{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T02:29:37Z","timestamp":1781058577975,"version":"3.54.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2018,4,28]],"date-time":"2018-04-28T00:00:00Z","timestamp":1524873600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>There is conflicting evidence as to whether repeat syphilis is more likely to present asymptomatically than initial syphilis. If it is, then this would motivate more frequent and long-term syphilis screening in persons with a history of multiple episodes of syphilis. We conducted detailed folder reviews of all individuals with 4 or more diagnoses of syphilis between 2000 and 2017 at the Institute of Tropical Medicine, Antwerp, and assessed if there was a difference in the proportion presenting with symptomatic (primary and secondary) vs asymptomatic (latent) syphilis in initial vs repeat syphilis. Forty-five clients with 4 or more episodes of syphilis were included in the study. All were HIV-infected. Repeat episodes of syphilis were less likely to be symptomatic than initial episodes (35\/160 [21.9%] vs 28\/45 [62.2%]; P &amp;lt; .001). Frequent screening in those with HIV infection may be the only way to diagnose repeat episodes of syphilis. Care providers can use this information to motivate persons with multiple episodes of syphilis to be screened every 3 to 6 months.<\/jats:p>","DOI":"10.1093\/ofid\/ofy096","type":"journal-article","created":{"date-parts":[[2018,4,28]],"date-time":"2018-04-28T06:34:39Z","timestamp":1524897279000},"source":"Crossref","is-referenced-by-count":39,"title":["Repeat Syphilis Is More Likely to Be Asymptomatic in HIV-Infected Individuals: A Retrospective Cohort Analysis With Important Implications for Screening"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2557-8998","authenticated-orcid":false,"given":"Chris","family":"Kenyon","sequence":"first","affiliation":[{"name":"HIV\/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium"},{"name":"Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara Krista","family":"Osbak","sequence":"additional","affiliation":[{"name":"HIV\/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludwig","family":"Apers","sequence":"additional","affiliation":[{"name":"HIV\/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,4,28]]},"reference":[{"key":"2020081004281752100_CIT0001","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1097\/OLQ.0b013e3181e9afc7","article-title":"Reinfections during the Florida syphilis epidemic, 2000-2008","volume":"38","author":"Brewer","year":"2011","journal-title":"Sex Transm Dis"},{"key":"2020081004281752100_CIT0002","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/OLQ.0b013e3181fe650b","article-title":"Repeat syphilis among men who have sex with men\u2013San Diego County, 2004-2009","volume":"38","author":"Katz","year":"2011","journal-title":"Sex Transm Dis"},{"key":"2020081004281752100_CIT0003","doi-asserted-by":"crossref","first-page":"20958","DOI":"10.2807\/1560-7917.ES2014.19.45.20958","article-title":"Syphilis reinfections pose problems for syphilis diagnosis in Antwerp, Belgium\u20141992 to 2012","volume":"19","author":"Kenyon","year":"2014","journal-title":"Euro Surveill"},{"key":"2020081004281752100_CIT0004","article-title":"Is early latent syphilis more likely in patients with a prior syphilis infection","volume-title":"British Society for Sexual Health and HIV","author":"Kerani"},{"key":"2020081004281752100_CIT0005","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1159\/000369617","article-title":"Clinical aspects of syphilis reinfection in HIV-infected patients","volume":"230","author":"Courjon","year":"2015","journal-title":"Dermatology"},{"key":"2020081004281752100_CIT0006","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1136\/sextrans-2017-053312","article-title":"Repeat syphilis has a different immune response compared to initial syphilis: an analysis of biomarker kinetics in two cohorts","volume":"94(3)","author":"Kenyon","year":"2018","journal-title":"Sex Transm Infect"},{"key":"2020081004281752100_CIT0007","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1001\/archinte.1991.00400030071013","article-title":"Characteristics of patients with syphilis attending Baltimore STD clinics. 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