Division of STD Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Florida Department of Health, Tallahassee, Florida, USA.
AIDS Patient Care STDS. 2021 Nov;35(11):435-440. doi: 10.1089/apc.2021.0081.
Syphilis rates have continued to rise in the United States. Florida and Louisiana consistently report high numbers of cases. We evaluated rates of reinfection to see if frequent rescreening might lead to earlier treatment and prevent infections. All syphilis records of all stages for males and females aged 15-70 years from the Florida and Louisiana Departments of Health surveillance databases 2000-2018 were evaluated. The first episode of syphilis during this period was considered the initial diagnosis for each person. Demographics of cases and repeaters (individuals reported with two or more cases of syphilis) were examined. Percentages of syphilis cases from repeaters by year were calculated as were percentages from HIV+ males. During 2000-2018, 124,827 syphilis cases were reported from 107,405 individuals: 73,811 (68.7%) males; 33,594 (31.3%) females. There were 12,545 individuals (repeaters) with two or more syphilis diagnoses ( = 17,422 cases; range, 2-10). From 2010 to 2018, repeaters accounted for steadily increasing percentage of all syphilis reported: 2010 (11%), 2013 (16%), 2015 (20%), and 2018 (26%). Among HIV+ male cases the percentage from repeaters also increased: 2010 (28%), 2013 (35%), 2015 (42%), and 2018 (50%). In 2018, 19% of all cases ( = 2455) were from HIV+ males who had a previous syphilis diagnosis. Among HIV+ males diagnosed with syphilis in 2015, 34% had a repeat syphilis diagnosis within 3 years. Most syphilis diagnosed in Florida and Louisiana was among persons infected for the first time. However, some subgroups could possibly benefit from more frequent screening. Males living with HIV who had a prior syphilis diagnosis were at very high risk of repeat infection.
梅毒在美国的发病率持续上升。佛罗里达州和路易斯安那州一直报告有大量病例。我们评估了再感染率，以确定是否频繁筛查可能会导致更早的治疗并预防感染。评估了 2000 年至 2018 年佛罗里达州和路易斯安那州卫生部监测数据库中所有年龄段为 15-70 岁的男性和女性的所有阶段梅毒记录。在此期间的第一例梅毒被视为每个人的初始诊断。检查了病例和重复者（报告有两次或两次以上梅毒病例的个人）的人口统计学特征。按年计算重复者的梅毒病例百分比，以及 HIV+男性的百分比。在 2000 年至 2018 年期间，从 107,405 名个体中报告了 124,827 例梅毒病例：73,811（68.7％）男性；33,594（31.3％）女性。有 12,545 人（重复者）有两次或两次以上梅毒诊断（ = 17,422 例；范围，2-10）。从 2010 年到 2018 年，重复者在报告的所有梅毒病例中所占比例稳步增加：2010 年（11％），2013 年（16％），2015 年（20％）和 2018 年（26％）。在 HIV+男性病例中，来自重复者的百分比也有所增加：2010 年（28％），2013 年（35％），2015 年（42％）和 2018 年（50％）。2018 年，所有病例的 19％（ = 2455）来自以前患有梅毒的 HIV+男性。在 2015 年被诊断患有梅毒的 HIV+男性中，34％在三年内再次感染梅毒。佛罗里达州和路易斯安那州诊断出的大多数梅毒是首次感染的人。然而，一些亚组可能会从更频繁的筛查中受益。以前患有梅毒的 HIV 感染者男性再次感染的风险极高。
