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1.
PLoS One ; 15(8): e0237949, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32817658

RESUMEN

Syphilis, caused by Treponema pallidum ssp. pallidum (TPA), is a persisting global health problem. Although syphilis diagnostics relies mainly on serology, serological tests have some limitations, and it is recommended that the final diagnosis be supported by additional tests. The purpose of this study was to analyze the relationship between serology and PCR in syphilis diagnostics. From the year 2004 to May 2019, a total of 941 samples were taken from 833 patients suspected of having syphilis, in Czech Republic. In all these samples, both nested PCR detection of TPA and serology testing were performed. Of the 941 samples, 126 were seronegative, 651 were seropositive, and 164 were serodiscrepant. Among seronegative samples (n = 126), 11 were PCR-positive (8.7%). Among seropositive samples (n = 651; i.e., samples positive for both non-treponemal and treponemal serology tests), 368 samples were PCR-positive (56.5%). The remaining 164 serodiscrepant samples included RPR negative and treponemal serological test-positive samples (n = 154) and a set of 10 RPR-positive samples negative in treponemal serological tests. While the first group revealed 73 PCR-positive samples (47.4%), the second revealed 5 PCR positive samples (50.0%). PCR detection rates were highest in primary syphilis, with lower rates in the secondary and undetermined syphilis stages. As shown here, the nested PCR can improve diagnostics of syphilis, especially in seronegative patients and in patients with discrepant serology.


Asunto(s)
Reacción en Cadena de la Polimerasa , Serodiagnóstico de la Sífilis/métodos , Sífilis/diagnóstico , Treponema/aislamiento & purificación , Humanos , Estudios Retrospectivos , Sífilis/sangre , Treponema/genética , Treponema/inmunología , Treponema/fisiología
2.
BMC Infect Dis ; 20(1): 444, 2020 Jun 23.
Artículo en Inglés | MEDLINE | ID: mdl-32576149

RESUMEN

BACKGROUND: The syphilis epidemic continues to cause substantial morbidity and mortality worldwide, particularly in low- and middle-income countries, despite several recent disease control initiatives. Though our understanding of the pathogenesis of this disease and the biology of the syphilis agent, Treponema pallidum subsp. pallidum has improved over the last two decades, further research is necessary to improve clinical diagnosis and disease management protocols. Additionally, such research efforts could contribute to the identification of possible targets for the development of an effective vaccine to stem syphilis spread. METHODS: This study will recruit two cohorts of participants with active syphilis infection, one with de novo infection, one with repeat infection. Whole blood specimens will be collected from each study participant at baseline, 4, 12, 24, 36, and 48 weeks, to track specific markers of their immunological response, as well as to compare humoral reactivity to Treponema pallidum antigens between the two groups. Additionally, we will use serum specimens to look for unique cytokine patterns in participants with early syphilis. Oral and blood samples, as well as samples from any syphilitic lesions present, will also be collected to sequence any Treponema pallidum DNA found. DISCUSSION: By furthering our understanding of syphilis pathogenesis and human host immune response to Treponema pallidum, we will provide important data that will help in development of new point-of-care tests that could better identify active infection, leading to improved syphilis diagnosis and management. Findings could also contribute to vaccine development efforts.


Asunto(s)
Vacunas Bacterianas/uso terapéutico , Sífilis/epidemiología , Sífilis/prevención & control , Treponema pallidum/inmunología , Vacunación , Antígenos Bacterianos/inmunología , Secuencia de Bases , Estudios de Cohortes , Citocinas/análisis , ADN Bacteriano/genética , Estudios de Seguimiento , Humanos , Tipificación Molecular , Perú/epidemiología , Sífilis/sangre , Sífilis/inmunología , Treponema pallidum/genética
3.
BMC Infect Dis ; 20(1): 165, 2020 Feb 22.
Artículo en Inglés | MEDLINE | ID: mdl-32087699

