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1.
Turk J Ophthalmol ; 49(5): 297-299, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31650814

RESUMO

We report a patient with unilateral syphilitic intermediate uveitis without dermatological, neurological, or any systemic involvement. He presented to our clinic with complaints of eye floaters and worsening visual acuity in the left eye. He had intermediate uveitis and cystoid macular edema in that eye and both venereal disease research laboratory and microhemagglutination assay for Treponema pallidum serological tests were confirmatory for syphilis. Ocular manifestations of syphilis have variable presentations, and it should be considered when diagnosing unexplained ocular inflammatory diseases, even if the patient's recent history and systemic evaluation are not compatible.


Assuntos
Infecções Oculares Bacterianas/etiologia , Sífilis/complicações , Uveíte Intermediária/etiologia , Acuidade Visual , Anticorpos Antibacterianos/análise , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/microbiologia , Humanos , Macula Lutea/patologia , Masculino , Sífilis/diagnóstico , Sífilis/microbiologia , Tomografia de Coerência Óptica , Treponema pallidum/imunologia , Uveíte Intermediária/diagnóstico , Uveíte Intermediária/microbiologia , Adulto Jovem
2.
Afr Health Sci ; 19(2): 1858-1865, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656468

RESUMO

Background: A significant proportion of newborns in the developing countries are born with congenital anomalies. Objective: This study investigated congenital infections due to Rubella virus, Toxoplasma gondii, Treponema pallidum among presumed normal neonates from full term pregnant women in Mwanza, Tanzania. Methods: Sera from mothers were tested for Treponema pallidum and Toxoplasma gondii infection while newborns from mothers with acute infections were tested for T. pallidum and T. gondii, and all newborns were tested for Rubella IgM antibodies. Results: A total of 13/300 (4.3 %) mothers had T. pallidum antibodies with 3 of them having acute infection. Two (0.7 %) of the newborns from mothers with acute infection were confirmed to have congenital syphilis. Regarding toxoplasmosis, 92/300 (30.7 %) mothers were IgG seropositive and 7 had borderline positivity, with only 1/99 (1%) being IgM seropositive who delivered IgM seronegative neonate. Only 1/300 (0.3 %) newborn had rubella IgM antibodies indicating congenital rubella infection. Conclusion: Based on these results, it is estimated that in Mwanza city in every 100,000 live births about 300 and 600 newborns have congenital rubella and syphilis infections, respectively. Rubella virus and T. pallidum are likely to be among common causes of congenital infections in developing countries.


Assuntos
Complicações Infecciosas na Gravidez/epidemiologia , Vírus da Rubéola/imunologia , Rubéola (Sarampo Alemão)/congênito , Rubéola (Sarampo Alemão)/epidemiologia , Sífilis Congênita/epidemiologia , Toxoplasma/imunologia , Toxoplasmose Congênita/epidemiologia , Treponema pallidum/imunologia , Adolescente , Adulto , Anticorpos Antivirais/sangue , Estudos Transversais , Feminino , Sangue Fetal/imunologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Cuidado Pré-Natal , Prevalência , Rubéola (Sarampo Alemão)/diagnóstico , Vírus da Rubéola/isolamento & purificação , Estudos Soroepidemiológicos , Sífilis/complicações , Sífilis/epidemiologia , Sífilis Congênita/diagnóstico , Tanzânia/epidemiologia , Toxoplasma/isolamento & purificação , Toxoplasmose/complicações , Toxoplasmose/epidemiologia , Toxoplasmose Congênita/diagnóstico , Treponema pallidum/isolamento & purificação , População Urbana
3.
Pan Afr Med J ; 33: 90, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489068

RESUMO

Introduction: Syphilis rapid test results may be influenced by numerous environmental and genetic factors. Methods: The proportion of false positive syphilis non-treponemal (NT) and treponemal (T) test results using immuno-chromatographic dual syphilis rapid test on serum from Cameroonian blacks (n=103) versus French blacks (n=104) or French caucasians (n=51), all HIV-negative and free of clinical syphilis, was examined. Results: Black individuals in Cameroon had a significantly higher frequency of false positive NT or T tests than black individuals in France. black individuals in France had a higher frequency of indeterminate NT tests as compared to caucasians in France. Conclusion: Both racial and environmental factors may affect immuno-chromatographic dual syphilis rapid testing.


