ArticleBMC infectious diseases2019
Early syphilis: risk factors and clinical manifestations focusing on HIV-positive patients.
Article in BMC infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 45 citations in OpenAlex.
- Extensive Condyloma Lata Lesions in Unusual Sites: An Atypical Manifestation of Secondary Syphilis.Case reports in medicine · 2025Article
- Predictors of Serological Cure in Syphilis Patients: A Retrospective Study at a Tertiary Hospital in Bandung, Indonesia.Infection and drug resistance · 2025Article
- High increase of Nichols-like clade circulating Treponema pallidum subsp. pallidum in Barcelona from 2021 to 2023.Scientific reports · 2024Article
- Atypical Manifestations of Syphilis: A 10-Year Retrospective Study.Journal of clinical medicine · 2024Article
- Developing a symptoms-based risk score for infectious syphilis among men who have sex with men.Sexually transmitted infections · 2023Article
- Incidence and Risk Factors for Early Syphilis Among Men Who Have Sex With Men in Australia, 2013-2019: A Retrospective Cohort Study.Open forum infectious diseases · 2023Article
- Biological, Behavioral, and Demographic Drivers of Recent Syphilis Infection Among Emerging Adult Sexual Minority Men in New York City: The P18 Cohort Study.AIDS patient care and STDs · 2022Article
- Clinical Protocols and Treatment Guidelines for the Management of Maternal and Congenital Syphilis in Brazil and Portugal: Analysis and Comparisons: A Narrative Review.International journal of environmental research and public health · 2022Review
- Genital ulcer disease: A review.Journal of family medicine and primary care · 2022Review
- Rash, red eyes, lip erosions and genital ulcer - What is the diagnosis?Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia · 2022Article
- Impact of Asymptomatic Neurosyphilis on Patients Quality of Life and Social Stigma.Psychology research and behavior management · 2022Article
- Concomitant Follmann balanitis and secondary syphilis.BMJ case reports · 2021Article
- High Lifetime Prevalence of Syphilis in Men Who Have Sex With Men and Transgender Women Versus Low Lifetime Prevalence in Female Sex Workers in Lima, Peru.Sexually transmitted diseases · 2020Review
- Herpetiform Manifestation of Primary Syphilis: A Case Series.Acta dermato-venereologica · 2020Article
- Prevalence of syphilis among people living with HIV who attend a large urban antiretroviral therapy clinic in Panama: a cross-sectional epidemiological study.Therapeutic advances in infectious diseaseArticle
- The Changing Trend of Syphilis: Is It a Sign of Impending Epidemic?Indian journal of dermatologyArticle
- High Prevalence of Asymptomatic STIs in MSM PWH in a Male HIV Clinic in Mexico City.Journal of the International Association of Providers of AIDS CareArticle
- Is the great imitator back? A case series on atypical presentation of primary syphilis as multiple herpetiform ulcers.Indian journal of sexually transmitted diseases and AIDSArticle
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSince 2000, substantial increases in syphilis in men who have sex with men (MSM) have been reported in many cities. Condomless anal sex (CAS) is one of the factors, along with drugs for sex and sex in group. This study identified factors and clinical manifestations as well as Treponema pallidum (T.pallidum) strains that could be related to early syphilis in Barcelona.
methodsThis prospective study was conducted in a sexually transmitted infections unit in 2015. Epidemiological, behavioral, clinical and microbiological variables were collected in a structured form. Univariate and multivariate statistical analyses were performed focusing on HIV-positive patients.
resultsOverall, 274 cases were classified as having early syphilis (27.5% primary, 51.3% secondary, and 21.2% early latent syphilis). In all, 94% of participants were MSM and 36.3% were HIV-positive. The median number of sexual contacts in the last 12 months was 10; 72.5% practiced CAS, 50.6% had sex in group, and 54.7% consumed drugs. HIV-positive cases had more anonymous sex contacts (p = 0.041), CAS (p = 0.002), sex in group (p < 0.001) and drugs for sex (p < 0.001). In the multivariate analysis, previous syphilis (adjusted odds ratio [aOR] 4.81 [2.88-8.15]), previous Neisseria gonorrhoeae infection (aOR 3.8 [2.28-6.43]), and serosorting (aOR 20.4 [7.99-60.96]) were associated with having syphilis. Clinically, multiple chancres were present in 31% of cases with no differences on serostatus, but anal chancre was most common in HIV-positive patients (p = 0.049). Molecular typing did not conclusively explain clinical presentation in relation to specific T.pallidum strains.
conclusionControl of syphilis remains a challenge. Similar to prior studies, HIV-positive patients were found to engage more often in sexual behaviors associated with syphilis than HIV-negative patients. Clinical manifestations were rather similar in both groups, although anal chancre was most common in HIV-positive patients. Various strain types of syphilis were found, but no clinical associations were identified.
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