing for syphilis. There is a marked association between STIs and HIV. Syphilis, LGV and Hepatits C are strongly overrepresented in HIV positive MSM, while gonorrhoea, LGV and syphilis increase the HIV susceptibility. Syphilis leads to increased viral load in HIV positive. The major risk factors for Hepatitis B are number of sex partners and receptive anal intercourse. High grade Human Papilloma Virus (HPV) anal lesions can progress to cancer. There is a 30 fold increase risk for anal cancer among MSM, a risk that is doubled in HIV infection, making anal cancer one of the most common non-AIDS tumours. All MSM should be offered Hepatitis A and B vaccination and the inclusion of boys in HPV vaccination programs must be considered. The aim of this article is to describe asymptomatic and symptomatic bacterial and viral STIs of the oral cavity, penis/urethra and rectum and the sexually transmittable viral Hepatitis and HIV in MSM and to inspire the medical establishment to adhere to testing guidelines in this group. This article is built on a review of published findings, the presentation of own data on Gonorrhoea and chlamydia and our own experience in treating all STIs including HIV in MSM since 1982 at a Gay Men's Health Clinic (Venhälsan) at Stockholm South General Hospital, Sweden.

a prospective cohort study was carried out to examine the relationship of BV and HSV-2 acquisition among women in Mysore. Quarterly, data were collected on sociodemographics, risk behaviour, partner characteristics, followed by a physical examination to diagnose and treat reproductive tract infections. BV was defined using Nugent scoring of gram stained vaginal smears. Persistent BV was calculated using generalised estimating equation methods. Women gave informed consent prior to enrolment in the study. Results Of the 420 women for which there were data available for all three visits, 114 (27%) had two or more BV episodes. Women with a history of 2 or more BV episodes were more likely to be infected with Trichomonas vaginalis [OR 72.93, 95% CI 9.69 to 548.4] and be diagnosed with HSV-2 infection [OR 2.58, 95% CI 1.44 to 4.63] compared to women with no BV history. Women with a history of BV were also more likely to report no education, tubal ligation, being a non-Muslim, and having a sex partner who had other sex partners. Conclusions Young reproductive age women in India have a high persistence of BV. Although the association between BV and Trichomonas vaginalis is unclear, it seems prudent to recommend that women with BV or TV be screened for both infections. Background Preterm birth (PTB) accounts for 65% neonatal deaths and 50% neurological disability in children. Prior spontaneous PTB is the highest risk factor for subsequent PTB and is usually associated with sub-clinical infection, possibly due to genetic polymorphisms of proinflammatory cytokines. Bacterial vaginosis (BV) has been implicated in PTB and early treatment may reduce it but less attention has been paid to other infections. We assessed the infective and obstetric complications in a group of pregnant women at high risk of PTB and the interventions to reduce PTB. Methods Study group: Pregnant women at high risk of PTB Interventions: Microbiological screening for infections from beginning of second trimester then 4-weekly until 28 weeks gestation with treatment of infections found; 2-weekly ultrasound assessment of cervical length during second trimester with cerclage and progesterone injections if needed. Outcome: Gestational age at delivery. Results We have managed 104 pregnancies in 95 multiparous women who had at least one previous mid-trimester miscarriage (MTM), PTB or stillbirth due to chorioamnionitis. 21% had two previous MTM and/or PTB; 5% had three; 4% had four and 1% had five MTM/PTB. 75% were of white ethnicity, 7% asian, 18% black. One or more infection was identified in 51 (49%) of the pregnancies; Group B streptococcal infection (GBS) in 21%, BV in 16%, S aureus in 3%, heavy growth vaginal or urinary coliforms in 16%. Prevalence of infections was more frequent in black (68%), than white (48%), than asian (14%) women. Pregnancy outcome: Exact gestational age unknown in 4 due to transfer to different hospital when >28/40 gestation so outcomes for 100 pregnancies. Four resulted in MTM leaving 96 viable pregnancies. Gestational age a...

suggests that phylotypes differ phenotypically. An accurate survey of genetic diversity and population structure will facilitate responsible selection of drug and/or vaccine targets for future treatments, and will enable better understanding of virulence factors contributing to the wide range of severity of symptoms associated with trichomoniasis. Objectives To develop a novel diagnostic protein in order to enhance early detection of syphilis infections and improve overall syphilis diagnosis. Methods Using pooled serum samples from patients infected with syphilis, immunoreactive regions of two previously identified diagnostic protein candidates, Tp0326 and Tp0453, were elucidated. Focusing on these regions, a chimeric protein construct was created for expression in Escherichia coli and expression conditions were optimised to produce soluble protein expression. This Tp0326/Tp0453 chimeric construct was screened against serum samples from; patients with primary, secondary, latent, and neurosyphilis and uninfected individuals. These results were directly compared to the rapid plasma regain (RPR) test, and the microhemagglutination assay for T pallidum (MHA-TP). P4-S3.08 DEVELOPMENT OF A NOVEL CHIMERIC PROTEIN CONSTRUCT FOR IMPROVED DIAGNOSIS OF SYPHILISdoiResults Screening results show high degrees of sensitivity and specificity for the Tp0326/Tp0453 chimeric construct, identifying all stages of syphilis infection from early primary to late latent. Conclusion The Tp0326/Tp0453 chimera shows promise as a new diagnostic antigen for detecting all stages of syphilis infection and for development into point-of-care diagnostic test formats. Objective Trichomonas vaginalis, a highly prevalent non-viral sexually transmitted infection, has been shown to be infected by a doublestranded RNA virus known as T vaginalis virus (TVV). The presence of this virus has been associated with increased trafficking of the immunogenic P270 to the surface of the parasite, and has therefore been hypothesised to be an important virulence factor in trichomoniasis. In the present study, we investigate the prevalence of TVV in globally distributed T vaginalis isolates and find an association between TVV infection and genetically distinct T vaginalis populations. Methods 150 T vaginalis isolates from the USA, Mexico, Italy, Southern Africa, Papua New Guinea and Australia were screened for TVV infection by running total RNA extract on 1% agarose gels to detect the presence or absence of the diagnostic 4.5 kb dsRNA genome of the virus. The prevalence of TVV in genetically distinct T vaginalis phylotypes was compared using c 2 tests. Results TVV was found to be present in 37% of T vaginalis isolates. We find a difference in the prevalence of TVV infection between genetically distinct populations of parasites, with 3% of phylotype 1 isolates containing the virus vs 73% of phylotype 2 parasites (<0.001). P4-S3.09 THE PREVALENCE OF TRICHOMONAS VAGINALISConclusions TVV prevalence varies between T vaginalis phylotypes 1 and 2. This finding has implicatio...

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