Tire suas dúvidas sobre a sífilis | Coisa de Homem

Fala, truta! Firmeza? Neste episódio do Coisa de Homem você vai tirar suas dúvidas sobre a sífilis, infecção sexualmente transmissível que tem tratamento e pode ser evitada.

[Do not overuse doxycycline as prophylaxis for uncomplicated sexually transmitted infections]. / Överanvänd inte doxycyklin som profylax mot STI.

STI prophylaxis using doxycycline is discussed internationally for persons at high risk of STIs (Doxy-PEP). Doxy-PEP would probably have limited effect on gonorrhoea due to resistance to tetracyclines. Doxy-PEP may reduce the incidence of chlamydia and syphilis, but would not reduce the number of complicated infections. Further studies are needed on the effects of intermittent antibiotic use on the microbiome or antibiotic resistance in general.

Syphilis testing in blood donors, France, 2007 to 2022.

BackgroundSyphilis in blood donors (BD) has increased in many countries.AimWe aimed to describe trends in syphilis seroposivity in BD in France, to identify risk factors and assess if a non-treponemic test (NTT) could define BD having recovered from syphilis for more than 1 year.MethodsThe analysis covered the period 2007 to 2022 and 45,875,939 donations. Of the 474 BD syphilis-positive in 2022, 429 underwent additional investigations with an NTT. History of syphilis was obtained at the post-donation interview or based on serology results for repeat donors.ResultsUntil 2021, positivity rates remained stable (mean: 1.18/10,000 donations, range: 1.01-1.38). An increased rate was observed in 2022 (1.74/10,000; p = 0.02). Over the whole study period, prevalence was 2.2 times higher in male than in female BD (4.1 times higher in 2022). The proportion of males with an identified risk factor who have sex with men increased from 16.7% in 2007 to 64.9% in 2022. Based on NTT, 79 (18%) of the donors who were seropositive in 2022 were classified as having been infected in the previous year. History of syphilis was available for 30 of them. All had an infection within the previous 3 years. Among seven donors with a syphilis < 12 months before testing, one had an NTT titre ≥ 8, three a titre between 1 and 4, three were negative.ConclusionSyphilis seropositivity increased considerably in BDs in 2022, mostly in males, notably MSM. Available data did not allow appropriate evaluation of the NTT to distinguish recent from past infection.

Causes of pre and post-donation deferrals among blood donors, at Kwale Satellite Blood Transfusion Center, Kwale County, Kenya, 2018-2022.

BACKGROUND: Both pre-donation and post-donation deferrals pose challenges to blood safety and availability. This study delved into the deferral rates before donations and their underlying reasons, as, transfusion transmissible infections (TTIs) leading to post-donation deferrals among potential blood donors at the Kwale Satellite Blood Transfusion Centre (KSBTC) in Kenya. METHODS: We performed a retrospective electronic record review of pre- and post-donation deferrals among blood donors at KSBTC, 2018-2022. The pre-donations deferral rate and reasons for deferral were analyzed. Accepted donations were analyzed to determine the prevalence of HIV, hepatitis B (HBV), hepatitis C (HCV), and syphilis. Descriptive statistics were calculated and both crude odds ratio (COR) and adjusted odds ratio (AOR), and their 95% confidence intervals (CI) were calculated. Variables with p < 0.05 were considered statistically significant. RESULTS: A review was conducted on 12,633 blood donation records. Among these, individuals 2,729/12,633 (21.60%) were deferred from donating with the primary reason being low hemoglobin levels, constituting 51.86% of deferrals. Around 773/9,904 (7.80%) of blood units, were discarded due to at least one TTI. Among these, HBV accounted for 4.73%, HIV for 2.01%, HCV for 1.21%, and Syphilis for 0.59% of cases. The adjusted odds ratio for male donors were, (aOR = 1.3, 95% CI 1.01-1.57), donors with none or primary education level (aOR = 1.4 95% CI 1.11-1.68), first-timer donors (aOR = 1.2, 95% CI 1.01-1.44), and static strategy for blood collection (aOR = 1.4, 95%CI 1.12-1.63) were independently potentially associated with testing positive for at least one TTI. CONCLUSION: The study indicates that TTIs continue to pose a risk to the safety of Kenya's bloodstock, with a notable prevalence of HBV infections. Male donors, individuals with limited education, first-time donors, and utilizing a fixed strategy for blood collection were identified as potential risk factors independently associated with TTIs.