Assuntos
Antígenos de Bactérias/imunologia , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Treponema pallidum/imunologia , Grupo com Ancestrais do Continente Africano , Camarões , Grupo com Ancestrais do Continente Europeu , Reações Falso-Positivas , França , Humanos , Estudos Prospectivos , Sífilis/imunologia
4.
Infect Immun ; 87(8)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31182617

RESUMO

In silico analyses of Treponema pallidum subsp. pallidum genomes and predicted proteomes to search for homologs of known bacterial outer membrane proteins (OMPs) led to the identification of tp0126 as a gene encoding a putative member of the OmpW family of porins/virulence factors. Our previous investigations on the role of Tp0126 in T. pallidum biology and syphilis pathogenesis showed that Tp0126 is fully conserved among T. pallidum strains and that transcription of tp0126 is driven by σ70 These initial results pointed to a housekeeping function for this protein. We also demonstrated that a guanosine homopolymer of various lengths located between the -10 and -35 consensus sequences in the tp0126 promoter modulates transcription consistently with phase variation, a mechanism that we also previously described for other T. pallidum genes encoding putative OMPs/virulence factors and that is often employed as a strategy for immune evasion. Circular dichroism spectra of recombinant Tp0126 also supported its structural homology with OmpW. Here we further investigated the humoral and cellular responses to Tp0126 during experimental and natural syphilis and the ability of Tp0126 to confer protection against syphilis in immunized rabbits. B-cell epitope mapping showed that compared to sera from experimentally infected animals, immunizations enhanced humoral immunity to sequences located in the putative Tp0126 surface-exposed loops, while phagocytosis assays showed that postimmunization sera opsonized T. pallidum Despite such promising results, no significant protection was seen following infectious challenge in immunized animals versus controls. Functional redundancy and phase variation might explain the lack of effectiveness of this vaccine candidate and/or design.


Assuntos
Proteínas da Membrana Bacteriana Externa/imunologia , Vacinas Bacterianas/imunologia , Treponema pallidum/imunologia , Animais , Proteínas da Membrana Bacteriana Externa/genética , Modelos Animais de Doenças , Imunização , Masculino , Fagocitose , Regiões Promotoras Genéticas , Coelhos , Sífilis/prevenção & controle
5.
Eur J Clin Microbiol Infect Dis ; 38(10): 1803-1809, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31201641

RESUMO

Men who have sex with men (MSM) have a disproportionate risk of acquiring sexually transmitted infections (STIs), such as syphilis. However, prevalence and determinants of syphilis among this population are less known in West Africa. This study aims to estimate syphilis prevalence among MSM in Burkina Faso. We conducted a cross-sectional biological and behavior survey in the two main cities of Burkina Faso, Ouagadougou and Bobo-Dioulasso. MSM were recruited using Respondent Driven Sampling (RDS) methods. Data were collected from January to April 2013 in Ouagadougou and from May to August 2013 in Bobo-Dioulasso. Out of the 657 MSM screened for syphilis, 6.1% (40/657) tested positive for Treponema pallidum antibodies and 1.1% (7/657) for active syphilis. Population-weighted prevalence of active syphilis was 2.1% (95% CI, 01.1-04.4) in Ouagadougou and 0.0% in Bobo-Dioulasso. Serologic markers of syphilis (anti-Treponema antibodies) were found among 7.4% (95% CI 5.0-10.8) of MSM in Ouagadougou and 5.0% (95% CI 3.1-8.0) in Bobo-Dioulasso. No significant differences were found in syphilis serological markers prevalence by participants' sociodemographic and behavioral characteristics. The prevalence of syphilis among MSM is low and comparable to that of other individuals of reproductive age in Burkina Faso. This low prevalence is very encouraging and suggests implementation of effective public health intervention programs which direct resources and services toward MSM to prevent further spread of syphilis infection and to limit HIV transmission in this group.


Assuntos
Anticorpos Antibacterianos/sangue , Homossexualidade Masculina , Sífilis/epidemiologia , Treponema pallidum/imunologia , Adolescente , Adulto , Burkina Faso/epidemiologia , Cidades/epidemiologia , Estudos Transversais , Feminino , Humanos , Imunoensaio , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Inquéritos e Questionários , Adulto Jovem
7.
PLoS One ; 14(3): e0212893, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30835745

RESUMO

The serological detection of antibodies to Treponema pallidum is essential to the diagnosis of syphilis. However, for the presence of cross-reaction, the specific antibody tests [e.g., enzyme-linked immunosorbent assay (ELISA)] always have false-positive results. In this study, we derived and validated the dissociation of urea in an attempt to alleviate the situation of false-positive antibodies to T. pallidum detected by ELISA. Six serum samples that were false-positive antibodies to T. pallidum detected by ELISA, and 16 control serum samples (8 sera positive for both specific IgG and IgM, and 8 IgG-positive and IgM-negative sera) were collected to select the appropriate dissociated concentration and time of urea. Our goal was to establish improved an ELISA method based on the original detection system of ELISA. The sensitivity of the improved ELISA was evaluated by 275 serum samples with class IgM-positive antibodies to T. pallidum. At 6 mol/L with 10 minutes dissociation of urea, 6 samples with false-positive antibodies to T. pallidum were converted to negative, and compared with true-positive antibodies to T. pallidum. The sensitivity of the improved ELISA was 100% by detecting the class IgM-positive antibodies to T. pallidum in sera of patients with syphilis. Considering the importance at the diagnosis of syphilis, antibodies to T. pallidum in serum samples should be retested by the improved ELISA method to avoid false-positive results.


