Syphilis Antibodies Research Articles

Epidemiological study on seroprevalence of syphilis in patients with mental diseases.

The objective of this study was to investigate the seroprevalence of syphilis and its possible influencing factors in patients with mental illness. A total of 24,414 patients with mental illness from 2019 to 2021 were included. Serum syphilis antibody test results and available demographic data were collected. Chi-square test and regression analysis were used to analyze the data. The seroprevalence of syphilis was 0.59% (95% CI 0.49-0.69%) in patients with mental illness in the study area. There were significant differences in the seroprevalence of syphilis in age, marital status, occupation, urban region, and mental disease classification. The seroprevalence of syphilis increased with age (p < 0.01). The seroprevalence of syphilis was higher in patients with "Nonorganic sleep disorders" and "Reaction to severe stress, and adjustment disorders". Adjusted logistic regression analysis showed that the seroprevalence of syphilis in patients with mental illness was associated with age, region, and psychiatric classification. Older age group was a risk factor for syphilis seropositivity. Compared with schizophrenia, "bipolar affective disorder" (OR = 1.707, 95% CI: 1.017-2.864, p = 0.043) and "severe stress response and adjustment disorders"(R = 4.912, 95% CI: 1.138-21.204, p = 0.033) were risk factors for syphilis antibody positivity. The patients with "nonorganic sleep disorders" and "reaction to severe stress, and adjustment disorders" had a high seroprevalence of syphilis. Age and psychosis types became the influencing factors of the positive rate of serum syphilis antibody in patients with mental illness.

A novel syphilis Treponema pallidum lipoprotein peptide antigen diagnostic assay using red cell kodecytes in routine blood centre column agglutination testing platforms.

The detection of treponemal antibodies, which are used to make a diagnosis of syphilis, is important both for diagnostic purposes and as a mandatory blood donor test in most countries. We evaluated the feasibility of using Kode Technology to make syphilis peptide red cell kodecytes for use in column agglutination serologic platforms. Candidate Kode Technology function-spacer-lipid (FSL) constructs were made for the Treponema pallidum lipoprotein (TmpA) of T. pallidum, using the peptide and FSL selection algorithms, and then used to make kodecytes. Developmental kodecytes were evaluated against a large range of syphilis antibody reactive and non-reactive samples in column agglutination platforms and compared against established methodologies. Overall, 150 reactive and 2072 non-reactive Syphicheck assay (a modified T. pallidum particle agglutination) blood donor samples were used to evaluate the agreement rate of the developed kodecyte assay. From three FSL-peptide candidate constructs, one was found to be the most suitable for diagnostics. Of 150 Syphicheck assay reactive samples, 146 were TmpA-kodecyte reactive (97.3% agreement), compared with 58.0% with the rapid plasmin reagin (RPR) assay for the same samples. Against the 2072 expected syphilis non-reactive samples the agreement rate for TmpA-kodecytes was 98.8%. TmpA-kodecytes are viable for use as cost-effective serologic reagent red cells for the detection of treponemal antibodies to diagnose syphilis with a high level of specificity in blood centres. This kodecyte methodology also potentially allows for introduction of the reverse-algorithm testing into low-volume laboratories, by utilizing existing transfusion laboratory infrastructure.

Uncovering the mechanisms of host mitochondrial cardiolipin release in syphilis: Insights from human microvascular endothelial cells

The release of host mitochondrial cardiolipin is believed to be the main factor that contributes to the production of anti-cardiolipin antibodies in syphilis. However, the precise mechanism by which mitochondria release cardiolipin in this context remains elusive. This study aimed to elucidate the mechanisms underlying mitochondrial cardiolipin release in syphilis. We conducted a cardiolipin quantitative assay and immunofluorescence analysis to detect mitochondrial cardiolipin release in human microvascular endothelial cells (HMEC-1), with and without Treponema pallidum (Tp) infection. Furthermore, we explored apoptosis, a key mechanism for mitochondrial cardiolipin release. The potential mediator molecules were then analyzed through RNA-sequence and subsequently validated using in vitro knockout techniques mediated by CRISPR-Cas9 and pathway-specific inhibitors. Our findings confirm that live-Tp is capable of initiating the release of mitochondrial cardiolipin, whereas inactivated-Tp does not exhibit this capability. Additionally, apoptosis detection further supports the notion that the release of mitochondrial cardiolipin occurs independently of apoptosis. The RNA-sequencing results indicated that microtubule-associated protein2 (MAP2), an axonogenesis and dendrite development gene, was up-regulated in HMEC-1 treated with Tp, which was further confirmed in syphilitic lesions by immunofluorescence. Notably, genetic knockout of MAP2 inhibited Tp-induced mitochondrial cardiolipin release in HMEC-1. Mechanically, Tp-infection regulated MAP2 expression via the MEK-ERK-HES1 pathway, and MEK/ERK phosphorylation inhibitors effectively block Tp-induced mitochondrial cardiolipin release. This study demonstrated that the infection of live-Tp enhanced the expression of MAP2 via the MEK-ERK-HES1 pathway, thereby contributing to our understanding of the role of anti-cardiolipin antibodies in the diagnosis of syphilis.