The hare syphilis agent is related to, but distinct from, the treponeme causing rabbit syphilis.

The treponemes infecting lagomorphs include Treponema paraluisleporidarum ecovar Cuniculus (TPeC) and ecovar Lepus (TPeL), infecting rabbits and hares, respectively. In this study, we described the first complete genome sequence of TPeL, isolate V3603-13, from an infected mountain hare (Lepus timidus) in Sweden. In addition, we determined 99.0% of the genome sequence of isolate V246-08 (also from an infected mountain hare, Sweden) and 31.7% of the genome sequence of isolate Z27 A77/78 (from a European hare, Lepus europeaus, The Netherlands). The TPeL V3603-13 genome had considerable gene synteny with the TPeC Cuniculi A genome and with the human pathogen T. pallidum, which causes syphilis (ssp. pallidum, TPA), yaws (ssp. pertenue, TPE) and endemic syphilis (ssp. endemicum, TEN). Compared to the TPeC Cuniculi A genome, TPeL V3603-13 contained four insertions and 11 deletions longer than three nucleotides (ranging between 6 and2,932 nts). In addition, there were 25 additional indels, from one to three nucleotides long, altogether spanning 36 nts. The number of single nucleotide variants (SNVs) between TPeC Cuniculi A and TPeL V3603-13 were represented by 309 nucleotide differences. Major proteome coding differences between TPeL and TPeC were found in the tpr gene family, and (predicted) genes coding for outer membrane proteins, suggesting that these components are essential for host adaptation in lagomorph syphilis. The phylogeny revealed that the TPeL sample from the European brown hare was more distantly related to TPeC Cuniculi A than V3603-13 and V246-08.

Gestational syphilis in a tertiary health service in Paraná, Brazil: A case-control study.

Approximately 10-12 million new syphilis infections occur annually worldwide, including in pregnant women. This study identified the factors associated with syphilis in pregnant women admitted to a tertiary maternity ward in the State of Paraná, Brazil. This is an ambispective, paired case-control study (1:2 ratio) conducted from September 2020 to October 2021. Pregnant patients (n = 93) admitted to the maternity ward, who were tested with the Venereal Disease Research Laboratory (VDRL) and rapid reagent test, were compared with 186 controls, matched by age and period of hospital admission. Sociodemographic, behavioral, prenatal, and maternity healthcare information was collected through interviews. The data were analyzed using binary logistic regression. Results showed that race/skin color other than white (OR: 2.12; 95%CI: 1.19-3.80; p < 0.001), having more than one sexual partner (OR: 3.69; 95%CI: 1.70-8.00; p = 0.001), being a former smoker (OR: 2.07; 95%CI: 1.07-4.01; p = 0.030) and a current smoker (OR: 4.31; 95%CI: 1.55-11.98; p = 0.005), as well as having a history of sexually transmitted infections (OR: 10.87; 95%CI: 4.04-29.27; p < 0.0.01) were risk factors for gestational syphilis. In summary, the study indicated that sociodemographic, behavioral, and healthcare-related variables were associated with gestational syphilis. Therefore, practitioners could benefit from incorporating these factors to deliver evidence-based treatment for gestational syphilis.

Seroprevalence of HIV, HBV, and syphilis co-infections and associated factors among pregnant women attending antenatal care in Amhara regional state, northern Ethiopia: A hospital-based cross-sectional study.