Assuntos
Anticorpos Antibacterianos/isolamento & purificação , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Treponema pallidum/isolamento & purificação , Ureia/química , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Antígenos de Bactérias/imunologia , Ensaio de Imunoadsorção Enzimática/métodos , Reações Falso-Positivas , Humanos , Imunoglobulina M/sangue , Imunoglobulina M/imunologia , Imunoglobulina M/isolamento & purificação , Sensibilidade e Especificidade , Sífilis/sangue , Sífilis/microbiologia , Treponema pallidum/imunologia
8.
Int J Infect Dis ; 82: 73-76, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30853444

RESUMO

INTRODUCTION: The confirmation or analysis and exclusion of a diagnosis of neurosyphilis has long presented a challenge for infectious diseases clinicians. The authors reviewed the concordance between cerebrospinal fluid (CSF) analysis and the subsequent antibiotic strategy for patients undergoing evaluation of a diagnosis of neurosyphilis. METHODS: All patients with positive serum syphilis serology referred for CSF analysis between January 2009 and May 2016 were included. Indications for CSF analysis were determined by review of the hospital electronic medical records. CSF parameters were determined from the hospital pathology database. Cases were defined as either 'confirmed', 'supportive' of, or 'not supportive' of a diagnosis of neurosyphilis based on existing definitions. Subsequent therapy was defined as for neurosyphilis, late latent primary syphilis or no therapy based on existing guidelines. RESULTS: Of 131 patients reviewed, 95.4% were male and HIV co-infected (74%). A confirmed diagnosis of neurosyphilis was met by fourteen patients (10.7%). All but two of these were treated with a neurosyphilis-directed regimen. Of the 58 patients treated with neurosyphilis antibiotics, 17.2% had no CSF findings suggestive of the diagnosis. Seventy-three patients were not treated for neurosyphilis; however 35 of these met the CSF criteria for a diagnosis supportive of neurosyphilis. CONCLUSIONS: The results of routine CSF analysis in patients with a possible diagnosis of neurosyphilis are inconsistently applied in the clinical setting, calling into question the value of routine CSF. Empirical neurosyphilis treatment should be considered up front in patients with high pre-test probability of the diagnosis.


Assuntos
Antibacterianos/uso terapêutico , Infecções por HIV/complicações , Neurossífilis/diagnóstico , Treponema pallidum/imunologia , Adulto , Idoso , Estudos de Coortes , Coinfecção , Feminino , Teste de Absorção do Anticorpo Treponêmico Fluorescente , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Neurossífilis/líquido cefalorraquidiano , Neurossífilis/complicações , Neurossífilis/dietoterapia , Punção Espinal , Sorodiagnóstico da Sífilis
9.
J Clin Lab Anal ; 33(5): e22878, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30861169

RESUMO

BACKGROUND: We evaluated the recently FDA cleared BioPlex 2200 Syphilis Total Screen and automated rapid plasma reagin (RPR) assay for the detection of total (IgG/IgM) treponemal and non-treponemal antibodies in the reverse syphilis algorithm. METHODS: Prospectively submitted samples (n = 885) were assayed by both the IgG/IgM BioPlex Syphilis Screen and the original IgG BioPlex Syphilis Screen. The IgG screen reactive samples were reflexed to traditional RPR, and IgG/IgM screen reactive samples were reflexed to the automated RPR. Nonreactive RPR samples were tested by the Treponemal Pallidum Particle Agglutination test (TP-PA). Additional samples were collected (n = 404 total samples) to directly compare the automated and traditional RPR assays with each other. RESULTS: The sensitivity and specificity of the IgG/IgM screen with automated RPR was 95.6% (95% confidence interval [CI] 87.0-99.1) and 99.6% (CI 99.2-99.8) while the sensitivity and specificity of the BioPlex IgG screen with traditional RPR was 97.8% (CI 89.1-99.9) and 99.3% (CI 98.8-99.4). The sensitivity and specificity of the BioPlex RPR compared with traditional RPR was 95.8% (CI 93.9-97.0) and 94.1% (CI 89.4-91.1) and 95.3% (CI 92.6-97.1). The mean of the titer differences between the BioPlex RPR and the traditional RPR was 1.0 ± 0.9 SD titers. CONCLUSION: The addition of the detection of treponemal IgM antibodies to the IgG/IgM screen did not significantly affect the sensitivity and specificity compared to the original IgG screen. However, the addition of the comparable BioPlex RPR assay to the instrumentation significantly reduces the overall labor of syphilis screening and confirmation.