RESUMEN

BACKGROUND: Treponema pallidum (T. pallidum) infection evokes significant immune responses, resulting in tissue damage. The immune mechanism underlying T. pallidum infection is still unclear, although microRNAs (miRNAs) have been shown to influence immune cell function and, consequently, the generation of antibody responses during other microbe infections. However, these mechanisms are unknown for T. pallidum. METHODS: In this study, we performed a comprehensive analysis of differentially expressed miRNAs in healthy individuals, untreated patients with syphilis, patients in the serofast state, and serologically cured patients. miRNAs were profiled from the peripheral blood of patients obtained at the time of serological diagnosis. Then, both the target sequence analysis of these different miRNAs and pathway analysis were performed to identify important immune and cell signaling pathways. Quantitative reverse transcription-polymerase chain reaction (RT-PCR) was performed for microRNA analysis. RESULTS: A total of 74 differentially regulated miRNAs were identified. Following RT-qPCR confirmation, three miRNAs (hsa-miR-195-5p, hsa-miR-223-3p, hsa-miR-589-3p) showed significant differences in the serofast and serologically cured states (P < 0.05). One miRNA (hsa-miR-195-5p) showed significant differences between untreated patients and healthy individuals. CONCLUSIONS: This is the first study of miRNA expression differences in peripheral blood mononuclear cells (PBMCs) in different stages of T. pallium infection. Our study suggests that the combination of three miRNAs has great potential to serve as a non-invasive biomarker of T. pallium infections, which will facilitate better diagnosis and treatment of T. pallium infections.


Asunto(s)
Leucocitos Mononucleares/metabolismo , MicroARNs/genética , Sífilis/sangre , Transcriptoma/genética , Treponema pallidum/inmunología , Biomarcadores , Perfilación de la Expresión Génica , Humanos , MicroARNs/inmunología , Pronóstico , Reacción en Cadena en Tiempo Real de la Polimerasa , Pruebas Serológicas , Sífilis/diagnóstico , Sífilis/microbiología , Treponema pallidum/aislamiento & purificación
4.
J Infect Public Health ; 13(2): 299-305, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31953019

RESUMEN

BACKGROUND: Screening of blood products is considered a mandatory protocol implemented in health care facilities in order to reduce the onset of transfusion-transmitted infections (TTIs). This study was aimed to determine the sero-prevalence of ABO and Rh blood groups and their associated TTIs among blood donors in the Central Region of Saudi Arabia. METHODS: This was retrospective study performed on the blood donors' records from March 2017 to December 2018 at Buraidah Central Hospital Blood Bank. Study was conducted on a total of 4590 blood donors. ABO and Rh typing was performed.The blood samples were also screened serologically for hepatitis B surface antigen (HBsAg), anti-hepatitis B core total antibodies (anti-HBc total), hepatitis C virus (HCV), human immunodeficiency viruses (HIV), human T-lymphotrophic virus-1 (HTLV-1) and veneral disease research laboratory test(VDRL) for syphilis. RESULTS: Out of 4590 blood donors, O positive blood group was found to be highest (42%), followed by A positive (23.4%), B positive (20.9%), O negative (5.45%), AB positive (3.4%), A negative (2.8%), B negative (2.1%) and AB negative (0.5%). Moreover, total number of Rh-negative donors was significantly lowered as compared with Rh-positive. Seroreactive tests were found to be positive in only 1.002% of all studied donors and mainly found in male donors. Among TTI, anti-HBc total was the highest (0.784%), followed by HBsAg, HCV, VDRL and TPHA. Whereas all tested donors were found to be negative for HIV infections. CONCLUSIONS: The information collected for the frequency of ABO blood phenotypic groups has a vital significance in establishing a simple blood group database. This study clearly determined significantly lower rate of seropositive TTIs among the studied blood donors but still steps are needed to improve the knowledge and to prevent the seropositive occurrence of TTIs.


Asunto(s)
Sistema del Grupo Sanguíneo ABO , Donantes de Sangre , Sistema del Grupo Sanguíneo Rh-Hr , Reacción a la Transfusión/epidemiología , Adolescente , Adulto , Anciano , Tipificación y Pruebas Cruzadas Sanguíneas , Transfusión Sanguínea/métodos , Femenino , Infecciones por VIH/sangre , Infecciones por VIH/epidemiología , Anticuerpos contra la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Hepatitis C/sangre , Hepatitis C/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Arabia Saudita/epidemiología , Estudios Seroepidemiológicos , Sífilis/sangre , Sífilis/epidemiología , Reacción a la Transfusión/sangre , Adulto Joven
5.
Am J Perinatol ; 37(7): 671-678, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31910464