A Potential Screening Strategy to Identify Probable Syphilis Infections in the Urban Emergency Department Setting.

Syphilis diagnosis in the emergency department (ED) setting is often missed due to the lack of ED-specific testing strategies. We characterized ED patients with high-titer syphilis infections (HTSIs) with the goal of defining a screening strategy that most parsimoniously identifies undiagnosed, untreated syphilis infections. Unlinked, de-identified remnant serum samples from patients attending an urban ED, between 10 January and 9 February 2022, were tested using a three-tier testing algorithm, and sociodemographic variables were extracted from ED administrative database prior to testing. Patients who tested positive for treponemal antibodies in the first tier and positive at high titer (≥1:8) for nontreponemal antibodies in the second tier were classified as HTSI. Human immunodeficiency virus (HIV) status was determined with Bio-Rad enzyme-linked immunosorbent assay and confirmatory assays. Exact logistic regression and classification and regression tree (CART) analyses were performed to determine factors associated with HTSI and derive screening strategies. Among 1951 unique patients tested, 23 (1.2% [95% confidence interval, .8%-1.8%]) had HTSI. Of those, 18 (78%) lacked a primary care physician, 5 (22%) were HIV positive, and 8 (35%) were women of reproductive age (18-49 years). CART analysis (area under the curve of 0.67) showed that using a screening strategy that measured syphilis antibodies in patients with HIV, without a primary care physician, and women of reproductive age would have identified most patients with HTSI (21/23 [91%]). We show a high prevalence of HTSI in an urban ED and propose a feasible, novel screening strategy to curtail community transmission and prevent long-term complications.

External quality assessment to support the WHO ProSPeRo study for the evaluation of two dual HIV/syphilis point-of-care tests in seven countries

BackgroundSexually transmitted infections (STIs) such as syphilis and HIV remain to be a significant public health issue worldwide. Dual rapid point-of-care tests (POCTs) have shown promise for detecting antibodies to HIV and syphilis but have not been fully evaluated in the field. Our study supported the WHO ProSPeRo study on Sexually Transmitted Infection Point-of-Care Testing (STI POCT) by providing external quality assessment (EQA) for HIV and syphilis testing in reference laboratories and their associated clinical sites in seven countries.MethodsHIV/syphilis serum liquid and dried tube specimen (DTS) panels were prepared by CDC. Liquid panels were distributed to the reference laboratories for three rounds of testing using commercially and locally available laboratory-based serological tests. DTS panels were sent to the clinical testing sites for 8 rounds of POC testing using the Abbott SD BIOLINE HIV/Syphilis Duo test (hereafter referred to as SD BIOLINE) and the Chembio Dual Path Platform (DPP) HIV-Syphilis assay. EQA panels were tested at CDC using the Rapid Plasma Reagin (RPR) test and the Treponema pallidum Particle Agglutination assay (TP-PA) for syphilis antibodies. Genetic Systems HIV-1/HIV-2 Plus O EIA, Geenius HIV Supplemental Assay and the Oraquick Advance HIV test were used to detect HIV antibodies in the EQA panels. Results from the reference laboratories and POCT sites were compared to those obtained at the CDC and a percentage agreement was calculated.ResultsQualitative RPR and TP-PA performed at the reference laboratories demonstrated 95.4–100% agreement with CDC results while quantitative RPR and TP-PA tests demonstrated 87.7% and 89.2% agreement, respectively. A 93.8% concordance rate was observed for qualitative HIV testing in laboratories. EQA testing at clinical sites using dual tests showed 98.7% and 99.1% agreement for detection of HIV antibodies and eight out of 10 sites had > 95.8% agreement for syphilis testing. However, two clinical sites showed only 65.0–66.7% agreement for SD BIOLINE and 84.0–86.7% for DPP, respectively, for syphilis testing.ConclusionsOverall, laboratories demonstrated high EQA performance in this study. Both HIV/syphilis POCTs gave expected results in the clinic-based evaluations using DTS. However, testing errors were identified in a few testing sites suggesting the necessity for continuous training and monitoring the quality of POC testing.

Prevalence of syphilis among people living with HIV who attend a large urban antiretroviral therapy clinic in Panama: a cross-sectional epidemiological study.