Assuntos
Imunoglobulina G/sangue , Imunoglobulina M/sangue , Sorodiagnóstico da Sífilis/métodos , Sífilis/sangue , Sífilis/diagnóstico , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Automação Laboratorial , Reações Falso-Positivas , Humanos , Reaginas/sangue , Sensibilidade e Especificidade , Treponema pallidum/imunologia
10.
Med Mal Infect ; 49(2): 102-111, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30765286

RESUMO

Bacteria of the Borrelia burgdorferi sensu lato complex, responsible for Lyme disease, are members of the spirochetes phylum. Diagnostic difficulties of Lyme disease are partly due to the characteristics of spirochetes as their culture is tedious or even impossible for some of them. We performed a literature review to assess the value of the various diagnostic tests of spirochetes infections of medical interest such as Lyme borreliosis, relapsing fever borreliae, syphilis, and leptospirosis. We were able to draw similarities between these four infections. Real-time PCR now plays an important role in the direct diagnosis of these infections. However, direct diagnosis remains difficult because of a persistent lack of sensitivity. Serological testing is therefore crucial in the diagnostic process. All currently available diagnostic tools are imperfect, with a potential risk of false positive and false negative results depending on the clinical context. Physicians should always take into consideration the clinical and epidemiological context when Lyme disease, relapsing fever borreliae, syphilis, and leptospirosis are suspected.


Assuntos
Testes Diagnósticos de Rotina , Doença de Lyme/diagnóstico , Spirochaetales/isolamento & purificação , Antígenos de Bactérias/análise , Antígenos de Bactérias/imunologia , Borrelia/imunologia , Borrelia/isolamento & purificação , Grupo Borrelia Burgdorferi/imunologia , Humanos , Leptospira/imunologia , Leptospira/isolamento & purificação , Reação em Cadeia da Polimerase , Testes Sorológicos , Spirochaetales/imunologia , Treponema pallidum/imunologia , Treponema pallidum/isolamento & purificação
11.
BMC Infect Dis ; 19(1): 1, 2019 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-30606108

RESUMO

BACKGROUND: Sexually transmitted infections, such as HIV and syphilis, are one of the major health care problems worldwide, especially in low- and middle income countries. HIV screening programmes have been widely used for many years. The introduction of rapid point-of-care tests (RDTs) that can detect both HIV and syphilis, using one single blood specimen, would be a promising tool to integrate the detection of syphilis into HIV programmes and so improve the accessibility of syphilis testing and treatment. METHODS: As part of the World Health Organization pre-qualification of in vitro diagnostics assessment, the laboratory performance of four dual HIV-Syphilis rapid diagnostic tests (SD Bioline HIV/Syphilis Duo, DPP HIV-Syphilis Assay, Multiplo Rapid TP/HIV Antibody Test and Insti Multiplex HIV-1/HIV-2/Syphilis Antibody Test) was assessed using a well characterized multiregional panel of stored sera specimens. RESULTS: In total 400 specimens were tested with each assay, resulting in excellent sensitivities and specificities for HIV, ranging from 99.5 to 100% and from 93.5 to 99.5%, respectively. Results obtained for the Treponema pallidum antibodies were lower, with the lowest sensitivity of 73.5% for Multiplo and the highest of 87% for SD Bioline. Specificities ranged from 99.0 to 100%. CONCLUSION: Although these results suggest that the tests could further improve in accuracy in detection of treponemal antibodies, their introduction into screening programmes to increase the accessibility of HIV/Syphilis diagnosis and treatment for difficult to reach populations in the world is promising.