RESUMEN

OBJECTIVE: This study aimed to evaluate the association of ARCHITECT chemiluminescent immunoassay (CIA) signal strength (signal-to-cutoff [S/CO] ratio), with maternal syphilis stage, rapid plasma reagin (RPR) reactivity, and congenital syphilis. STUDY DESIGN: A prospective observational study of reverse syphilis screening was conducted. Pregnant women were screened with CIA. Reactive CIA was reflexed to RPR; particle agglutination test (Treponema pallidum particle agglutination [TPPA]) was performed for CIA+/RPR- results. Clinical staging with history and physical was performed, and disease stage was determined. Prior treatment was confirmed. We compared S/CO ratio and neonatal outcomes among the following groups: Group 1: CIA+/RPR+/TPPA+ or CIA+/RPR-/TPPA+ with active syphilis; Group 2: CIA+/RPR-/TPPA+ or CIA+/serofast RPR/TPPA+, previously treated; Group 3: CIA+/RPR-/TPPA+, no history of treatment or active disease; Group 4: CIA+/RPR-/TPPA-, false-positive CIA. RESULTS: A total of 144 women delivered with reactive CIA: 38 (26%) in Group 1, 69 (48%) in Group 2, 20 (14%) in Group 3, and 17 (12%) in Group 4. Mean (±standard deviation) S/CO ratio was 18.3 ± 5.4, 12.1 ± 5.3, 9.1 ± 4.6, and 1.9 ± 0.8, respectively (p < 0.001). Neonates with overt congenital syphilis occurred exclusively in Group 1. CONCLUSION: Women with active syphilis based on treatment history, clinical staging, and laboratory indices have higher CIA S/CO ratio and are more likely to deliver neonates with overt evidence of congenital syphilis.


Asunto(s)
Inmunoensayo , Complicaciones Infecciosas del Embarazo/diagnóstico , Sífilis Congénita , Sífilis/diagnóstico , Treponema pallidum/inmunología , Adulto , Algoritmos , Anticuerpos Antibacterianos/sangre , Femenino , Humanos , Inmunoensayo/métodos , Recién Nacido , Mediciones Luminiscentes , Masculino , Tamizaje Masivo/métodos , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Estudios Prospectivos , Sífilis/sangre , Serodiagnóstico de la Sífilis
6.
J Clin Lab Anal ; 34(1): e23033, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31617243

RESUMEN

BACKGROUND AND OBJECTIVES: To prevent Treponema Pallidum (TP) transmission from blood transfusion, enzyme-linked immunosorbent assay (EIA) for anti-TP has been widely used in routine blood donation screening in China for many years. The aim of this study was to evaluate the performance of the Abbott CMIA assay for detection of anti-TP in Chinese blood donors. MATERIALS AND METHODS: A total of 2420 plasma samples, already routinely screened for anti-TP by two different EIAs, from four blood Centers were tested for anti-TP by Abbott CMIA. Subsequently, all samples with positive results by one or both EIAs and/or by Abbott CMIA were subjected to confirmatory testing (CT) using recombinant immunoblot assay (RIBA) or Treponema Pallidum particle agglutination assay (TPPA). TP infection was defined by a RIBA or TPPA positive. RESULTS: Compared with two EIAs strategy, Abbott CMIA showed a relatively best sensitivity as 98.80% (95% CI: 97.44%-100.16%) and a relatively best specificity as 99.58% (95% CI: 99.30%-99.85%), yielding the best consistency (99.49%) between anti-TP CT results with the highest κ value of .98. CONCLUSION: This is the first study to evaluate the performance of the Abbott CMIA assays for detection of syphilis in Chinese blood donors. Our results suggested that CMIA performed better than both EIAs, and implementation of CMIA replacing two different EIA reagents might help to further reduce the risk of transfusion-transmitted TP infection, decrease unnecessary blood waste and loss of blood donors.


Asunto(s)
Grupo de Ascendencia Continental Asiática , Donantes de Sangre , Inmunoensayo/métodos , Mediciones Luminiscentes/métodos , Serodiagnóstico de la Sífilis/métodos , Sífilis/sangre , Sífilis/diagnóstico , Humanos , Tamizaje Masivo , Treponema pallidum/inmunología
7.
Clin Microbiol Infect ; 26(2): 240-246, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31212076

