The Re-Emergence of Syphilis in the United Kingdom: The New Epidemic Phases

Simms, Ian; Fenton, Kevin; Ashton, M.; Turner, Katherine Mary Elizabeth; Crawley-Boevey, Emma; Gorton, Russell; Thomas, Daniel; Lynch, Audrey; Winter, Andrew; Fisher, Martin; Lighton, Lorraine; Maguire, Helen; Solomou, Maria

doi:10.1097/01.olq.0000149848.03733.c1

Cited by 197 publications

(138 citation statements)

References 17 publications

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“…In the early 2000s, epidemics of syphilis and then of LGV occurred in all Western European countries, mainly among HIV-infected MSM [26][27][28][29][30][31]. The number of new HIV diagnoses among MSM and bisexual men increased by 86% between 2000 and 2006 in 23 European countries [32].…”

Section: Discussionmentioning

confidence: 99%

Recently acquired HIV infection in men who have sex with men (MSM) in France, 2003-2008

et al. 2009

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An increase in the number of new HIV diagnoses among men who have sex with men (MSM) was observed in several countries in the early 2000s. In this article, we explore the trends among MSM in France between 2003 and 2008. To estimate the number of MSM newly diagnosed with HIV, we take into account the reporting delay, underreporting and missing data for HIV case notification. To identify recent infections (RI) (acquired an average of six months before diagnosis), we used an enzyme immunoassay for recent HIV-1 infections (EIA-RI) which has been performed routinely for new HIV diagnoses since 2003. Multivariate analysis was used to identify factors associated with RI. We estimate that between 1,900 and 2,400 MSM have been newly diagnosed with HIV every year: the proportion of MSM among all newly diagnosed with HIV cases has increased from 25.2% (95% confidence interval ( . The risk of RI decreased with age. The HIV situation among MSM living in France is a cause of concern, despite the prevention campaigns dedicated to this highly educated sub-population.

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Section: Discussionmentioning

confidence: 99%

Recently acquired HIV infection in men who have sex with men (MSM) in France, 2003-2008

et al. 2009

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“…Despite the availability of effective antimicrobials, syphilis remains a significant threat to global health and can facilitate the transmission of human immunodeficiency virus (3)(4)(5). After cutaneous inoculation, the bacteria become blood-borne and invade various organ systems, including the liver, heart, and nervous system (1,2).…”

mentioning

confidence: 99%

Crystal Structure of the Tp34 (TP0971) Lipoprotein of Treponema pallidum

Deka

Brautigam

Tomson

et al. 2007

Journal of Biological Chemistry

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The Tp34 (TP0971) membrane lipoprotein of Treponema pallidum, an obligate human pathogen and the agent of syphilis, was previously reported to have lactoferrin binding properties. Given the non-cultivatable nature of T. pallidum, a structureto-function approach was pursued to clarify further potential relationships between the Tp34 structural and biochemical properties and its propensity to bind human lactoferrin. The crystal structure of a nonacylated, recombinant form of Tp34 (rTp34), solved to a resolution of 1.9 Å , revealed two metaloccupied binding sites within a dimer; the identity of the ion most likely was zinc. Residues from both of the monomers contributed to the interfacial metal-binding sites; a novel feature was that the ␦-sulfur of methionine coordinated the zinc ion. Analytical ultracentrifugation showed that, in solution, rTp34 formed a metal-stabilized dimer and that rTp34 bound human lactoferrin with a stoichiometry of 2:1. Isothermal titration calorimetry further revealed that rTp34 bound human lactoferrin at high (submicromolar) affinity. Finally, membrane topology studies revealed that native Tp34 is not located on the outer surface (outer membrane) of T. pallidum but, rather, is periplasmic. How propensity of Tp34 to bind zinc and the iron-sequestering lactoferrin may relate overall to the biology of T. pallidum infection in humans is discussed.

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“…2 During the same period, 3375 diagnoses of infectious syphilis were observed in heterosexuals. Although previously driven by imported infections and commercial sex work, in 2008, a total of 68% of cases of heterosexually transmitted syphilis were acquired in the UK.…”

Section: 2mentioning

confidence: 99%

“…Individuals diagnosed with syphilis should always be offered an HIV test, particularly as approximately one-third of all cases of infectious syphilis in men who have sex with men in the UK involve coinfection with HIV. 2,3 Cases of syphilitic tonsillitis have been described both in secondary syphilis and in the late stages of syphilis. [4][5][6] Cases of tonsillar involvement in secondary syphilis have usually involved other cutaneous manifestations.…”

Section: 2mentioning

confidence: 99%

“…Although previously driven by imported infections and commercial sex work, in 2008, a total of 68% of cases of heterosexually transmitted syphilis were acquired in the UK. 2 Although there are classic descriptions of the stages and natural history of syphilis, it is worthy of its moniker of 'the great pretender' due to its wide variety of multisystem manifestations. The primary chancre is a painless ulcer with a rolled margin followed 4-8 weeks later by secondary syphilis, characterised by a maculopopular non-itchy rash on the trunk, palms, soles of the feet, arms, legs, face, mucous membranes, and genitalia.…”

Section: 2mentioning

confidence: 99%

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