Assuntos
Testes Diagnósticos de Rotina , Infecções por HIV/diagnóstico , Sífilis/diagnóstico , Anticorpos Antibacterianos/sangue , Anticorpos Anti-HIV/sangue , HIV-1/imunologia , HIV-2/imunologia , Humanos , Imunoensaio , Laboratórios , Programas de Rastreamento/métodos , Testes Imediatos , Sensibilidade e Especificidade , Testes Sorológicos , Sorodiagnóstico da Sífilis/métodos , Treponema pallidum/imunologia
12.
J Eur Acad Dermatol Venereol ; 33(1): 178-184, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30223307

RESUMO

BACKGROUND: Currently, many laboratories have switched the traditional screening algorithm (TSA) to reverse screening algorithm (RSA) for the efficiencies in high-volume syphilis screening. However, confusions have been arisen regarding this paradigm shift. OBJECTIVE: To compare the performance of two algorithms with head-to-head mode. METHODS: Sera screening for syphilis were tested in parallel with chemiluminescence immunoassay (CIA) and toluidine red unheated serum test (TRUST). CIA-reactive sera from the RSA were reflexively tested with TRUST and confirmed with Treponema pallidum particle agglutination assay (TPPA), while the TRUST-reactive serology from the TSA were afterwards tested with TPPA. RESULTS: A total of 110 663 serum samples were screened. The RSA identified 2259 (2.0%) CIA-reactive results, of which 377 (16.7%) showed TPPA nonreactive results, while the TSA identified 934 (0.8%) TRUST-reactive results, of which 67 (7.2%) showed TPPA-nonreactive results. Among the 2259 CIA-reactive results, 1392 (61.6%) were TRUST-nonreactive, of which 350 (25.1%) were TPPA-nonreactive. A total of 182 sera from the 350 TPPA-nonreactive sera were further tested by a second CIA (VITROS Syphilis TPA, VITROS TPA), of which 155 (85.2%) were nonreactive and 27 (14.8%) were reactive. The 27 VITROS TPA-reactive sera were further tested with a treponemal Western blot assay (Euroimmun IgG Western Blot, EuroWB), of which 11 (41%) were indeterminate, 6 (22%) were nonreactive and 10 (37%) were reactive. Among the 10 EuroWB-reactive sera, two seroconverted to TPPA 1:80+/- after 1-year follow-up. Of 867 CIA-reactive/TRUST-reactive results, 27 (3.1%) were TPPA-nonreactive. CONCLUSIONS: The RSA identified more patients with reactive treponemal serology. However, it also yielded an increased likely false-reactive rate compared with the TSA, especially those results with low index values and TRUST-nonreactive serology, were necessary to retest with a second treponemal test. Further testing results with TPPA, VITROS TPA and EuroWB suggested the false-reactive CIA screening results and the likely false-nonreactive TPPA results when the reactive treponemal results screened with RSA were to be identified.


Assuntos
Algoritmos , Sorodiagnóstico da Sífilis , Sífilis/sangue , Sífilis/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Testes de Aglutinação , Anticorpos Antibacterianos/sangue , Compostos Azo , Western Blotting , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Humanos , Medições Luminescentes , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Treponema pallidum/imunologia
13.
Int J STD AIDS ; 30(2): 173-180, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30348065

RESUMO

The SD BIOLINE HIV/Syphilis Duo (SD BIOLINE DUO) rapid test is a dual rapid lateral flow immunoassay that detects antibodies to both human immunodeficiency virus (HIV) and Treponema pallidum (TP) 'syphilis' via fingerprick whole blood. We evaluated the field performance of the SD BIOLINE HIV/Syphilis Duo test among two populations in Hanoi, Vietnam - men who have sex with men (MSM) and pregnant women. We also surveyed factors that influence participants' willingness to test for HIV and syphilis. This test has the potential to increase HIV and syphilis screening in low-resource settings. Patients who received healthcare services at a sexual health clinic for MSM and a district antenatal care center in Hanoi, Vietnam were recruited for the study. Participants with HIV and syphilis were intentionally recruited for adequate test performance evaluation via convenience sampling. At each facility, venipuncture blood specimens were obtained for reference testing for HIV and TP using SD BIOLINE HIV 1/2 3.0 and TP particle agglutination, respectively. SD BIOLINE DUO was compared to the standard reference tests and sensitivity and specificity were calculated. We calculated 95% confidence interval (CI) using the exact binomial method. We used conjoint analysis to identify test attributes that are associated with participant likelihood to seek HIV and syphilis testing. Of 280 participants, 100 (35.7%) were MSM and 180 (64.3%) were pregnant women. Of MSM, 17 (17.0%) were HIV positive and 49 (49.0%) were TP seropositive. All women were negative for both HIV and syphilis antibodies. For HIV antibody testing, sensitivity and specificity were 100.0% (95% CI: 80.5-100.0%) and 100.0% (95% CI: 98.6-100.0%), respectively. For the syphilis antibody testing, sensitivity and specificity were 83.1% (95% CI: 71.0-91.6%) and 100.0% (95% CI: 98.3-100.0%), respectively. Potential for false positives, preference for one blood draw over two, and shorter wait time for testing results were the highest ranked attributes by participants according to their willingness to test. The SD BIOLINE HIV/Syphilis Duo rapid test demonstrated very good performance in this field setting and participants preferred attributes that aligned well with this test.