RESUMEN

OBJECTIVES: We aimed to characterize kinetics of non-treponamal antibody titres during the natural course of syphilis and explore their roles in monitoring syphilis treatment efficacy. METHODS: Sixty New Zealand white male rabbits were challenged with Nichols or Amoy Treponema pallidum strains, and the rapid plasma reagin (RPR) test was performed to quantify non-treponemal antibody titres during the infection course. Viable T. pallidum in the challenged rabbits was assessed with rabbit infectivity tests. RESULTS: The RPR titres of the Nichols or Amoy strain between no benzathine penicillin G (BPG) and BPG treatment subgroups displayed a similar trend: first ascending and then descending. Compared with baseline, the proportions of fourfold decline in RPR titres in the Nichols or Amoy group presented a similar result on days 30, 60 and 180 between the no BPG and BPG treatment subgroups (0%, 0/5; 80%, 4/5; 100%, 5/5; vs. 0%, 0/5; 80%, 4/5; 100%, 5/5; p 0.999; 0%, 0/5; 80%, 4/5; 80%, 4/5; vs. 40%, 2/5; 100%, 5/5; 100%, 5/5; p 0.098, respectively). Compared with the maximum baseline titre, the proportion of fourfold decline in PRR titre also showed a similar result in the two groups on days 30, 60 and 180 between the no BPG and the BPG treatment subgroups (0%, 0/5; 100%, 5/5; 100%, 5/5, vs. 40%, 2/5; 100%, 5/5; 100%, 5/5; p 0.129; 0%, 0/5; 100%, 5/5; 100%, 5/5, vs. 80%, 4/5; 100%, 5/5; 100%, 5/5; p 0.091, respectively. Moreover, regardless of whether the RPR titres presented a fourfold decline, viable T. pallidum could be detected in untreated rabbits' lymph nodes at 30, 60 and 180 days post infection, while viable T. pallidum was not detected in any of the treated rabbits' lymph nodes. CONCLUSIONS: The RPR titre increased and then decreased (even became negative) during the natural course of syphilis, similar to that seen after BPG treatment. The RPR tetre is thus a questionable indicator of syphilis treatment efficacy.


Asunto(s)
Antiinfecciosos/uso terapéutico , Anticuerpos Antibacterianos/sangre , Sífilis/tratamiento farmacológico , Treponema pallidum/efectos de los fármacos , Animales , Modelos Animales de Enfermedad , Masculino , Plasma , Conejos , Sífilis/sangre , Sífilis/inmunología , Resultado del Tratamiento
8.
Infect Dis (Lond) ; 52(3): 177-185, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31718355

RESUMEN

Introduction: Antinuclear antibody (ANA) tests are widely used for the diagnosis of autoimmune diseases, but ANAs are also commonly found in patients with various infections. This retrospective study aimed to investigate the relationship between infections and ANA status.Methods: Patients that visited the Department of Infectious Diseases at Inha University Hospital between January 2007 and July 2018 were investigated. We analysed their ANA test results and reviewed rheumatic and infectious diagnoses of patients with positive ANA findings.Results: Of the 9,320 patients during the study period, 1,111 underwent ANA testing and 110 tested positive. Seven of the 110 patients were previously diagnosed with ANA-positive disease, and 21 were diagnosed with autoimmune disease during the present study. Of the remaining 82 patients, 43 were confirmed with infectious disease. The most common pathogen was Mycobacterium tuberculosis (n = 10), followed by Treponema pallidum (n = 5), Orientia tsutsugamushi (n = 5), Escherichia coli (n = 5), Bartonella henselae (n = 3), and human immunodeficiency virus (n = 3). Of the 39 patients without a confirmed pathogen, 7 were seropositive for O. tsutsugamushi, B. henselae, or Rickettsia spp. Patients were observed at an average of 24 weeks in our hospital. One patient developed systemic lupus erythematosus after being diagnosed with Epstein-Barr virus-induced infectious mononucleosis, and another patient developed adult-onset Still's disease after being diagnosed with scrub typhus.Conclusion: This study showed that various relationships exist between infections and rheumatic diseases. In particular, several patients with a positive ANA test result were found to have intracellular infections such as mycobacterial infections, syphilis, or scrub typhus.