Syphilis is a serious global public health challenge. Despite prior progress in syphilis control, incidence has been increasing in recent years. Syphilis is a common coinfection among people living with HIV (PLHIV). In Panama, few data describe syphilis prevalence among PLHIV. We describe syphilis antibody and high-titer (⩾1:8) active syphilis prevalence and associated factors among individuals who attended an antiretroviral clinic. A cross-sectional study was undertaken during February-March 2022 and September-October 2022 for adults (⩾18 year) assigned male and female at birth, respectively. Participants provided peripheral blood samples and self-administered a questionnaire. Samples were screened using immunochromatography; antibody-positive samples were tested using rapid plasma regain to 1:512 dilutions. Logistic regression was used to identify factors associated with syphilis antibody and high-titer active syphilis. In all, 378 participants gave blood samples; 377 individuals participated in the questionnaire (216 self-reported male sex [males], 158 female [females], and three intersex individuals). Median age was 36 years (interquartile range: 28-45 years). Overall, syphilis antibody prevalence was 32.3% (122/378) (males, 50.7% [108/2013]; females, 5.7% [9/158]; intersex individuals, 100.0% (3/3)], p < 0.01. High-titer active syphilis was found among 24.6% (n = 30) of samples with positive antibody test (males 27.8% [n = 30], females 0.0% [0/9], intersex individuals 0.0% [0/3]). Antibody positivity was associated in the multivariable model with males (50.7%, AOR = 24.6, 95%CI: 1.57-384.53). High-titer active syphilis was associated with younger participant age (18-30 years, 13.2%, OR = 4.82, 95%CI: 1.17-19.83); 31-40 years, 7.8%, OR = 4.24, 95%CI: 1.04-17.21 versus 3.2% >40 years), homosexual identity (16.0% OR = 34.2, 95%CI: 4.50-259.27 versus 0.6% among heterosexual identity); in the multivariable model, associated with sexual identity (bisexual 19.1%, AOR = 10.89, 95%CI: 1.00-119.06) compared to heterosexual identity (0.6%) and weakly associated with concurrency (⩾1 ongoing sexual relationships, 15.9%, AOR = 3.09, 95%CI: 0.94-10.14). This study found very high prevalence of syphilis antibodies and high-titer syphilis among PLHIV in Panama. Those most affected are males, younger in age, those who practice concurrent sexual relationships, and those who reported homosexual and bisexual identity. Targeted interventions should include repetitive testing and treatment, especially among individuals who may be at increased infection risk.

Evaluation and experience from routine use of chemiluminescence assays for serological screening of blood and plasma donations on the Alinity s system and the Alinity i system, two new fully-automated immunoassay systems in Poland

In Poland, independent evaluations under the auspices of the Institute of Hematology and Transfusion Medicine (IHTM) are mandated for any new device, assay, systems for screening samples from whole blood and plasma donors prior to implementation by Blood Transfusion Center (BTC). In last 5 years, two new systems were introduced to the market by Abbott GmbH, namely the Alinity s and the Alinity i. The evaluations performed for these two systems included the assessment of sensitivity, specificity and precision for each of the four mandatory serological screening markers in Poland: Hepatitis B Surface Antigen (HBsAg), Hepatitis C virus antibodies (Anti-HCV), HIV antibodies (anti-HIV) and Syphilis antibodies (anti-Treponema pallidum, anti-TP). Sensitivity was assessed by testing seroconversion panels, HBsAg international reference standard, well characterized local samples, and dilution panels. Specificity was assessed by testing routine donor samples. The results from Alinity i assays were compared to the results from Abbott ARCHITECT i2000SR and Ortho VITROS 3600 assays, while the results from Alinity s assays were compared to the results of ARCHITECT i2000SR assays. The evaluation of the Alinity s and Alinity i assays for sensitivity (100 %), specificity (99,92–100 %) and precision generated results that were as good as or better than generated by routinely used systems, were within acceptance criteria, and met all requirements for screening blood donor samples in accordance with Polish regulations. The specificity of the assays in routine use by BTCs, analyzed after approximately 150,000 donations on both systems, was comparable to the specificity observed during the evaluations at IHTM.

Abstract 16120: Efficacy of an Electronic Medical Record Alert System in Identifying Cardiac Implantable Electronic Device Infection

