Kaur Ravneet, Gupta Sharang, Sarangal Rishu, Chopra Dimple, Singh Harmeet
Department of Dermatology, Government Medical College, Patiala, Punjab, India.
Indian J Sex Transm Dis AIDS. 2023 Jan-Jun;44(1):45-48. doi: 10.4103/ijstd.ijstd_109_22. Epub 2023 Jun 6.
Syphilis remains a global health problem with recent reports of resurgence from various parts of the world. We undertook this study to analyze the current epidemiological and clinical trends of syphilis in our part of the country.
To analyze the changing trends in clinical presentation of syphilis and the current status of HIV/AIDS-syphilis co-infection in our area.
This is a hospital-based retrospective analysis of records of sexually transmitted disease (STD) patients enrolled in "Suraksha clinic" in the department of Skin and VD at a Tertiary Care Hospital in North India. Patient records were analyzed from January 2018 to December 2021. The demographic, clinical, and serological profiles of patients were assessed to study the percentage of syphilis patients attending the STD clinic and their clinical presentations.
A total of 7153 patients were enrolled in the"Suraksha clinic" from January 2018 to December 2021, these included the venereal disease patients (3137) and nonvenereal disease patients (4016) who were registered for HIV and venereal disease research laboratory (VDRL) screening from the dermatology outpatient department. Out of 3137 sexually transmitted infection (STI) patients, 139 patients tested positive for VDRL. hemagglutination was found positive in 137 patients and negative in two patients. Hence, 137 patients were confirmed syphilis cases, constituting 4.36% of total STD cases in our STI clinic in 4 years. Out of 137 patients, 2 (1.45%) presented with primary chancre, 6 (4.37%) with lesions of secondary syphilis and 129 (94.16%) were found serologically reactive without any symptoms or clinical signs, i.e., in latent syphilis. Our records also showed 14 (10.21%) cases of HIV and syphilis co-infection.
In our study, a remarkable rise in the number of patients in the latent syphilis stage is observed over primary and secondary syphilis stage. This signifies the persistence of syphilis in subclinical phase in the community and unfortunately, it goes unnoticed. These could be "warning signs" for changing disease pattern of syphilis in India and points toward hidden resurgence of syphilis as being reported in various parts of the world. To actively look for these "hidden cases," there is a need to strengthen "Suraksha clinics." VDRL testing should be mandatory along with routine testing in all patients visiting the hospital irrespective of their disease. We also propose for the central registration of syphilis patients on lines of HIV-infected patients' registry.
梅毒仍然是一个全球性的健康问题，最近有来自世界各地的复发报告。我们进行这项研究以分析我国该地区梅毒的当前流行病学和临床趋势。
分析梅毒临床表现的变化趋势以及我们地区艾滋病毒/艾滋病与梅毒合并感染的现状。
这是一项基于医院的回顾性分析，分析对象为印度北部一家三级护理医院皮肤与性病科“Suraksha诊所”登记的性传播疾病（STD）患者的记录。对2018年1月至2021年12月期间的患者记录进行分析。评估患者的人口统计学、临床和血清学特征，以研究前往性病诊所的梅毒患者百分比及其临床表现。
2018年1月至2021年12月期间，共有7153名患者在“Suraksha诊所”登记，其中包括性病患者（3137名）和非性病患者（4016名），这些患者是从皮肤科门诊登记进行艾滋病毒和性病研究实验室（VDRL）筛查的。在3137名性传播感染（STI）患者中，139名VDRL检测呈阳性。137名患者血凝试验呈阳性，2名患者呈阴性。因此，137名患者被确诊为梅毒病例，占我们性传播感染诊所4年中总性病病例的4.36%。在137名患者中，2名（1.45%）出现一期梅毒硬下疳，6名（4.37%）出现二期梅毒病变，129名（94.16%）血清学反应阳性但无任何症状或体征，即处于潜伏梅毒阶段。我们的记录还显示有14例（10.21%）艾滋病毒与梅毒合并感染病例。
在我们的研究中，观察到潜伏梅毒阶段的患者数量比一期和二期梅毒阶段有显著增加。这表明梅毒在社区亚临床阶段持续存在，不幸的是，它未被注意到。这些可能是印度梅毒疾病模式变化的“警示信号”，并指向梅毒在世界各地报告的隐性复发。为了积极寻找这些“隐性病例”，有必要加强“Suraksha诊所”。在所有就诊患者中，无论其疾病如何，VDRL检测应与常规检测一样成为强制性检测。我们还提议按照艾滋病毒感染患者登记的方式对梅毒患者进行中央登记。