Asunto(s)
Anticuerpos Antinucleares/sangre , Enfermedades Autoinmunes/sangre , Infecciones/sangre , Infecciones/microbiología , Enfermedades Reumáticas/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades Autoinmunes/diagnóstico , Bartonella henselae , Escherichia coli , Infecciones por Escherichia coli/sangre , Femenino , Infecciones por VIH/sangre , Humanos , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis , Orientia tsutsugamushi , Estudios Retrospectivos , Enfermedades Reumáticas/diagnóstico , Rickettsia , Tifus por Ácaros/sangre , Sífilis/sangre , Treponema pallidum , Tuberculosis Pulmonar/sangre , Adulto Joven
9.
Neurol Sci ; 41(1): 83-90, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31440863

RESUMEN

Diabetes mellitus (DM) and neurosyphilis (NS) may both damage the blood-brain barrier (BBB). It seems that non-neurosyphilis (non-NS) patients with high HbA1c levels are likely to develop into NS. However, the correlation of HbA1c level with BBB disruption in syphilis (non-NS) patients is unclear. In this study, we used dynamic contrast-enhanced (DCE) MRI to quantify regional BBB permeability in syphilis (non-NS) patients and detected several molecular biomarkers of cerebrospinal fluid (CSF). We found that BBB permeability values in the hippocampus, white matter, and cortex inferior temporal gyrus were correlated with albumin quotient (Qalb), CSF concentrations of interleukin IL-6 and IL-10. Moreover, BBB breakdown in white matter was correlated with CSF concentrations of sICAM-1 and sVCAM-1. In conclusion, our data suggest that BBB integrity may be liable to be disrupted in syphilis (non-NS) patients, patients with high HbA1c levels, as well as syphilis (non-NS) patients with high HbA1c levels, and it is particularly important to control blood glucose in these patients.


Asunto(s)
Barrera Hematoencefálica/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Hemoglobina A Glucada/metabolismo , Sífilis/sangre , Sífilis/diagnóstico por imagen , Adolescente , Adulto , Anciano , Biomarcadores/sangre , Barrera Hematoencefálica/metabolismo , Encéfalo/metabolismo , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales/métodos , Adulto Joven
10.
Diagn Microbiol Infect Dis ; 96(1): 114913, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31699543

RESUMEN

The Centers for Disease Control and Prevention's (CDC) Division of STD Prevention, in collaboration with the Association of Public Health Laboratories (APHL), is developing a nationally available syphilis serum repository for research of Food and Drug Administration (FDA)-cleared or investigational syphilis diagnostic assays in the United States. State and local public health laboratories (PHL) submitted de-identified residual sera with information on collection date, volume, storage conditions, freeze-thaw cycles, PHL serology results, reported syphilis stage and demographic details if available. Previous test results were blinded and sera (N = 152 reported syphilis stage, N = 131 unknown status) were tested at CDC using five FDA-cleared and one investigational syphilis tests. Treponemal and nontreponemal test sensitivity ranged from 76.3-100% and 63.2-100%, respectively, among staged specimens. The conventional treponemal assays showed high concordance of 95.4%. By providing syphilis stage and comprehensive serological test data, developed repository may serve as a valuable resource for diagnostic test validation studies.


Asunto(s)
Anticuerpos Antibacterianos/sangre , Bancos de Sangre , Tamizaje Masivo/métodos , Serodiagnóstico de la Sífilis , Sífilis/sangre , Adulto , Centers for Disease Control and Prevention, U.S. , Femenino , Humanos , Masculino , Sensibilidad y Especificidad , Sífilis/diagnóstico , Treponema pallidum , Estados Unidos , Adulto Joven
13.
Klin Lab Diagn ; 64(9): 546-552, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31610107

RESUMEN

The aim of the study was to characterize the dynamics of immunoglobulin IgG and IgM level in syphilis patients serum at different stages of the disease before and after the therapy towards 12 diagnostic antigens of T. pallidum in an microarray assay and to evaluate these data as possible prognostic markers. The dynamics of immunoglobulin IgG and IgM level was measured in the reaction of indirect immunofluorescence using microarray and compared to the results of non-treponemal RPR test and treponemal tests as EIA and reaction of passive hemagglutination. In microarray assay diagnostically high level of IgM in patients with primary, secondary and early latent and late latent syphilis decreased dramatically to zero after the successful therapy. Continuously high level of IgM after the therapy proposes the persistence of infection agents in the organism and points out the need of additional antimicrobial treatment. In most of the cases anti-treponemal IgG level also declined after the successful therapy and this confirms the appropriate treatment. The results of microarray assay coincide with the results of other mentioned laboratory tests for syphilis diagnostics. Microarray assay with the recombinant T. pallidum antigens gives the perspective for creating methods with wider spectrum of diagnostic and therapy control options using the IgM immunoglobulin level as a marker for successful syphilis treatment.


