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However, the presence and quantity of Treponema pallidum DNA in patients with syphilis in saliva is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>234 patients with syphilis with different stages and 30 volunteers were enrolled. Paired saliva and plasma samples were collected from all participants. Consecutive saliva samples from 9 patients were collected every 4 hours following treatment. Treponema pallidum DNA in samples was determined by nested polymerase chain reaction (PCR) and droplet digital PCR targeting polA and Tpp47.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Treponema pallidum DNA detection rates in saliva and plasma were 31.0% (9\/29) and 51.7% (15\/29) in primary syphilis (P\u2005=\u2005.11), 87.5% (63\/72) and 61.1% (44\/72) in secondary syphilis (P\u2005&amp;lt;\u2005.001), 25.6% (21\/82) and 8.5% (7\/82) in latent syphilis (P\u2005= .004), and 21.6% (11\/51) and 5.9% (3\/51) in symptomatic neurosyphilis (P\u2005=\u2005.021), respectively. Median (range) loads of Tpp47 and polA in saliva were 627 (0\u2013101 200) and 726 (0\u2013117 260) copies\/mL, respectively, for patients with syphilis. In plasma, however, loads of Tpp47 and polA were low: medians (range) of 0 (0\u2013149.6) and 0 (0\u2013176) copies\/mL, respectively. Loads of T. pallidum DNA in saliva during treatment fluctuated downward; the clearance time was positively correlated with the loads of T. pallidum DNA before treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Collection of saliva is noninvasive and convenient. The high loads of T. pallidum DNA in saliva and reduction after treatment indicated that saliva can be not only a diagnostic fluid for syphilis but also an indicator of therapeutic effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1613","type":"journal-article","created":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T07:31:39Z","timestamp":1603438299000},"page":"e3250-e3258","source":"Crossref","is-referenced-by-count":43,"title":["A New Specimen for Syphilis Diagnosis: Evidence by High Loads of\n                    <i>Treponema pallidum<\/i>\n                    DNA in Saliva"],"prefix":"10.1093","volume":"73","author":[{"given":"Cuini","family":"Wang","sequence":"first","affiliation":[{"name":"STD Institute, Shanghai Skin Disease Hospital, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixiang","family":"Hu","sequence":"additional","affiliation":[{"name":"STD Institute, Shanghai Skin Disease Hospital, Shanghai, 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