Assuntos
Sorodiagnóstico da AIDS/métodos , Anticorpos Antibacterianos/imunologia , Anticorpos Antivirais/imunologia , Infecções por HIV/diagnóstico , HIV/imunologia , Programas de Rastreamento/métodos , Aceitação pelo Paciente de Cuidados de Saúde , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Adolescente , Adulto , Anticorpos Antibacterianos/sangue , Anticorpos Antivirais/sangue , Feminino , Infecções por HIV/sangue , Infecções por HIV/virologia , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Sistemas Automatizados de Assistência Junto ao Leito , Testes Imediatos , Gravidez , Gestantes , Cuidado Pré-Natal , Sensibilidade e Especificidade , Sífilis/sangue , Sífilis/imunologia , Treponema pallidum/imunologia , Vietnã
15.
Int J STD AIDS ; 30(4): 323-328, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30472926

RESUMO

This cross-sectional study of 3212 pregnant women assessed the field performance, acceptability, and feasibility of two dual HIV/syphilis rapid diagnostic tests, the Chembio DPP HIV-syphilis Assay and the SD Bioline HIV/syphilis Duo in antenatal clinics. Sensitivity and specificity for HIV and syphilis were calculated compared to the rapid Determine HIV-1/2 with Uni-Gold to confirm positive results for HIV and the Treponema pallidum particle agglutination assay for syphilis. RPR titers ≥1:4 were used to define active syphilis detection. Acceptability and feasibility were assessed using self-reported questionnaires. For Chembio, the HIV sensitivity was 90.6% (95%CI = 87.4, 93.0) and specificity was 97.2% (95%CI = 96.2, 97.8); syphilis sensitivity was 68.6% (95%CI = 61.9, 74.6) and specificity was 98.5% (95%CI = 97.8, 98.9). For SD Bioline, HIV sensitivity was 89.4% (95%CI = 86.1, 92.0) and specificity was 96.3% (95%CI = 95.3, 97.1); syphilis sensitivity was 66.2% (95%CI = 59.4, 72.4) and specificity was 97.2% (95%CI = 96.4, 97.9). Using the reference for active syphilis, syphilis sensitivity was 84.7% (95%CI = 76.1, 90.6) for Chembio and 81.6% (95%CI = 72.7, 88.1) for SD Bioline. Both rapid diagnostic tests were assessed as highly acceptable and feasible. In a field setting, the performance of both rapid diagnostic tests was comparable to other published field evaluations and each was rated highly acceptable and feasible. These findings can be used to guide further research and proposed scale up in antenatal clinic settings.


Assuntos
Sorodiagnóstico da AIDS/métodos , Anticorpos Antivirais/imunologia , Infecções por HIV/diagnóstico , HIV/imunologia , Aceitação pelo Paciente de Cuidados de Saúde , Complicações Infecciosas na Gravidez/diagnóstico , Cuidado Pré-Natal/métodos , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Anticorpos Antivirais/sangue , Estudos de Viabilidade , Feminino , Infecções por HIV/sangue , Infecções por HIV/virologia , Humanos , Programas de Rastreamento/métodos , Gravidez , Sensibilidade e Especificidade , Sífilis/sangue , Sífilis/microbiologia , Treponema pallidum/imunologia , Treponema pallidum/isolamento & purificação , Zâmbia
16.
Clin Chim Acta ; 488: 76-80, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30389458

RESUMO

OBJECTIVE: The study was designed to analyze three different algorithms with the implementation of treponemal tests for detecting suspected syphilis in west China where no syphilis algorithms guideline exists. METHODS: We retrospectively collected data to reanalyze three syphilis testing algorithms: the classical reverse algorithm, and two options of syphilis screening in European syphilis guideline. The kappa (κ) coefficients were used to compare the concordance between algorithms using different syphilis assays during two periods. A receiver operating characteristic curve was used to determine the optimal S/CO ratios of InTec EIA or Lumipulse® G TP-N assay (CLIA) to predict confirmatory TPPA results. RESULTS: The agreements between the reverse algorithm and the EU option 1 algorithms were perfect irrespective of EIA or CLIA used (all κ > 0.9). But the agreements between the EU option 2 algorithms and reverse or EU option 1 were not good (κ < 0.4). >50% cases confirmed syphilis infections by reverse or EU option 1 algorithm were missed by EU option 2. There is no very need for a confirmatory TPPA assay in EU Option 1 when S/CO is above 6.12 for CLIA (3.67 for EIA). The false-positive rate was 0.26% above this cutoff level. CONCLUSIONS: EU Option 1, involving a reactive TT, followed by another TT of a different type and a quantitative NTT if second TT is positive, which is the same as the 2015 UK syphilis algorithm, is recommended. We also propose that when S/CO of the CLIA or EIA is high enough, TPPA confirmation can be omitted from the testing algorithm, and costs would be significantly reduced.