Introduction: Cardiac Implantable Electronic Device infection (CIED-I) is common, morbid, and frequently under recognized. Electronic Medical Record (EMR) based alerts have been proposed as a solution to improve detection of CIED-I. Hypothesis: Development of a real-time EMR algorithm to identify CIED-I can improve recognition of patients with CIED-I. Methods: An EMR (Epic, Verona, WI) alert system to identify inpatients with CIED-I was developed based on the presence of CIED and positive blood cultures. The presence of CIED was determined using patient problem list, structured data elements describing device implantation, and prior device interrogation. Alerts were generated each time a patient with CIED had a positive blood culture. We examined patients admitted between January 2020 - March 2023. Identified patients were adjudicated manually to confirm: (1) the presence of CIED and (2) true bacteremia versus contaminant based on patient and microbiological characteristics. Results: The algorithm generated 255 alerts, corresponding to 100 unique patients over 142 hospitalizations. Of these alerts, 213 appropriately identified 88 unique patients with positive blood cultures and CIEDs, resulting in an alert specificity of 84% and patient specificity of 88%. The remaining 42 (16.6%) alerts occurred in 10 patients who no longer had CIED due to prior CIED extraction (6 at the time of heart transplant and 4 with extraction without reimplantation) as well as 2 patients with erroneous blood culture identification (one positive syphilis antibody test and one lab documentation error). In patients with appropriate alerts, 27 patients had 4/4 positive blood culture bottles, 5 patients had 3/4, 10 patients had 2/4, 41 patients had 1/4, 2 patients had 2/2, and 1 patient had 1/2. The positive predictive value of the algorithm to identify true bacteremia was 0.65 (138/213). Conclusions: The algorithm has high specificity to identify patients with possible CIED infection. Improving the accuracy of device detection, by incorporating radiology imaging or history of extraction, could further improve specificity. Positive predictive value and alert fatigue could be improved by stratifying alerts by blood culture species and total number of positive blood cultures.

Sero-prevalence of syphilis infection among people living with HIV in Sierra Leone: a cross-sectional nationwide hospital-based study

BackgroundGlobally, there were an estimated 7.1 million new syphilis infections in 2020, with more than 30% of these new infections reported in African countries such as Sierra Leone. Despite this, there is no HIV-specific syphilis screening program in Sierra Leone. Thus, data are needed to inform public health practice. In this study, we aimed to determine the prevalence of syphilis seropositivity and factors associated with syphilis seropositivity among people living with HIV (PLHIV).MethodsA cross-sectional study was conducted at 10 health facilities in Sierra Leone, among adults with HIV, aged 18 years or older, from September 2022 to January 2023. Parameters of interest were collected including age, sex, marriage, antiretroviral therapy (ART) regimen, HIV viral load, duration of ART treatment, and hospital level of care. The syphilis antibody was detected by a rapid test based on immunochromatography assay. Data were analyzed using R-software version 4.2.3 (R Core Team, Vienna, Austria). Pearson’s χ2 test, Fisher’s exact test and Kruskal–Wallis H test were applied to assess the differences in syphilis seropositivity between groups as appropriate. Univariate logistic regression and multivariate logistic regression analysis was used to assess factors associated with syphilis seropositivity. The level of statistical significance was set at P < 0.05.ResultsOf the 3082 PLHIV individuals in our study, 2294 (74.4%) were female and 2867 (93.0%) were receiving ART. With a median age of 36 years, 211 (6.8%, 95% CI 6.0–7.7) were positive for syphilis. The prevalence of syphilis was highest in people aged 60 years and over (21.1%, 95%CI 14.7–29.2), followed by people aged 50–60 years (15.5%, 95%CI 11.9–19.9) and in the widowed population (11.9%, 95%CI 8.9–15.8). There were no differences in syphilis seropositivity between gender, ART status, ART regimen, duration of ART, HIV viral load and hospital level of care. Older age (50–60 years: adjusted OR 3.49, 95%CI 2.09–5.85 P < 0.001; 60–100 years: adjusted OR 4.28, 95%CI 2.21–8.17, P < 0.001) was an independent predictor of seropositive syphilis.ConclusionsWe observed a high prevalence of syphilis among PLHIV. Older people and widowed population have higher syphilis seropositivity. Older age was an independent predictor of syphilis positivity. Therefore, we call for the integration of syphilis screening, treatment and prevention in HIV services.

Treponema pallidum PCR screening at mucosal sites of asymptomatic men who have sex with men taking HIV pre-exposure prophylaxis.

Early detection and treatment of syphilis will reduce the infectious period and transmission. We aimed to determine whether screening men who have sex with men (MSM) taking HIV pre-exposure prophylaxis (PrEP) for syphilis using Treponema pallidum polymerase chain reaction (PCR) could detect syphilis before the appearance of syphilis antibodies in serology. MSM attending 3-monthly PrEP clinic visits in Melbourne, Australia, were screened with a PCR assay targeting the polA gene of T. pallidum from an anal swab and an oral rinse between November 2019 and March 2020. Participants were serologically screened for syphilis using chemiluminescence immunoassay. A total of 309 asymptomatic participants provided an anal swab and oral rinse sample for T. pallidum PCR screening. Two syphilis cases (0.6%) were detected: one man had a positive serology only; another man had T. pallidum detected by PCR from an anal swab and a positive serology. PCR positivity was 0.3% (n = 1) for anal swabs and 0% (n = 0) for oral rinse. In this study, T. pallidum PCR screening at routine PrEP clinic visits did not identify additional cases of early syphilis over serological screening performed at these visits. IMPORTANCE With the ongoing syphilis epidemic in men who have sex with men (MSM), we investigated the role of using Treponema pallidum polymerase chain reaction (PCR) testing at the oral cavity and anus in MSM taking pre-exposure prophylaxis for the early detection of syphilis. We evaluated whether the PCR tests from these mucosal sites can detect syphilis infection early, before the development of syphilis antibodies in serology. Our study found two syphilis cases among 309 MSM, and only one syphilis case had a positive anal PCR swab, although serology was positive. We conclude that additional PCR testing is likely to be expensive and would not be cost effective for individuals who regularly screen for syphilis. However, future studies with a larger sample size are required.

