Allan-Blitz Lao-Tzu, Konda Kelika A, Vargas Silver K, Wang Xiaoyan, Segura Eddy R, Fazio Boris M, Calvo Gino M, Caceres Carlos F, Klausner Jeffrey D
Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Los Angeles CA, 90095, USA.
Centre for Interdisciplinary Studies in Sexuality, AIDS and Society, Cayetano Heredia University, Av. Honorio Delgado 430, San Martín de Porres, 15102, Peru.
Sex Health. 2018 Jun;15(3):261-268. doi: 10.1071/SH17118.
Background Syphilis incidence worldwide has rebounded since 2000, particularly among men who have sex with men (MSM). A predictive model for syphilis infection may inform prevention counselling and use of chemoprophylaxis.
Data from a longitudinal cohort study of MSM and transgender women meeting high-risk criteria for syphilis who were followed quarterly for 2 years were analysed. Incidence was defined as a four-fold increase in rapid plasma reagin (RPR) titres or new RPR reactivity if two prior titres were non-reactive. Generalised estimating equations were used to calculate rate ratios (RR) and develop a predictive model for 70% of the dataset, which was then validated in the remaining 30%. An online risk calculator for the prediction of future syphilis was also developed.
Among 361 participants, 22.0% were transgender women and 34.6% were HIV-infected at baseline. Syphilis incidence was 19.9 cases per 100-person years (95% confidence interval (CI) 16.3-24.3). HIV infection (RR 2.22; 95% CI 1.54-3.21) and history of syphilis infection (RR 2.23; 95% 1.62-3.64) were significantly associated with incident infection. The final predictive model for syphilis incidence in the next 3 months included HIV infection, history of syphilis, number of male sex partners and sex role for anal sex in the past 3 months, and had an area under the curve of 69%. The online syphilis risk calculator based on those results is available at: www.syphrisk.net.
Using data from a longitudinal cohort study among a population at high risk for syphilis infection in Peru, we developed a predictive model and online risk calculator for future syphilis infection. The predictive model for future syphilis developed in this study has a moderate predictive accuracy and may serve as the foundation for future studies.
背景 自2000年以来，全球梅毒发病率有所回升，尤其是在男男性行为者（MSM）中。梅毒感染预测模型可为预防咨询和化学预防的使用提供依据。
对符合梅毒高危标准的男男性行为者和跨性别女性进行的纵向队列研究数据进行分析，这些参与者每季度随访2年。发病率定义为快速血浆反应素（RPR）滴度增加四倍或如果前两次滴度无反应则为新的RPR反应性。使用广义估计方程计算率比（RR）并为70%的数据集建立预测模型，然后在其余30%的数据集中进行验证。还开发了一个用于预测未来梅毒的在线风险计算器。
在361名参与者中，22.0%为跨性别女性，34.6%在基线时感染了艾滋病毒。梅毒发病率为每100人年19.9例（95%置信区间（CI）16.3 - 24.3）。艾滋病毒感染（RR 2.22；95% CI 1.54 - 3.21）和梅毒感染史（RR 2.23；95% 1.62 - 3.64）与新发感染显著相关。未来3个月梅毒发病率的最终预测模型包括艾滋病毒感染、梅毒史、男性性伴侣数量以及过去3个月肛交的性角色，曲线下面积为69%。基于这些结果的在线梅毒风险计算器可在以下网址获取：www.syphrisk.net。
利用秘鲁梅毒感染高危人群纵向队列研究的数据，我们开发了一个未来梅毒感染的预测模型和在线风险计算器。本研究中开发的未来梅毒预测模型具有中等预测准确性，可为未来研究奠定基础。