Assuntos
Algoritmos , Sorodiagnóstico da Sífilis , Sífilis/diagnóstico , China , Ensaio de Imunoadsorção Enzimática , Humanos , Estudos Retrospectivos , Treponema pallidum/imunologia , Treponema pallidum/isolamento & purificação
17.
J Infect Chemother ; 25(1): 68-70, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30054230

RESUMO

We retrospectively compared the performance of an existing syphilis diagnostic algorithm with a new algorithm that analyzes the results of Treponema pallidum latex agglutination (TPLA) tests. Of the 100 clinical blood samples, 51 were classified as positive through both Mediace TPLA and ESPLINE TP; 2/51 were classified as negative by Architect Syphilis TP, whereas 1/51 was negative as per LUMIPULSE Presto TP. The false positive rate when the results of Mediace TPLA and ESPLINE TP were combined was 1.96% versus 0% for both Architect Syphilis TP and LUMIPULSE Presto TP. The sensitivity of Mediace TPLA (98%) was comparable to that of Architect Syphilis TP (98%) but lower than that of LUMIPULSE Presto TP (100%). The specificity of Mediace TPLA was 98.0% versus 100% for Architect Syphilis TP, and versus 100% for LUMIPULSE Presto TP. We conclude that the performance of Mediace TPLA in combination with a reverse algorithm is nearly equal to that of enzyme immunoassay (EIA) or chemiluminescence immunoassay (CIA). Because TPLA is low cost, highly sensitive method for IgM detection, and is easy to operate, we have recommended its adoption for initial syphilis screening tests.


Assuntos
Anticorpos Antibacterianos/imunologia , Imunoglobulina M/imunologia , Testes de Fixação do Látex/métodos , Kit de Reagentes para Diagnóstico , Sífilis/diagnóstico , Treponema pallidum/isolamento & purificação , Anticorpos Antibacterianos/sangue , Reações Falso-Positivas , Humanos , Técnicas Imunoenzimáticas , Imunoglobulina M/sangue , Estudos Retrospectivos , Sensibilidade e Especificidade , Sífilis/sangue , Sorodiagnóstico da Sífilis , Treponema pallidum/imunologia
18.
J Immunol Methods ; 464: 9-14, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30138611

RESUMO

BACKGROUND: Serological methods have great importance for the detection of Treponema pallidum antibodies in syphilis diagnosis. The goal of the present study is to evaluate various commercially available screening assays in comparison with the FTA-abs test. METHODS: A total of 363 serum samples were enrolled in the study. Following routine testing including RPR and TPHA tests, each sample was tested by treponemal immunoassays (Chorus Syphilis Screen Recombinant, Architect Syphilis TP, Syphilis Virclia Monotest, Siemens Advia Centaur Syphilis, Euroimmun Treponema pallidum Screen ELISA, Vircell Syphilis ELISA IgG + IgM, SD Bioline Syphilis). The result obtained from each test was compared with the confirmatory FTA-abs test. Kappa (κ) coefficients were used to compare the concordance of the tests. RESULTS: When the various tests were evaluated in comparison with the FTA-abs test, the sensitivity, specificity and percent agreement of each test were as follows: Architect Syphilis TP, 92.3%, 94.5%, 92.8%; Chorus Syphilis Screen Recombinant, 87.9%, 91.2%, 88.7%; Syphilis Virclia Monotest, 80.5%, 97.8%, 84.9%; Siemens Advia Centaur Syphilis, 87.5%, 89%, 87.9%; Euroimmun Treponema pallidum Screen ELISA, 87.5%, 85.7%, 87.1%; Vircell Syphilis ELISA IgG + IgM, 73.2%, 62.6%, 70.5%; TPHA, 89%, 63.7%, 82.6%; SD Bioline Syphilis, 58.1%, 94.5%, 67.2%; RPR test, 57.7%, 57.1%, 57.6%. CONCLUSION: The results of the present study show that Treponema pallidum specific immunoassays with a performance similar or better than TPHA test generally performed well with the confirmatory FTA-abs test and may be an alternative for screening total antibodies in syphilis infection.


