Repeat Syphilis Among Men Who Have Sex With Men—San Diego County, 2004–2009

Katz, Kenneth A.; Lee, Marjorie A.; Gray, Tom J.; Marcus, Julia L.; Pierce, Elaine F.

doi:10.1097/olq.0b013e3181fe650b

Cited by 26 publications

(29 citation statements)

References 7 publications

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“…Follow‐up to ascertain cure and detect reinfection or relapse is achieved by assessing the clinical and serological response to treatment. Globally many studies confirm that follow‐up is poor …”

Section: Managementmentioning

confidence: 99%

2014 European guideline on the management of syphilis

Janier

Hegyi

Dupin

et al. 2014

Acad Dermatol Venereol

351

348

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Section: Managementmentioning

confidence: 99%

2014 European guideline on the management of syphilis

Janier

Hegyi

Dupin

et al. 2014

Acad Dermatol Venereol

351

348

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“…(iv) Partial immunity. Screening programmes have been taking place in high-risk populations, in which an increasing proportion of syphilis is due to reinfection [15,26]. T. pallidum infection induces partial immunity to reinfection in both humans and other animals, which may lead to an increased proportion of repeat infections being asymptomatic [14,15,24].…”

Section: (I) False-positive Test Resultsmentioning

confidence: 99%

“…A study of MSM from San Diego, California, US, in 2004-07 found no difference [26], whereas other US studies from Florida and Seattle, Washington, in 2000-08 and 1992-2008, respectively, found that persons with repeat syphilis were more likely to present with asymptomatic disease -although in the Florida study this was only statistically significant for the HIV-infected MSM group [9,27]. In the Seattle study, repeat syphilis presented as early latent disease in 113/254 (44.5%) cases, while 309/1,191 (25.9%) cases with initial syphilis [9].…”

Section: Discussionmentioning

confidence: 99%

Syphilis reinfections pose problems for syphilis diagnosis in Antwerp, Belgium – 1992 to 2012

et al. 2014

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Persons with multiple syphilis reinfections may play an important role in syphilis transmission. We analysed all syphilis tests carried out for people attending the HIV/sexually transmitted infection (STI) clinic at the Institute of Tropical Medicine, Antwerp, Belgium, from 1992 to 2012 to evaluate the extent to which syphilis reinfections were contributing to the syphilis epidemic in Antwerp. We then characterised the features of the syphilis infections in individuals with five or more episodes of syphilis. A total of 729 syphilis episodes were diagnosed in 454 persons. The majority of syphilis episodes occurred in people who had more than one episode of syphilis (445/729; 61%). A total of 10 individuals had five or more episodes of syphilis diagnosed over this period. All were men who have sex with men, HIV positive and on antiretroviral therapy. They had a total of 52 episodes of syphilis diagnosed and treated. In 38/42 of the episodes of repeat syphilis in these 10 individuals, they presented without any signs or symptoms of syphilis. Given that the majority of cases of incident syphilis in our clinic were persons with reinfections and that they frequently presented without signs of symptoms of syphilis, there is a strong case for frequent and repeated screening in all persons with a diagnosis of syphilis.

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“…Among men who have sex with men, syphilis is particularly common in those coinfected with HIV and those engaging in sexual behaviors that are associated with a high risk for STDs . And among men who have sex with men, approximately 6–12% of those who have an initial syphilis infection are reinfected within two years . Importantly, those who have repeated syphilis infections are potential core transmitters, because repeated infection suggests continued practice of risky sexual behaviors …”

mentioning

confidence: 99%