BACKGROUND: Co-infections involving human immunodeficiency virus (HIV), hepatitis B virus (HBV), and syphilis pose significant public health problems during pregnancy. It can increase the risk of adverse outcomes for both the woman and the infant more than each infection alone does. However, the magnitude of these co-infections remains insufficiently documented. Hence, this study aimed to determine the seroprevalence of HIV, HBV, and syphilis co-infections and associated risk factors among pregnant women attending antenatal care in Amhara region referral hospitals in northern Ethiopia. METHODS: A hospital-based cross-sectional study was conducted in Amhara regional state referral hospitals from January 1 to February 30, 2024, among 606 pregnant women. Pregnant women were selected using a systematic random sampling technique. An interviewer-administered questionnaire and chart review were used to collect data. Data were analyzed in SPSSV26.0. Descriptive statistics were used to determine the magnitude of co-infections, and binary logistic regression was used to determine associated factors. Variables with a P-value < 0.05 were used to declare statistical significance. RESULT: Overall, 4.1% (95% CI: 2.7, 6.1) of pregnant women were co-infected. The prevalence of specific co-infections was 2% (95% CI: 1, 3.5) for HIV/HBV, 1.3% (95% CI: 0.6, 2.6) for HIV/syphilis, and 0.8% (95% CI: 0.3, 1.9) for HBV/syphilis. No cases of triple co-infection were observed. Women with a history of unsafe sex (AOR = 8.2, 95% CI: 1.5, 16.7) and incarceration (AOR = 9.3, 95% CI: 1.6, 20.8) were associated with HIV/syphilis co-infection. For HIV/HBV co-infection, contact with jaundice patients (AOR = 5.5, 95% CI: 1.3, 22.5) and women with a history of STIs (AOR = 4.6, 95% CI: 1.4, 14.9) was significantly associated. Women with STI history (AOR = 6.3, 95% CI: 1.2, 15.9) were also significantly associated with HBV/syphilis co-infection. CONCLUSION: Despite the government's elimination efforts, a relatively high prevalence of coinfections with the infections studied was found among pregnant women. Therefore, HIV, HBV, and syphilis testing and treatment packages should be strengthened by targeting pregnant women with a history of STIs, contact with patients with jaundice, a history of incarceration, and unsafe sex.

Transfusion transmitted infections among blood donors of Kamenge Teaching Hospital blood bank in Burundi.

Background: The current risk of contracting a transfusion transmitted infections (TTIs) is unknown in Burundi. Objectives: The aim of this study was to assess sociodemographic profiles of blood bank donors at Kamenge Teaching Hospital, the prevalence and associated risk factors of HIV, syphilis, HBV and HCV from 2015 to 2020. Methods: We conducted a cross-sectional study including all blood donors of Kamenge Teaching Hospital blood bank. During this study, 1370 blood samples were screened for HIV, Syphilis, HBV and HCV. We calculated prevalence of TTIs and performed logistic regression to know associated risk factors. Results: Blood donors were males at 77% and 23% females. They were mostly students (54.2%). On screening, 83 blood samples (6.06%) were seropositive for at least one TTI. The overall prevalence rate of HIV, Syphilis, HBV and HCV among blood donors was 1.3%, 0.2% ,1.6%, 2.9% respectively. There was difference in distribution of the four TTIs among blood donors which is statistically significant (x2=33.997, ϱ-value<0.001). Private donors were associated with a high risk of syphilis and being a first-time donor was associated with a high HBV risk factor. Conclusion: The prevalence of TTIs found still to be high; mandatory and continuous screening is necessary.

Current syphilis infection in virally suppressed people living with HIV: a cross-sectional study in eastern China.

Background: Antiretroviral therapy (ART) has been shown to reduce human immunodeficiency virus (HIV) viral replication and ultimately achieve viral suppression and eliminate HIV transmission. However, little is known about the impact of viral suppression on high-risk behaviors and sexually transmitted infections (STIs). Objective: This study aimed to assess the rates of current syphilis infection in virally suppressed people living with HIV (PLWH) and whether with the duration of ART can reduce the current syphilis infection in eastern China. Method: We conducted a cross-sectional survey of PLWH in Zhejiang Province, China, in 2022. PLWH who were on ART >6 months and were virally suppressed (viral load <50 copies/mL) were included in the study. Data were collected from the National Epidemiological Database of Zhejiang Province and all participants were tested for viral load and current syphilis. Multivariable logistic regression was used to identify risk factors associated with current syphilis infection. Result: A total of 30,744 participants were included in the analysis. 82.7% of participants were male, the mean age was 44.9 ± 14.1 years, 84.9% had received ART in a hospital setting, the mean time on ART was 5.9 ± 3.1 years and 5.6% of participants were infected with current syphilis. Multivariable logistic regression showed that being male [adjusted odds ratio (aOR): 2.12, 95% confidence interval (CI): 1.69-2.66], high level of education (aOR: 1.23, 95% CI: 1.02-1.49), homosexual route of HIV infection (aOR: 1.80, 95% CI: 1.60-2.04), non-local registered residence (aOR: 1.29, 95% CI: 1.11-1.51), had history of STIs before HIV diagnosis (aOR: 1.95, 95 % CI: 1.75-2.18) and treatment provided by a municipal hospital (aOR: 2.16, 95% CI: 1.31-3.55) were associated with increased risk of current syphilis infection. Being married (aOR: 0.67, 95% CI: 0.58-0.76) was associated with a decreased risk of current syphilis infection. Conclusion: Our findings revealed a high rate of current syphilis infection among virally suppressed PLWH in eastern China. Duration of ART did not reduce the prevalence of current syphilis infection. Targeted interventions to reduce current syphilis infection should be prioritized for subgroups at higher risk.

