Clinical and epidemiological characteristics of patients with syphilis: 5 year-case study from Thailand

Abstract

Background: Syphilis has been increasing dramatically worldwide since 2000, especially among men who have sex with men (MSM), and in those with human immunodeficiency virus (HIV) infection. However most previous reports studied about prevalence and riskfactors ofsyphilis in MSMpopulation without statistical comparison with non-MSMpopulation.

Objective: The present study aimed to describe epidemiological trends, clinical manifestations, laboratory investigation, treatment, and HIV co-infection in patients diagnosed with syphilis, including statistical evaluation these data between MSMand non-MSM as well as HIV and non-HIVpopulations.

Material and method: This was a retrospective medical records review ofpatients diagnosed with syphilis who attended Sexual Transmitted Diseases (STD) clinic between January 2008 and December 2012. Demographic data, clinical manifestations, HIVstatus, VDRL titer; and treatment regimens were collected.

Results: Of the 922 patients that attended the STD clinic, 143 syphilis patients were recruited with an overall prevalence of 15.5%. Twenty-six patients were MSM and 31 were HIV infected patients. Prevalence rate of syphilis in MSMand HIV infected patients were 2.8% and 3.4%, respectively. Prevalence had upward trend that startedfrom 2008 and reachedpeak in 2011. When taking MSMinto account, MSMsignificantly had younger age than non-MSM Early stage ofsyphilis, VDRL titer higher than 1:32 at diagnosis, and MSMpopulation were significantly associated with HIV-positivity among syphilis patients. Regarding treatment ofsyphilis, median time to cure syphilis was 117 days (95% confidence interval = 93-141). Treatment regimen, MSM and HIVco-infection did not significantly show influence on duration to cure.

Conclusion: Prevalence ofsyphilis has been continuously increasing. MSM with syphilis significantly associated with younger age. Moreover, early stage of syphilis, VDRL titer higher than 1:32, and MSMpopulation were significantly related with HIVinfection. Treatment regimen, MSM and HIVco-infection did not significantly show influence on duration to cure.