Increase of infectious syphilis among heterosexuals in Amsterdam: its relationship to drug use and prostitution.

Since 1986, an increase in heterosexually acquired syphilis cases has been seen in Amsterdam. The proportion of syphilis patients who reported using hard drugs, increased from 7% in 1985 to 23% in 1988, which was mainly due to increased numbers of addicted prostitute women with syphilis.     

Early syphilis among men in Connecticut: epidemiologic and spatial patterns

OBJECTIVE: The objective of this study was to describe the epidemiology of early syphilis among men in Connecticut, a moderate-prevalence region, in 2004. STUDY DESIGN: The authors conducted a cross-sectional analysis of health department data. RESULTS: Fifty-five cases were reported from 25 different towns. A majority of cases (82%) were reported among men who have sex with men, and 22% reported coinfection with HIV. Spatial analysis indicated moderate clustering of cases. Approximately half of 197 reported sex partners were not from Connecticut, including 28% from New York City and 20% from other states/countries. The median distance between partners was 48 km (30 miles). Twenty-three percent of syphilis cases had both local and nonlocal partners. CONCLUSIONS: The current epidemiology of early syphilis in Connecticut is consistent with national trends. However, the dispersal of cases throughout the state and the high proportion of reported sex partners residing outside of Connecticut suggest that this state is not a core area of endemic transmission.     

The re-emergence of syphilis in the United Kingdom: the new epidemic phases

OBJECTIVE: The objective of this study was to characterize the resurgence of infectious syphilis in the United Kingdom between 1997 and 2003. STUDY: The authors conducted a retrospective analysis of routine surveillance data from genitourinary medicine clinics and data collected through enhanced surveillance. RESULTS: Between 1997 and 2002, diagnoses of primary, secondary, and early latent syphilis made at genitourinary medicine clinics increased by 213% in heterosexual males, 1412% in men who have sex with men (MSM), and 22% in females. These increases have been driven by a series of outbreaks, the largest of which were seen in Manchester (528) and London (1222) up to the end of October 2003. All the outbreaks have been geographically localized and the majority of cases occurred in MSM. A high percentage of concurrent HIV infection was reported, and oral sex was often reported as a route of transmission. CONCLUSIONS: Syphilis has re-emerged in response to behavior change, probably driven by changes in the HIV epidemic. The future course of the epidemic is difficult to predict and control remains elusive.     

China's syphilis epidemic: a systematic review of seroprevalence studies

OBJECTIVE: The objective of this study was to investigate syphilis prevalence among low- and high-risk groups in China. GOAL: The goal of this study was to explore the magnitude of China's syphilis epidemic. STUDY DESIGN: A systematic literature review of syphilis seroprevalence studies in China was performed searching PubMed and the Chinese Periodicals Database (CPD). RESULTS: Five and 169 studies were retrieved from PubMed and the CPD, respectively. From 2000 to 2005, select low-risk groups had the following median syphilis prevalence: antenatal women (0.45%), premarital individuals (0.66%), and food and service employees (0.3%). Select high-risk groups had the following median prevalence: incarcerated female sex workers (12.49%), drug users (6.81%), and men who have sex with men (14.56%). In the last decade, prevalence has increased in all groups with the steepest rises seen among high-risk groups. CONCLUSIONS: Syphilis infection is increasing among low- and high-risk groups in China, suggesting unsafe sexual behavior that may accelerate HIV transmission and challenge current syphilis prevention and control efforts.     

嫖娼易感心理及自我防治分析

基于嫖娼发生的个案和已有的研究,文章首先分析嫖娼易感心理,包括错误认知、处女情结、意志薄弱、人格缺陷、性需要缺失、失衡的心理状态,然后针对性地提出嫖娼的自我防治对策,包括矫正错误的认知、增强警惕性和自制力、培养积极健康的业余爱好、调节性生理需要、缓解性紧张、寻求心理帮助。     

Manifestations and treatment of ocular syphilis during an epidemic in France

OBJECTIVES: To review cases of ocular syphilis presenting to a tertiary uveitis clinic during a syphilis epidemic in France between January 2001 and January 2004. STUDY DESIGN: Retrospective chart and patient database review. RESULTS: Ten patients who presented with symptoms and signs of uveitis tested positive for active syphilis. Some of the patients also presented with a rash or headache. Human immunodeficiency virus (HIV) antibody testing was positive in eight of the 10 patients, with CD4 cell counts >200 cells/mm3 in seven of the patients. Ocular inflammation resolved and visual acuity improved in all patients after treatment. CONCLUSIONS: A diagnosis of ocular syphilis should be considered in any patient with visual loss associated with a rash or headache, irrespective of the patient's CD4 cell count. Ocular syphilis in HIV-positive patients should be treated as neurosyphilis, whereas ocular syphilis in non-HIV patients can be treated as secondary syphilis.     