Asunto(s)
Anticuerpos Antibacterianos/sangre , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Técnica del Anticuerpo Fluorescente Indirecta , Humanos , Sífilis/sangre , Serodiagnóstico de la Sífilis , Treponema pallidum
14.
PLoS One ; 14(9): e0219709, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31536507

RESUMEN

OBJECTIVE: Blood transfusion is the most frequently used and life-saving therapeutic procedure today. Transmission of virus, bacteria and parasitic microorganisms may occur due to transfusion (Transfusion transmitted infections-TTIs). Hepatitis B and C, human immunodeficiency virus (HIV) and syphilis (Treponema pallidum) bear the risk of transmission by transfusion. Hepatitis B surface antigen (HBsAg), anti-HCV, anti-HIV½ and syphilis antibody (VDRL: Venereal Disease Research Laboratory) are routinely controlled in all donated blood samples. The aim of the present study was to analyze the seroprevalence rates of blood donors through screening test results according to duration, age range and gender. MATERIAL AND METHODS: Data of all blood donors obtained from blood Centre of Marmara University Pendik Training and Research Hospital between January 2013 and October 2018 were analyzed retrospectively. Serum samples of the donors were analyzed for HBsAg, anti-HCV, anti-HIV½ and VDRL. Test results of 114.240 donors were scanned. Gender, age range and distribution by years of these donors were analyzed. According to age distribution of donors were divided into 4 groups. RESULTS: There were 114.240 participants including 106.153 (92.9%) males and 8.087 (7.1%) females. The positivity rate of HBsAg was detected 0.4% (36/8087) in females and 0.5% (500/106.153) in males. The positivity rate of anti-HCV was detected 0.4% (32/8.087) in females and 0.3% (344/106.153) in males. The positivity rate of anti HIV½ was 0.1% (9/8.087) in females and 0.1% (92/106.153) in males whereas the positivity rate of VDRL was 0.5% (41/8.087) in females and 0.3% (362/ 106.153) in males. Positivity rate for HBsAg and HCV were lower in the cases between 18 and 30 years of age. The positivity rates for anti-HIV½ was not significantly different according to the age range. Positivity rate for VDRL was higher in the cases at 51 years of age and older. CONCLUSION: No difference was found between men and women in terms of HBsAg, anti-HCV and anti-HIV½positivity. However, VDRL test positivity was significantly higher in female participants. Furthermore, HBsAg, anti-HCV and VDRL positivity rates increased by age.


Asunto(s)
Anticuerpos Antibacterianos/sangre , Anticuerpos Anti-VIH/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Anticuerpos contra la Hepatitis C/sangre , Adolescente , Adulto , Anciano , Femenino , Infecciones por VIH/sangre , Infecciones por VIH/epidemiología , Hepatitis B/sangre , Hepatitis B/epidemiología , Hepatitis C/sangre , Hepatitis C/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Vigilancia en Salud Pública , Estudios Seroepidemiológicos , Sífilis/sangre , Sífilis/epidemiología , Adulto Joven
15.
BMJ Case Rep ; 12(9)2019 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-31537590

RESUMEN

Syphilis infection has shown a marked resurgence over the past several years. Ocular involvement is a rare complication of syphilis, occurring in approximately 1% of cases. We present the case of a man in his 50s who presented to hospital with acute unilateral vision loss and a widespread maculopapular rash. Ophthalmological examination showed unilateral optic disc swelling and bilateral vitritis. Intracranial imaging revealed no acute pathology. Initial blood tests were normal apart from mildly elevated inflammatory markers. A comprehensive autoimmune and infection screen revealed positive syphilis serology. The patient was subsequently treated for syphilis with ocular involvement with a course of intravenous benzylpenicillin, resulting in rapid symptomatic improvement. This case highlighted the importance of considering syphilis infection as part of the differential diagnosis for unexplained multisystemic symptoms, such as loss of vision in combination with dermatological involvement.


