美国报告的原发性和继发性梅毒病例：对 HIV 感染的影响。
Reported Primary and Secondary Syphilis Cases in the United States: Implications for HIV Infection.
机构信息
From the Divisions of STD Prevention and.
Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
出版信息
Sex Transm Dis. 2018 Sep;45(9S Suppl 1):S42-S47. doi: 10.1097/OLQ.0000000000000810.
BACKGROUND
Recent increases in syphilis among men who have sex with men (MSM) are especially concerning, given the biologic and epidemiologic associations between syphilis and HIV infection. We sought to better describe the current epidemiology of primary and secondary (P&S) syphilis and the prevalence of HIV infection among reported P&S syphilis cases by demographic group, including sex of sex partner, in the United States in 2016.
METHODS
We reviewed national P&S syphilis case report data from 2016, including available risk factor information such as sex of sex partner and HIV status. Data were extracted from the National Electronic Telecommunications System for Surveillance, the system through which Centers for Disease Control and Prevention receives notifiable sexually transmitted disease data from all 50 states and the District of Columbia. The proportion of cases with HIV coinfection was calculated using cases with known HIV status as the denominator.
RESULTS
Of 27,814 P&S syphilis cases reported in 2016, 58.1% were among MSM, 13.9% were among men who have sex with women only, 11.0% were among women, and 16.9% were among men without data on sex of sex partners. Similar patterns were observed across geographic regions, race/ethnicity groups, and most age groups. Overall, 38.5% of reported P&S syphilis cases with known HIV status were coinfected with HIV. The prevalence of HIV coinfection was highest among MSM (47.0%) compared with men who have sex with women only (10.7%) or women (4.1%). Among MSM with P&S syphilis, the prevalence of HIV coinfection was highest among black MSM, ranging from 33.8% among black MSM aged 15 to 19 years to 77.8% among black MSM aged 45 to 49 years.
CONCLUSIONS
These data underscore the epidemiologic linkages between syphilis and HIV, particularly among MSM. Primary and secondary syphilis may represent an opportunity to prevent HIV infection among persons who are HIV negative and identify and link to care persons living with HIV infection but not currently engaged in care.
背景
最近男男性行为者（MSM）中的梅毒发病率上升尤其令人担忧，因为梅毒和 HIV 感染之间存在生物学和流行病学关联。我们试图更好地描述 2016 年美国报告的原发性和继发性（P&S）梅毒病例的当前流行病学情况，以及按性别和性伴侣的人口统计学特征描述报告的 P&S 梅毒病例中 HIV 感染的流行率。
方法
我们审查了 2016 年全国 P&S 梅毒病例报告数据，包括性伴侣的性别和 HIV 状况等可用的风险因素信息。数据从国家电子电信监测系统中提取，该系统是疾病控制与预防中心从 50 个州和哥伦比亚特区接收法定传染病数据的系统。利用已知 HIV 状况的病例作为分母，计算出 HIV 合并感染的病例比例。
结果
2016 年报告的 27814 例 P&S 梅毒病例中，58.1%为 MSM 病例，13.9%为仅与女性发生性行为的男性病例，11.0%为女性病例，16.9%为男性病例，其性伴侣的性别信息不详。在地理区域、种族/民族群体和大多数年龄组中都观察到类似的模式。总体而言，报告的已知 HIV 状况的 P&S 梅毒病例中，有 38.5%合并感染 HIV。与仅与女性发生性行为的男性（10.7%）或女性（4.1%）相比，MSM 中 HIV 合并感染的流行率最高（47.0%）。在患有 P&S 梅毒的 MSM 中，HIV 合并感染的流行率在黑人 MSM 中最高，范围从 15 至 19 岁的黑人 MSM 中 33.8%到 45 至 49 岁的黑人 MSM 中 77.8%。
结论
这些数据突出了梅毒和 HIV 之间的流行病学联系，尤其是在 MSM 中。原发性和继发性梅毒可能代表了一个机会，可以预防 HIV 阴性人群感染 HIV，并发现和联系那些目前未参与 HIV 治疗的 HIV 感染者进行治疗。
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