Assuntos
Anticorpos Antibacterianos/sangue , Ensaio de Imunoadsorção Enzimática , Teste de Absorção do Anticorpo Treponêmico Fluorescente , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Sífilis/diagnóstico , Treponema pallidum/imunologia , Biomarcadores/sangue , Humanos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Sífilis/sangue , Sífilis/microbiologia
19.
Clin Chim Acta ; 488: 13-19, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30326217

RESUMO

OBJECTIVE: The objective of this study was to screen new antigens for syphilis serodiagnosis. METHODS: First, we determined whether the Treponema pallidum proteins Tp0971, Tp0768 and Tp0462 were infection phase-dependent antigens by observing serum reactivity differences in New Zealand rabbits infected with activated or inactivated T. pallidum. A non-infection phase-dependent antigen, the Tp92 membrane protein, was used as the negative control. Next, Tp0971-, Tp0768- and Tp0462-based ELISA was performed on 2138 human serum samples and compared with the T. pallidum passive particle agglutination assay (TPPA) and LiZhu™ Tp-ELISA. In addition, another 60 paired serum samples from patients at follow-up were analysed to evaluate the relationships between titre changes and differences in the A450 nm values of the Tp0971, Tp0768, Tp0462 and Tp92 antibodies measured by ELISA. RESULTS: Compared with Tp92 (negative control), Tp0971, Tp0768 and Tp0462 were determined to be infection phase-dependent antigens. Compared with those of the TPPA, the sensitivities of Tp0971-, Tp0768- and Tp0462-based ELISA were 96.4%, 96.9% and 93.0%, respectively, and the specificities were 97.7%, 95.4% and 98.9%, respectively, resulting in consistencies of 97.1%, 96.2% and 95.9%, respectively. Compared with those of the LiZhu™ Tp-ELISA, the consistencies of Tp0971-, Tp0768- and Tp0462-based ELISA were 95.1%, 94.2% and 94.0%, respectively, with kappa values of 0.902, 0.884 and 0.880, respectively. Tp0971, Tp0768 and Tp0462 demonstrated high sensitivities and specificities, as well as high conformity to the TPPA and LiZhu™ Tp-ELISA. Moreover, a significantly positive Spearman rank correlation coefficient (0.82,*P < 0.05) was found between the difference in the A450 nm values of the Tp0971 antibody and the RPR titre change. CONCLUSION: The infection phase-dependent antigens Tp0971, Tp0768 and Tp0462 are promising for syphilis diagnosis, and Tp0971 may be utilized to monitor curative effects during syphilis treatment.


Assuntos
Antígenos de Bactérias/imunologia , Sorodiagnóstico da Sífilis , Sífilis/tratamento farmacológico , Sífilis/imunologia , Treponema pallidum/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Antígenos de Bactérias/sangue , Antígenos de Bactérias/genética , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Coelhos , Software , Sífilis/sangue , Treponema pallidum/isolamento & purificação , Adulto Jovem
20.
Emerg Microbes Infect ; 7(1): 177, 2018 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-30405111

RESUMO

Plasmid DNA encoding flagellin FlaB3 was used as a vaccination candidate for the evaluation of immunogenicity and protection against Treponema pallidum subsp. pallidum dissemination. First, intramuscular injection of the flagellin encoded by the plasmid DNA into New Zealand rabbits elicited both humoral and cellular immune responses. Total IgG production increased in response to flagellin. In addition, serum IFN-γ secretion and CD8+ cells were substantially greater in the rabbits immunized with the plasmid encoding flagellin FlaB3 than those in the rabbits immunized with recombinant flagellin. The flagellin encoded by the plasmid DNA induced significant upregulation of serum IL-6 and IL-8 compared to that of the control rabbits. Subsequently, intradermal challenge of the vaccinated New Zealand rabbits with 1 × 107T. pallidum resulted in a significant reduction of the bacterial organ burden in the blood, liver, spleen, and testicles in the flagellin plasmid DNA-vaccinated rabbits. Furthermore, the histopathological analysis demonstrated that the rabbits immunized with the plasmid DNA-encoded flagellin (FlaB3) showed better immune protection. These findings provide evidence that plasmid DNA-encoded flagellin (FlaB3) may be useful as a potential immunization route for future development of a vaccine to inhibit T. pallidum dissemination in related animals.


Assuntos
Vacinas Bacterianas/imunologia , Flagelina/genética , Imunogenicidade da Vacina , Sífilis/prevenção & controle , Treponema pallidum/imunologia , Vacinas de DNA/imunologia , Adjuvantes Imunológicos , Animais , Carga Bacteriana , Vacinas Bacterianas/genética , Linfócitos T CD8-Positivos/imunologia , Citocinas/imunologia , Flagelina/imunologia , Células HeLa , Humanos , Imunidade Celular , Imunidade Humoral , Imunoglobulina G/sangue , Injeções Intramusculares , Interferon gama/imunologia , Plasmídeos/genética , Coelhos , Sífilis/imunologia
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