Asunto(s)
Ceguera/etiología , Erupciones por Medicamentos/etiología , Sífilis/complicaciones , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Ceguera/diagnóstico , Diagnóstico Diferencial , Erupciones por Medicamentos/patología , Humanos , Masculino , Persona de Mediana Edad , Penicilina G/administración & dosificación , Penicilina G/uso terapéutico , Sífilis/sangre , Sífilis/tratamiento farmacológico , Serodiagnóstico de la Sífilis/métodos , Resultado del Tratamiento
16.
Rheumatol Int ; 39(11): 1859-1866, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31468123

RESUMEN

A false-positive result of syphilis screening test (FPST) is a characteristic finding in patients with systemic lupus erythematosus (SLE). We evaluated the clinical characteristics of SLE patients with FPST at SLE diagnosis. We reviewed the medical records of patients with SLE who underwent the Venereal Disease Research Laboratory or Rapid Plasma Reagin tests at SLE diagnosis at Severance Hospital between 2006 and 2016. The baseline characteristics and clinical outcomes were compared between patients with FPST and those with a negative result of syphilis screening test. Of 145 patients with SLE, 20 patients showed FPST and 125 patients showed a negative syphilis screening result. At SLE diagnosis, patients with a negative result had higher SLE disease activity index (5.0 vs. 8.0, P < 0.001) and were more commonly complicated with nephritis (15.0% vs. 41.6%, P = 0.026). High level of serum total protein (> 8 g/dL) and the presence of anti-cardiolipin antibodies were independently associated with FPST (P = 0.010 and 0.037, respectively). During the follow-up (median 61 months), 5 patients with FPST (20.0%) and 12 patients without FPST (9.6%) were finally diagnosed with APS. The long-term risk of de novo thrombosis was higher in the FPST group (n = 4/20, 20% vs n = 6/125, 4.8%, P = 0.041). However, all-cause mortality showed no difference between the FPST group and the negative group. Patients with SLE showing FPST showed lower disease activity at SLE diagnosis but higher thrombotic risk and similar overall survival compared to those without FPST.


Asunto(s)
Lupus Eritematoso Sistémico/complicaciones , Nefritis Lúpica/complicaciones , Sífilis/diagnóstico , Adulto , Anticuerpos Anticardiolipina/sangre , Síndrome Antifosfolípido , Reacciones Falso Positivas , Femenino , Humanos , Lupus Eritematoso Sistémico/sangre , Lupus Eritematoso Sistémico/inmunología , Nefritis Lúpica/sangre , Nefritis Lúpica/inmunología , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Sífilis/sangre , Sífilis/complicaciones , Serodiagnóstico de la Sífilis , Adulto Joven
18.
Acta Derm Venereol ; 99(11): 978-983, 2019 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-31282975

RESUMEN

Various autoantibodies are detected more frequently in HIV-infected individuals than in HIV-negative controls; however, limited data exist regarding autoimmune blistering skin diseases. Using enzyme-linked immunoassay (ELISA) and indirect immunofluore-scence, no difference in the frequency and magnitude of autoantibodies against BP180, BP230, desmoglein 1 and 3 was found between 594 HIV-infected patients and 248 uninfected controls in this cross-sectional study (16.0% vs. 11.7%, respectively, for at least one positive ELISA, p = 0.11). Interestingly, reactive syphilis serology in both HIV-infected individuals and uninfected controls was associated with positive anti-BP180 ELISA results (adjusted odds ratio (OR) 2.14, 95% confidence interval (CI) 1.07-4.29, p = 0.03 and OR 4.70, CI 1.3-16.86; p = 0.0180). Our study shows a comparably low prevalence of cutaneous autoantibodies in both HIV-infected patients and uninfected controls lacking signs of autoimmune blistering skin disease. Positive BP180 ELISA in the absence of clinical signs of bullous pemphigoid should prompt further evaluation for syphilis antibodies.


Asunto(s)
Autoanticuerpos/sangre , Autoantígenos/inmunología , Infecciones por VIH/inmunología , Colágenos no Fibrilares/inmunología , Piel/inmunología , Sífilis/inmunología , Adulto , Austria/epidemiología , Biomarcadores/sangre , Estudios de Casos y Controles , Coinfección , Estudios Transversales , Femenino , Infecciones por VIH/sangre , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Estudios Seroepidemiológicos , Sífilis/sangre , Sífilis/diagnóstico , Sífilis/epidemiología , Serodiagnóstico de la Sífilis
19.
J Transl Med ; 17(1): 196, 2019 06 11.
Artículo en Inglés | MEDLINE | ID: mdl-31186010