Analysis of characteristics of types of primary sexual partners and related factors of not being tested for HIV among men who have sex with men

Objective: To compare the characteristics of MSM with different types of primary sexual partners and to analyze the factors associated with MSM not being tested for HIV in the last six months. Methods: MSM were recruited in nine cities of Shandong Province from April to July 2021, and face-to-face questionnaires were conducted to collect information on sociodemographic characteristics, high-risk behaviors, and HIV testing of MSM. Blood samples were taken for serological tests of HIV and syphilis antibodies. Results: A total of 3 008 men who had anal sex with men in the last six months were divided into three groups according to the type of primary sexual partner in the last six months: the fixed sexual partner group (36.83%, 1 108/3 008), the commercial sexual partner group (3.06%, 92/3 008), and casual sexual partner group (60.11%, 1 808/3 008). There were statistically significant differences in the distribution of age, local residence time, education level, the primary place to find male sexual partners, use of new-type drugs in the last six months, consistent condom use every time during same-sex anal sex in the last six months, group sex in the last six months, no HIV testing in the last six months, having had a sexually transmitted disease in the last year, receiving peer education in the last year, and frequency of syphilis testing in the last year among different groups (P<0.05). Multivariable logistic regression analysis showed that related factors of not being tested for HIV in the last six months in MSM were those aged less than 30 years old (aOR=1.39, 95%CI: 1.06-1.83), married/cohabiting (aOR=1.74, 95%CI: 1.39-2.16), high school education or less (aOR=1.39, 95%CI: 1.15-1.67), had not used new-type drugs in the last six months (aOR=2.27, 95%CI: 1.89-2.71), had not received peer education in the last year (aOR=1.59, 95%CI: 1.28-1.98), had never been tested for syphilis (aOR=11.30, 95%CI: 8.15-15.66), had not been tested in the last year but had been previously tested for syphilis (aOR=5.65, 95%CI: 4.19-7.62), the type of primary sexual partner in the last six months being a commercial sexual partner (aOR=1.80, 95%CI: 1.01-3.20), and the type of primary sexual partner in the last six months being a casual sexual partner (aOR=1.50, 95%CI: 1.26-1.80). Conclusions: The characteristics of MSM with different types of primary sexual partners are different, and the proportion of HIV testing still needs to be improved. In the future, we should make full use of the Internet and peer education to expand the coverage of HIV testing for MSM, targeting the characteristics of MSM with different types of primary sexual partners.

Prevalence of residual risks of the transfusion-transmitted infections in Riyadh hospitals: A two-year retrospective study

Abstract This study aimed to evaluate the prevalence and trends of transfusion-transmitted infections (TTIs) in two hospitals in Riyadh, as well as to judge the best type of tests to ensure blood transfusion safety. By using serological and nucleic acid test (NAT) tests, these donors were screened for human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), human T-lymphotropic virus type 1 (HTLV-1), human T-lymphotropic virus type 2 (HTLV-2), syphilis, and malaria infection as a first time of donation. Out of 58,898 blood units, 336 units were reacted for HBsAg, 5,318 units for HBcAbs, 506 units for HCV antibodies, 214 units for HIV Ab/Ag combinations, 206 units for HTLV antibodies, 355 units for syphilis antibodies, and 81 units for malaria. Moreover, the genotypic prevalence of these products showed that 349 units reacted for HBV DNA, HCV RNA, and HIV RNA in blood donation. This study reflects the seriousness of the residual risk of TTI, which is still a threat factor for the transmission of blood-borne infectious diseases. It was discovered that utilising (NAT) could increase test sensitivities while also lowering residual TTI risks, improving blood safety, and being cost-effective.

Secondary immunoreaction in patients with neurosyphilis and its relevance to clinical outcomes.

