Sexually transmitted infections in the elderly

Relhan, Vineet; Bansal, Anuva; Hegde, Pallavi; Sahoo, Bijaylaxmi

doi:10.4103/ijstd.ijstd_60_20

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…HPV infection may have been acquired during this time also, or alternatively may have been latent and subsequently reactivated ( 63 ). There is increased evidence of acute STIs in the elderly ( 64 ); this may be due to multiple factors including loss of spouse ( 65 ), high risk sex ( 66 ), immunosuppression ( 67 ), and erectile dysfunction drugs ( 68 ). The CDC reports that STI incidence more than doubled in U.S. adults 65 years and older between 2007-2017.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Resolution of high grade anal squamous intraepithelial lesion with antibiotics proposes a new role for syphilitic infection in potentiation of HPV-associated ASCC

Ranabhotu,

Habibian,

Patel

et al. 2023

Front. Oncol.

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IntroductionHuman Papillomavirus (HPV) is the primary risk factor for the development of anal intraepithelial neoplasia (AIN) and is a leading risk factor for anogenital squamous cell carcinoma (ASCC). Despite common shared risk factors for both HPV and syphilis, co-infection is not well documented, and the role of syphilitic infection in HPV-associated AIN and ASCC potentiation is not defined.Case description/methodsA 72-year-old single male presented with complaints of mild rectal pain and intermittent rectal bleeding. A flexible sigmoidoscopy was performed, and a firm 4.5cm x 3cm perianal mass was detected and superficially biopsied. Pathology findings demonstrated evidence of a high grade squamous intraepithelial lesion (HGSIL, AIN II/III/AIS) with viral cytopathic effect, consistent with HPV infection. Much of the biopsied lesion showed acanthotic squamous mucosa with intraepithelial neutrophils and abundant submucosal plasma cells, suggesting possible syphilitic involvement. Subsequent immunohistochemical staining for p16 as a surrogate marker for HPV was positive, as was an immunohistochemical stain for spirochetes, supportive of co-infection with Treponema pallidum pallidum (T. pallidum), the causative agent in venereal syphilis. The patient was referred to an infectious disease specialist for syphilitic infection and was treated with penicillin with surprisingly complete resolution of the lesion. EUAs were performed 2- and 3-months following treatment without lesion recurrence. However, one year following diagnosis, a flexible sigmoidoscopy revealed a 5 mm recurrent HPV-related low-grade AIN 1 lesion at the dentate line.DiscussionResolution of the lesion by antibiotic treatment for syphilitic infection suggested that co-infection by T. pallidum may potentiate HPV-associated squamous cell carcinoma based on histological findings. Findings from this case, as well as a review of bacterial involvement and potentiation in various cancers, are reviewed here. Such findings offer new insight regarding the role of STI-associated bacteria and HPV co-infection in the establishment of AIN and may additionally propose new treatment modalities for ASCC.

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Section: Discussionmentioning

confidence: 99%

Case Report: Resolution of high grade anal squamous intraepithelial lesion with antibiotics proposes a new role for syphilitic infection in potentiation of HPV-associated ASCC

Ranabhotu,

Habibian,

Patel

et al. 2023

Front. Oncol.

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“…Nowadays, people aged 50 and older are at greater risk for sexually transmitted infections, such as syphilis, due to increased quality of life and the availability of medications to prolong sexual life [6,11,12]. In 2021, people from this age group accounted for 12% of syphilis infection cases in Poland [6].…”

Section: Discussionmentioning

confidence: 99%

“…In 2021, people from this age group accounted for 12% of syphilis infection cases in Poland [6]. Studies report that elderly people are more likely to present syphilis at a late or unknown stage [6,11,12]. Clinicians, unfortunately, often forget about this and overlook the symptoms of the disease caused by Treponema palladium so that proper diagnosis is delayed, as happened with the first 72-year-old female patient mentioned in our manuscript [6,11,12].…”

Section: Discussionmentioning

confidence: 99%

Late latent syphilis as a challenging issue in the twenty-first century

Plagens-Rotman,

Merks,

Jarząbek-Bielecka

et al. 2023

Journal of Sexual and Mental Health

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Introduction: Syphilis is one of the oldest sexually transmitted diseases caused by the bacterium Treponema pallidum. It is characterized by multiple clinical presentations and a long duration. Acquired syphilis is divided into early (≤ 1 year after infection) and late (> 1 year after infection) stages. Venereal diseases, more often defined as sexually transmitted diseases (STDs), result from behaviours influenced by socio-economic, psychological, and cultural factors. Although the spectrum of sexually transmitted diseases, apart from classic syphilis and gonorrhoea, encompasses a wide range of aerobic and anaerobic bacteria, viruses, protozoans, fungi, and even insects, the frequency of late syphilis has been on the rise in recent years. It is a significant clinical problem in our country. Irrespective of the COVID SARS-19 pandemic, this is an important issue of contemporary epidemiology.

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“…We read with interest the recent publication by Relhan et al . entitled “Sexually transmitted infections in the elderly: A 6-year retrospective study in a tertiary care hospital in New Delhi.”[ 1 ]…”

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confidence: 99%