{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:18:49Z","timestamp":1792498729277,"version":"4.5.0"},"reference-count":29,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2021,2,5]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>HIV-positive men who have sex with men (MSM) may be at a higher risk of repeat syphilis, have different clinical manifestations and have a different serological response to treatment compared with HIV-negative MSM. The objective of this study was to assess whether HIV-negative and HIV-positive MSM with infectious syphilis (primary, secondary or early latent) differed in history of previous syphilis episodes, disease stage and non-treponemal titre of initial and repeat episodes, and the titre response 6 and 12 months after treatment. Furthermore, determinants associated with an inadequate titre response after treatment were explored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective analysis used data of five longitudinal studies (four cohorts; one randomised controlled trial) conducted at the STI clinic in Amsterdam, the Netherlands. Participants were tested for syphilis and completed questionnaires on sexual risk behaviour every 3\u20136 months. We included data of participants with \u22651 syphilis diagnosis in 2014\u20132019. Pearson\u2019s \u03c7\u00b2 test was used to compare HIV-negative and HIV-positive MSM in occurrence of previous syphilis episodes, disease stage of initial and repeat syphilis episode and non-treponemal titre treatment responses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 355 participants with total 459 syphilis episodes. HIV-positive MSM were more likely to have a history of previous syphilis episodes compared with HIV-negative MSM (68\/90 (75.6%) vs 96\/265 (36.2%); p&lt;0.001). Moreover, HIV-positive MSM with repeat syphilis were less often diagnosed with primary syphilis (7\/73 (9.6%) vs 36\/126 (28.6%)) and more often diagnosed with secondary syphilis (16\/73 (21.9%) vs 17\/126 (13.5%)) and early latent syphilis (50\/73 (68.5%) vs 73\/126 (57.9%)) (p=0.005). While not significantly different at 12 months, HIV-negative MSM were more likely to have an adequate titre response after 6 months compared with HIV-positive MSM (138\/143 (96.5%) vs 66\/74 (89.2%); p=0.032).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In repeat syphilis, HIV infection is associated with advanced syphilis stages and with higher non-treponemal titres. HIV infection affects the serological outcome after treatment, as an adequate titre response was observed earlier in HIV-negative MSM.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2020-054887","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T23:02:54Z","timestamp":1613775774000},"page":"95-100","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Clinical outcomes of syphilis in HIV-negative and HIV-positive MSM: occurrence of repeat syphilis episodes and non-treponemal serology responses"],"prefix":"10.1136","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1466-5292","authenticated-orcid":false,"given":"Silvia Achia","family":"Nieuwenburg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Jamie","family":"Sprenger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4903-7002","authenticated-orcid":false,"given":"Maarten Franciscus","family":"Schim van der Loeff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9784-547X","authenticated-orcid":false,"given":"Henry John Christiaan","family":"de Vries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,2,19]]},"reference":[{"key":"2024092104100594000_98.2.95.1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0159309"},{"key":"2024092104100594000_98.2.95.2","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s40471-018-0138-z","article-title":"An update on the global epidemiology of syphilis","volume":"5","author":"Kojima","year":"2018","journal-title":"Curr Epidemiol Rep"},{"key":"2024092104100594000_98.2.95.3","doi-asserted-by":"crossref","DOI":"10.1017\/S0950268819000281","article-title":"The resurgence of syphilis in high-income countries in the 2000s: a focus on Europe","volume":"147","author":"Spiteri","year":"2019","journal-title":"Epidemiol Infect"},{"key":"2024092104100594000_98.2.95.4","unstructured":"Soetens LC , Koedijk FDH , van den Broek IVF . Sexually transmitted infections, including HIV, in the Netherlands in 2012. In: Epidemiology and surveillance unit CfIDC. National Institute for Public Health and the Environment, 2013."},{"key":"2024092104100594000_98.2.95.5","unstructured":"Slurink IAL , van Aar F , Op de Coul ELM . Sexually transmitted infections in the Netherlands in 2018. In: Sti department EaSU, centre for infectious disease control. National Institute for Public Health and the Environment, 2019."