Several reported cases of autoimmune conditions such as anti-NMDAR encephalitis and neuromyelitis optica (AQP4) have been considered to be potentially secondary to Treponema pallidum infection. Since the role of immune impairment in neurosyphilis is unclear, in this retrospective study, we examined the correlation of the immune impairment in patients with neurosyphilis with their clinical characteristics and outcomes. Clinical information was collected from patients with neurosyphilis in our center from January 2019 to December 2021. Cerebrospinal fluid (CSF) samples were subjected to indirect immunofluorescence tissue-based assay (IIF-TBA) on mouse brain sections and cell-based assay (CBA). The clinical characteristics and treatment outcomes of TBA-positive and-negative patients were compared. A total number of 81 patients diagnosed with neurosyphilis were included. The results of the CBA tests showed that three cases had anti-NMDAR, AQP4, or GAD65 antibodies, respectively. By TBA test, 38 patients (38/81, 46.9%) had positive immunostains, including staining of neuronal cells in 21 cases (21/38, 55.3%), glial cells in 11 cases (11/38, 28.9%), and neuronal and glial cells in six cases (6/38, 15.8%). We then compared the clinical characteristics and treatment outcomes between the TBA-positive and-negative patients and found that TBA-positive staining was significantly correlated with syphilis antibody titers (p = 0.027 for serum and p = 0.006 for CSF) and head MRI abnormalities (p < 0.001 for parenchymal abnormalities and p = 0.013 for white matter lesions). The cognitive prognosis of TBA-positive neurosyphilis patients was significantly worse than that of TBA-negative patients (p < 0.001). The correlation between the TBA results and clinical data of our neurosyphilis patients imply the presence of secondary immune damage, which affected their prognosis. Therefore, TBA can be used as an additional biomarker for neurosyphilis patient prognosis.

Seroprevalence of hepatitis C virus in Jinan, China, 2008–2020

BackgroundThe updated estimates of hepatitis C virus (HCV) seroprevalence are critical for developing strategies to manage or eliminate HCV infection.MethodsA comprehensive study on HCV seroprevalence was conducted among 365,210 patients at Jinan Central Hospital, China, from 2008 to 2020. The patients were tested for anti-HCV, HCV core antigen, hepatitis B surface antigen, syphilis antibody, human immunodeficiency virus antigen + antibody, antihepatitis A virus IgM, and antihepatitis E virus IgM.ResultsHCV seroprevalence was 0.79% and was related to age. HCV seropositivity was lower in children (aged < 18 years) than in adults (aged ≥ 18 years) (0.15% vs. 0.81%). High HCV prevalence was reported in adults aged ≥ 41 years, and HCV seropositivity in those aged 41–80 years accounted for 74.56% of all seropositive individuals. Notably, the rate of HCV–HIV coinfection was 0. HCV seroprevalence was considerably higher in patients at the Kidney Disease Unit and Dialysis Department than in those at other departments (inpatient or outpatient).ConclusionsHCV seroprevalence was lower in Jinan region but higher in patients at the Kidney Disease Unit and Dialysis Department, especially in those undergoing hemodialysis.

Sensitivity and specificity of two investigational Point of care tests for Syphilis and HIV (PoSH Study) for the diagnosis and treatment of infectious syphilis in Canada: a cross-sectional study

ObjectivesSingle-visit testing and treatment for syphilis can reduce follow-up visits. The objectives of this study were to evaluate the performance and treatment outcomes of two dual syphilis/HIV point-of-care tests (POCTs). MethodsParticipants aged 16 years and older were offered concurrent syphilis/HIV POCTs with fingerstick blood sampling using two extremely rapid (<5 minutes) devices (MedMira Multiplo Rapid TP/HIV test and INSTI Multiplex HIV-1/HIV-2/Syphilis Antibody Test). Those with positive POCT results were offered same-day syphilis treatment and linkage to HIV care. Nurses performed testing at two emergency departments, a First Nations community, a correctional facility, and a sexually transmitted infection clinic. POCT results were compared with those of standard serological testing. Sensitivity and specificity were calculated. ResultsBetween August 2020 and February 2022, 1526 visits were completed. Both POCTs accurately identified participants with HIV (sensitivity, 100% [24 of 24]; 95% CI, 86.2–100%; specificity, 99.6% [1319 of 1324]; 95% CI, 99.1–99.8%), linking 24 HIV cases to care. Both tests were most sensitive with a rapid plasma reagin (RPR) of ≥1:8 dilutions (Multiplo: sensitivity, 98.3% [231 of 235]; 95% CI, 95.7–99.3%; specificity, 99.5% [871 of 875]; 95% CI, 98.8–99.8%; INSTI Multiplex: sensitivity, 97.9% [230 of 235]; 95% CI, 95.1–99.1%; specificity, 99.8% [873 of 875]; 95% CI, 99.2–99.9%) and least sensitive with non-reactive RPR (Multiplo: sensitivity, 54.1% [59 of 109]; 95% CI, 44.8–63.2%; specificity, 99.5% [871 of 875]; 95% CI, 98.8–99.8%; INSTI Multiplex: sensitivity, 28.4% [31 of 109]; 95% CI, 20.8–37.5%; specificity, 99.8% [873 of 875]; 95% CI, 99.2–99.9%). Eighty-five percent of participants with infectious syphilis were treated on the same day as the positive POCT result. DiscussionTwo extremely rapid (<5 minutes) dual syphilis/HIV POCTs showed excellent sensitivity and specificity for the diagnosis of active syphilis (RPR, ≥1:8 dilutions) and HIV and confirmed the ability to offer single-visit testing and treatment for syphilis and linkage to HIV care in diverse clinical settings.