Incidence and risk factors associated with acquired syphilis in HIV pre-exposure prophylaxis users.

BACKGROUND: Acquired syphilis continues to affect millions of people around the world. It is crucial to study it in the context of HIV Pre-Exposure Prophylaxis (PrEP) to achieve the goals set out in the 2030 Agenda since the literature suggests increased risk behaviors for sexually transmitted infections. This study aimed to investigate the incidence and factors associated with acquired syphilis among PrEP users. MATERIALS AND METHODS: This retrospective cohort included data on PrEP users from all over Brazil from 2018 to 2020, retrieved from the national antiretroviral logistics system. We calculated the proportion of syphilis before PrEP, the incidence during the user's follow-up, reinfections, and their possible associated factors. We conducted descriptive, bivariate, and multivariate analysis, estimating the crude Relative Risk, adjusted Odds Ratio (aOR), and their respective confidence intervals (95%CI). RESULTS: Most of the 34,000 individuals who started PrEP were male (89.0%), white (53.7%), self-identified as male (85.2%), homosexual, gay, or lesbian (72.2%), and had 12 schooling years or more (67.8%). Of these, 8.3% had syphilis in the six months before starting PrEP, and 4% had it in the first 30 days of using the prophylaxis. We identified a loss-to-follow-up rate of 41.7%, although the loss and the cohort shared similar characteristics. The proportion of missed syphilis tests was high: 33.4% in the 30 days and 38.8% in the follow-up period. In the 19,820 individuals effectively monitored, the incidence of acquired syphilis was 19.1 cases per 100 person-years, and 1.9% of users had reinfection. The rate of missed syphilis tests at the 30-day follow-up was 33.4%, and the total follow-up test period was 38.8%. The multivariate analysis identified female gender (aOR 0.3; 95%CI 0.2-0.5), being white or Black (aOR 0.9; 95%CI 0.7-0.9 and aOR 0.7; 95%CI 0.7-0.99, respectively) as protective factors for syphilis. Being homosexual, gay, lesbian (aOR 2.7; 95%CI 2.0-3.7), or having a history of syphilis in the six months before PrEP (aOR 2.2; 95%CI 1.9-2.5) were risk factors for syphilis during PrEP use. Behaviors related to the risk of syphilis included accepting something in exchange for sex (aOR 1.6; 95%CI 1.3-1.9), irregular condom use (use in less than half of sexual intercourse sessions; aOR 1.7; 95%CI 1.53-2.1) and recreational drug use (poppers; aOR 1.5; 95%CI 1.53-2.1). CONCLUSION: Syphilis in the context of PrEP has high rates and is associated with sociodemographic and behavioral factors. We recommend additional studies targeting prevention in this population to curb these figures.

Syphilis.

This is a case report of 51-year-old male patient with various symptoms including skin rashes, sensory disturbances, and non-cicatricial hair loss. Despite previous tests, the cause remained elusive until a dermatological examination revealed signs of syphilis. The patient's history, including his sexual relationships, became key in confirming the diagnosis, leading to treatment for neurosyphilis. With a rising incidence of syphilis in Denmark, this case highlights the importance of considering syphilis as a potential diagnosis across medical specialities because of the diverse and challenging clinical manifestations.