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

Abstract

© 2014, Medical Association of Thailand. All rights reserved. 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 risk factors of syphilis in MSM population without statistical comparison with non-MSM population.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 MSM and non-MSM, as well as HIV and non-HIV populations.Material and Method: This was a retrospective medical records review of patients diagnosed with syphilis who attended Sexual Transmitted Diseases (STD) clinic between January 2008 and December 2012. Demographic data, clinical manifestations, HIV status, 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 MSM and HIV infected patients were 2.8% and 3.4%, respectively. Prevalence had upward trend that started from 2008 and reached peak in 2011.When taking MSM into account, MSM significantly had younger age than non-MSM. Early stage of syphilis, VDRL titer higher than 1:32 at diagnosis, and MSM population were significantly associated with HIV-positivity among syphilis patients. Regarding treatment of syphilis, median time to cure syphilis was 117 days (95% confidence interval = 93-141). Treatment regimen, MSM, and HIV co-infection did not significantly show influence on duration to cure.Conclusion: Prevalence of syphilis has been continuously increasing. MSM with syphilis significantly associated with younger age. Moreover, early stage of syphilis, VDRL titer higher than 1:32, and MSM population were significantly related with HIV infection. Treatment regimen, MSM, and HIV co-infection did not significantly show influence on duration to cure.