Sero-prevalence and associated factors of sexually transmitted infections among youth-friendly services Attendees.

Worldwide, more than one million peoples acquire sexually transmitted infections (STIs). The burden of STIs and the youth awareness level on the transmission of STIs is under investigated in Sidama Regional State. To determine the seroprevalence of STIs such as hepatitis B surface antigen (HBsAg), Anti-hepatitis C virus (HCV) antibodies, Human Immunodeficiency virus (HIV) seroprevalence, and syphilis and to determine associated factors among youth-friendly services Attendees at selected health facilities in Hawassa city, Ethiopia. A multicenter cross-sectional study was conducted among 416 randomly selected youth attending youth-friendly services at selected health facilities from May to August 2021. To collect the background characteristics of participants an interviewer-administered questionnaire was used. Blood samples were collected, processed, and tested using Advanced Quality One Step rapid colloidal gold immunochromatographic assay for detection of antibodies for syphilis and hepatitis C virus infection, and hepatitis B virus surface antigen. For the diagnosis of syphilis Rapid Plasma Reagin was also used. HIV1/2 STAT PAK, HIV1/2/O ABON and HIV1/2 SD Bioline were used for testing antibodies for HIV infection. Data entry and analysis were performed using Statistical Package for the Social Sciences (SPSS) version 20.0 software. A crude and adjusted odds ratio with a 95% confidence interval (CI) was computed to identify associated factors. The overall seroprevalence of STIs was 11.5% (48/422), with a 95% CI: (8.7-14.9). Out of the 48 positive results, the proportions of HBsAg, Anti-HCV, HIV, and syphilis were 56.3% (27/48), 27.1% (13/48), 10.4% (5/48), and 6.3% (3/48) respectively. Out of 416 participants, 17.1% responded that it is safe to have sex without using a condom. The Odds of developing STI among female participants, participants who did not identify alcohol intake as a risk factor for STIs, and those who engaged in transactional sex were (AOR = 2.989: 95% CI: 1.27, 7.02), and (AOR = 2.393, 95% CI: 1.18, 4.81) and practice of transactional sex (AOR = 5.527, 95% CI: 1.62, 18.75). STIs are common among youth-friendly services Attendee in Hawassa city The overall STI was significantly associated with sex (females), not able to identify alcohol intake as a risk factor, and practice of transactional sex. High number of (n = 289, 69.5%) participants think that the use of condoms is not effective in preventing STIs and they engage in sexual activity without using condoms.

Serologic follow-up of solid organ transplant recipients who received organs from donors with reactive syphilis tests: A retrospective cohort study.

The increased procurement of organs from donors with risk factors for blood-borne diseases and the expanding syphilis epidemic have resulted in a growing number of organs transplanted from donors with reactive syphilis serology in our center. Based on guidelines, recipients typically receive therapy shortly after the transplant, but data on outcomes are limited. The primary objective of this study was to determine syphilis seroconversion rates at three months post-transplant in recipients of solid organs procured from donors with reactive syphilis serology. Organ donors and recipients were tested for syphilis antibody; positive results were confirmed with Treponema pallidum Particle Agglutination (TPPA). Eleven donors with reactive syphilis antibody donated organs to 25 syphilis negative recipients. Three recipients seroconverted at post-transplant month 3. All of them had received therapy shortly after transplant. TPPA was negative in all 3. Despite post-transplant treatment, 3 of 25 (12%) syphilis negative recipients of organs from syphilis positive donors seroconverted at 3 months. All remained TPPA negative possibly reflecting passive antibody transfer or differing test sensitivity to low level treponemal antibodies. Further studies are needed to assess optimal syphilis transmission prevention strategies and follow up recipient testing in organ transplantation.

Congenital syphilis as the cause of multiple bone fractures in a young infant case report

BackgroundThe differential diagnosis of multiple unexplained bone fractures in a young infant usually includes child abuse or bone disease such as osteogenesis imperfecta. Bone abnormalities can occur in 60–80% of cases with congenital syphilis and may be the sole manifestation. However, this frequent manifestation of this rare disease such as congenital syphilis is frequently disregarded. We describe a case of a young infant with multiple long bone fractures diagnosed with congenital syphilis.Case presentationThis 2-month-old male patient was referred to our hospital because of fractures of the ulna and distal radius bilaterally and noisy breathing with the suspicion of osteogenesis imperfecta. After thorough examination, the infant had anemia and a palpable spleen. We performed a screen for congenital infections among other investigations, which revealed positive non-treponemal and treponemal antibodies for syphilis. Hence the diagnosis for Congenital Syphilis was made.We performed a lumbar puncture (LP) which showed mild pleocytosis. The patient was treated with intravenous aqueous penicillin G 200 000 UI/KG per day for 10 days. In addition, a single dose of intramuscular penicillin G benzathine 50 000 UI/KG was given due to the abnormal result of CSF.On follow up admission 6 months later, the new syphilis serology had much improved and the new LP revealed no abnormal findings.ConclusionsWe present this case report in order to remind of a common manifestation of congenital syphilis, a rare disease which needs to be included in the differential diagnosis of multiple unexplained fractures in early infancy. In our case the fractures were symmetric and bilateral and they were accompanied by anemia and mild hepatosplenomegaly which led to the investigation of congenital syphilis as a possible cause. However, two thirds of infants with congenital syphilis are asymptomatic at birth. All women should have a proper syphilis screening during pregnancy.