RESUMEN

BACKGROUND: Current syphilis tests cannot distinguish between active and past syphilis among patients with serofast rapid plasma reagin (RPR) titers. We investigated whether cytokine profiles might provide insight in the differentiation of active and treated syphilis. METHODS: We collected quarterly serum samples from participants at risk for incident syphilis in a prospective cohort study of men and male-to-female transgender women. We defined incident syphilis as a new RPR titer ≥ 1:8 or a fourfold increase from a prior RPR titer and a positive Treponema pallidum particle agglutination assay. We measured cytokine expression using a 63-multiplex bead-based Luminex assay (eBiosciences/Affymetrix, San Diego, California, USA). We used tertile bins and Chi square tests to identify differences in proportions of cytokines between samples from patients with active and treated syphilis. We constructed a network of cytokine profiles from those findings. We used R software (R version 3.4.1, R, Vienna, Austria) to fit models. RESULTS: We identified 20 pairs of cytokines (out of 1953 possible pairs) that differed between active and treated syphilis. From those, we identified three cytokine networks of interest: an Eotaxin-Rantes-Leptin network, a Mig-IL1ra-Trail-CD40L network, and an IL12p40-IL12p70 network. CONCLUSIONS: Differences in cytokine profiles are present among men and male-to-female transgender women with active and treated syphilis. Cytokine assays may be a potentially useful tool for identifying active syphilis among patients with serologic syphilis reactivity.


Asunto(s)
Citocinas/sangre , Sífilis/sangre , Treponema pallidum , Adulto , Estudios de Cohortes , Femenino , Humanos , Incidencia , Masculino , Sífilis/epidemiología , Personas Transgénero/estadística & datos numéricos , Treponema pallidum/inmunología , Adulto Joven
20.
Sex Transm Dis ; 46(9): 584-587, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31181033

RESUMEN

BACKGROUND: Dual human immunodeficiency virus (HIV)/syphilis rapid, point-of-care testing may enhance syphilis screening among high-risk populations, increase case finding, reduce time to treatment, and prevent complications. We assessed the laboratory-based performance of a rapid dual HIV/syphilis test using serum collected from patients enrolled in the Zimbabwe Sexually Transmitted Infections (STI) Etiology study. METHODS: Blood specimens were collected from patients presenting with STI syndromes in 6, predominantly urban STI clinics in different regions of Zimbabwe. All specimens were tested at a central research laboratory using the Standard Diagnostics Bioline HIV/Syphilis Duo test. The treponemal syphilis component of the dual rapid test was compared with the Treponema pallidum hemagglutination assay (TPHA) as a gold standard comparator, both alone or in combination with a nontreponemal test, the rapid plasma reagin test. The HIV component of the dual test was compared with a combination of HIV rapid tests conducted at the research laboratory following the Zimbabwe national HIV testing algorithm. RESULTS: Of 600 men and women enrolled in the study, 436 consented to serological syphilis and HIV testing and had specimens successfully tested by all assays. The treponemal component of the dual test had a sensitivity of 66.2% (95% confidence interval [CI], 55.2%-77.2%) and a specificity of 96.4% (95% CI, 94.5%-98.3%) when compared with TPHA; the sensitivity increased to 91.7% (95% CI, 82.6%-99.9%) when both TPHA and rapid plasma reagin were positive. The HIV component of the dual test had a sensitivity of 99.4% (95% CI, 98.4%-99.9%) and a specificity of 100% (95% CI, 99.9%-100%) when compared with the HIV testing algorithm. CONCLUSIONS: Laboratory performance of the SD Bioline HIV/Syphilis Duo test was high for the HIV component of the test. Sensitivity of the treponemal component was lower than reported from most laboratory-based evaluations in the literature. However, sensitivity of the test increased substantially among patients more likely to have active syphilis for which results of both standard treponemal and nontreponemal tests were positive.


Asunto(s)
Técnicas de Laboratorio Clínico/normas , Infecciones por VIH/diagnóstico , Pruebas en el Punto de Atención/normas , Pruebas Serológicas/normas , Serodiagnóstico de la Sífilis/normas , Sífilis/diagnóstico , Adolescente , Adulto , Anticuerpos Antibacterianos/sangre , Técnicas de Laboratorio Clínico/métodos , Femenino , VIH , Infecciones por VIH/sangre , Humanos , Masculino , Persona de Mediana Edad , Juego de Reactivos para Diagnóstico/normas , Sensibilidad y Especificidad , Sífilis/sangre , Serodiagnóstico de la Sífilis/métodos , Treponema pallidum , Adulto Joven , Zimbabwe
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