男男性行为人群新型毒品使用及与HIV梅毒感染关系

目的探究在男男性行为人群中新型毒品使用的现状,及新型毒品使用与HIV梅毒感染关系,并分析影响新型毒品使用的影响因素。方法选取2015年1月至2017年6月黄冈市中心医院专科门诊诊治的400例患者作为研究对象。对于研究对象进行问卷调查,收集一般人口学特征、高危性行为和毒品使用等,对于HIV和梅毒进行实验室检测。结果本研究纳入的400名研究对象中,年龄(23.1±3.9)岁,有87名研究对象使用了新型毒品,占21.75%,主要使用的毒品为零号胶囊。使用新型毒品的MSM HIV感染率为24.1%,梅毒感染率为21.8%,远高于未使用新型的MSM人群。分析发现月收入、曾购买过性服务、做过男性性工作者、过去一年接受过性病艾滋病宣教等指标都对于新型毒品的使用有影响。结论在男男性行为人群中新型毒品的使用率较高,并且新型毒品的使用增加了梅毒和HIV的感染风险,应重点加强对于高收入人群、买卖性服务人群的健康教育和干预。     

梅毒与HLA关联性研究进展

疾病关联基因被分为易感或抵抗基因,在某些相同的外因作用下,不同个体对疾病的易感性不同,人类白细胞抗原（Human leucocyte antigen,HLA）是人体内最为复杂的遗传多态性系统,目前已发现多种疾病的发生与HLA有关,梅毒是由梅毒螺旋体(Treponema pallidum,TP)感染引起的一种传染力强、危害性大的性传播疾病,血清学分型已发现梅毒与HLA相关,但其绝对性和真实性尚需进一步证实。从基因水平寻找易感因素,虽不能解释梅毒发病的全部,但对梅毒的流行病学、发病机理和预防都有积极意义,本文就这方面研究作一综述。     

Homosexual prostitution among male drug users and its risk for HIV infection.

OBJECTIVE--to assess whether male prostitution is an independent risk factor for HIV infection among male (intravenous and nonintravenous) drug users. DESIGN--a cross-sectional study. SETTING--various low-threshold methadone clinics and the sexually transmitted diseases clinic of the Municipal Health Service in Amsterdam and a drug-treatment centre in The Hague. PARTICIPANTS--343 male intravenous drug users and 106 male non-intravenous drug users. MAIN OUTCOME MEASURES--characteristics concerning drug use behaviour, sexual behaviour, and sociodemography, related to prostitution and HIV-antibodies. RESULTS--of the 449 study participants, 88 (20%) reported a history of prostitution; no differences were found between intravenous and non-intravenous drug users. Younger age, West German nationality, and having had private homosexual sex contacts, were independent predictors of a history of prostitution. Independent predictors of HIV infection were (1) longer residency in Amsterdam; (2) having had predominantly homosexual private sex contacts; (3) longer duration of intravenous drug use; and (4) frequent needle sharing. CONCLUSION--no evidence was found to suggest that male prostitution in itself contributed to the risk of HIV infection.     

血清IL-17和IL-23水平与梅毒病期的相关性

目的：明确梅毒病期与IL-17和IL-23表达的相关性。方法：采用ELISA法检测收集到的早期梅毒和晚期梅毒患者血清中的IL-17和IL-23水平。结果：共检测18例早期梅毒，18例晚期梅毒及12例正常对照血清。早期梅毒组和晚期梅毒组IL-17分别为（12.723±8.547）ng/L和（18.757±10.607）ng/L，差异无统计学意义（P>0.05）；IL-23水平分别为（9.049±7.301）ng/L和（13.603±7.694）ng/L，差异无统计学意义（P>0.05）。早、晚期梅毒患者IL-17和IL-23水平均高于对照组患者［(5.766±2.153)ng/L和(2.756±1.843)ng/L］（均P<0.05）。结论：梅毒患者血清中的IL-17和IL-23表达水平与病期无相关性。