Analysis of related factors of new-type drug use and recent HIV infection among men who have sex with men in Shandong province

Objective: To understand the related factors of new-type drug use and recent HIV infection among men who have sex with men (MSM), and provide a reference for formulating targeted strategies for HIV/AIDS prevention and control. Methods: MSM were recruited in sentinel surveillance sites of nine cities in Shandong province from April to July 2021, with a sample size of 400 in each city. A face-to-face questionnaire was conducted to collect demographic characteristics, high-risk behaviors, acceptance of HIV intervention services, etc. Blood samples were collected for HIV and syphilis antibodies detection. Limiting-antigen avidity enzyme immunoassay (LAg-Avidity EIA) was used to detect recent HIV infection, and the rate of recent HIV infection was calculated. Results: 3 624 MSM were under study with the following characteristics as: aged (32.70±9.33) years old, the aged 30 and above (59.52%, 2 157/3 624), with high school education or below (55.99%, 2 029/3 624), being unmarried/divorced/widowed (57.70%, 2 091/3 624) and as having homosexual orientation (86.26%, 3 126/3 624) accounted for the more mainly. Of 32.95% (1 194/3 624) had same-sex unprotected anal sex in recent six months; 27.48% (993/3 613) ever used new-type drugs, and the HIV antibody positive rate was 3.12% (113/3 624). The recent HIV infection rate appeared as 2.61% (95%CI: 1.73%-3.49%). The multivariable logistic regression analysis indicated that the related factors of new-type drug use were unmarried/divorced/widowed (compared with being married/cohabitating, aOR=1.43, 95%CI: 1.22-1.69), educational level of college or above (compared with educational level of high school or below, aOR=1.47, 95%CI: 1.25-1.72), mainly through the Internet/dating software to find male sex partners (compared with mainly through bars/baths/parks and other places to find male sex partners, aOR=1.76, 95%CI: 1.41-2.19). Those who had unprotected anal sex in the last six months (compared with no unprotected anal sex, aOR=1.33, 95%CI: 1.13-1.57), had sexually transmitted diseases in the past year (compared with no sexually transmitted disease, aOR=2.77, 95%CI: 2.04-3.76) were more likely to use new-type drugs. The multinominal logistic regression showed that MSM who had unprotected anal sex in the last six months (compared with no unprotected anal sex, aOR=2.51, 95%CI: 1.25-5.01) or did not receive HIV intervention services in the past year (compared with those who received HIV intervention services, aOR=3.89, 95%CI: 1.30-11.60), were syphilis positive (compared with syphilis negative, aOR=8.18, 95%CI: 2.98-22.48), used new-type drugs (compared with those who did not use new-type drugs, aOR=4.75, 95%CI: 2.32-9.70) had a higher risk of recent HIV infection. Conclusions: New-type drugs have been widely used in MSM in Shandong province. The abuse of new-type drugs increases the risk of recent HIV infection.

Impact of Asymptomatic Neurosyphilis on Patients Quality of Life and Social Stigma.

Background/ObjectivesNeurosyphilis is a disease caused by Treponema pallidum when it invades the central nervous system. Asymptomatic neurosyphilis (ANS) is one of the most common types of neurosyphilis, however it is often misdiagnosed. This study aimed to explore the impact of ANS on patient’s quality of life and social stigma.MethodsA total of 159 ANS patients were diagnosed by their serology and cerebrospinal fluid. These patients’ stigma and quality of life were assessed separately through the Social Impact Scale (SIS) and the Easy Response Questionnaire.ResultsThe average age was 36.25±8.36 years old, and 114 patients were males (71.69%). The serum syphilis test of 159 selected patients was positive, and the indicators of nucleus cells, protein quantification, and syphilis antibodies in the cerebrospinal fluid met the criteria for ANS. The total stigma score was (40.23 ±10.12), with the scores of the different entries being clearly differentiated, with the highest being the 15th entry (I feel I need to keep my illness a secret), with an average score of 3.15/4.ConclusionPatients with asymptomatic neurosyphilis may feel social stigma and are more negative when facing their disease. Health-care workers should be aware of the particular aspects of their condition and pay special attention to the need for patient privacy.