},{"key":"2024092104100594000_98.2.95.6","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES2014.19.45.20958"},{"key":"2024092104100594000_98.2.95.7","doi-asserted-by":"publisher","DOI":"10.1212\/01.CPJ.0000435752.17621.48"},{"key":"2024092104100594000_98.2.95.8","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1209-0"},{"key":"2024092104100594000_98.2.95.9","doi-asserted-by":"crossref","first-page":"481","DOI":"10.5114\/ada.2018.77238","article-title":"Hiv infection and sex in sex-on-premises venues are associated with a higher risk of syphilis reinfection among men who have sex with men","volume":"35","author":"Pastuszczak","year":"2018","journal-title":"Postepy Dermatol Alergol"},{"key":"2024092104100594000_98.2.95.10","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1177\/0956462418757554","article-title":"Factors associated with repeat diagnosis of syphilis in genitourinary medicine (gum) clinic Attendees in the North East of England, 2002-2014","volume":"29","author":"Dolan","year":"2018","journal-title":"Int J STD AIDS"},{"key":"2024092104100594000_98.2.95.11","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1089\/lgbt.2016.0095","article-title":"Rates and correlates of syphilis reinfection in men who have sex with men","volume":"4","author":"Jain","year":"2017","journal-title":"LGBT Health"},{"key":"2024092104100594000_98.2.95.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0162156","article-title":"Risk factors associated with incident syphilis in a cohort of high-risk men in Peru","volume":"11","author":"Park","year":"2016","journal-title":"PLoS One"},{"key":"2024092104100594000_98.2.95.13","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2011.300383"},{"key":"2024092104100594000_98.2.95.14","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-017-2201-7","article-title":"The immunological response to syphilis differs by HIV status; a prospective observational cohort study","volume":"17","author":"Kenyon","year":"2017","journal-title":"BMC Infect Dis"},{"key":"2024092104100594000_98.2.95.15","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1071\/SH14168","article-title":"Management of syphilis in HIV-positive individuals","volume":"12","author":"Cresswell","year":"2015","journal-title":"Sex Health"},{"key":"2024092104100594000_98.2.95.16","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofy096","article-title":"Repeat syphilis is more likely to be asymptomatic in HIV-infected individuals: a retrospective cohort analysis with important implications for screening","volume":"5","author":"Kenyon","year":"2018","journal-title":"Open Forum Infect Dis"},{"key":"2024092104100594000_98.2.95.17","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.67.7.3631-3636.1999"},{"key":"2024092104100594000_98.2.95.18","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-018-3399-8","article-title":"Syphilis reinfection is associated with an attenuated immune profile in the same individual: a prospective observational cohort study","volume":"18","author":"Kenyon","year":"2018","journal-title":"BMC Infect Dis"},{"key":"2024092104100594000_98.2.95.19","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053312"},{"key":"2024092104100594000_98.2.95.20","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1093\/cid\/ciz943","article-title":"Previous syphilis alters the course of subsequent episodes of syphilis","volume":"71","author":"Marra","year":"2020","journal-title":"Clin Infect Dis"},{"key":"2024092104100594000_98.2.95.21","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1097\/QAD.0000000000002417","article-title":"Diverging trends in incidence of HIV versus other sexually transmitted infections in HIV-negative MSM in Amsterdam","volume":"34","author":"van Bilsen","year":"2020","journal-title":"AIDS"},{"key":"2024092104100594000_98.2.95.22","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-017-2474-x"},{"key":"2024092104100594000_98.2.95.23","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25105","article-title":"Men who have sex with men more often chose daily than event-driven use of pre-exposure prophylaxis: baseline analysis of a demonstration study in Amsterdam","volume":"21","author":"Hoornenborg","year":"2018","journal-title":"J Int AIDS Soc"},{"key":"2024092104100594000_98.2.95.24","doi-asserted-by":"crossref","unstructured":"Hulstein SH HE , Matser A , Hogewoning A , et al . Informal use of PrEP among MSM STI clinic visitors: preliminary results of the InPrEP study. IUSTI 2018 World & European Congress.","DOI":"10.26226\/morressier.5af060641dd164001d5ef498"},{"key":"2024092104100594000_98.2.95.25","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31065-5"},{"key":"2024092104100594000_98.2.95.26","unstructured":"LCI . Syfilis Richtlijn [Guideline]. RIVM, 2009. Available: https:\/\/lci.rivm.nl\/sites\/default\/files\/entity_print_pdf\/584\/Syfilis.pdf"},{"key":"2024092104100594000_98.2.95.27","doi-asserted-by":"publisher","DOI":"10.1086\/644618"},{"key":"2024092104100594000_98.2.95.28","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis757"},{"key":"2024092104100594000_98.2.95.29","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1177\/0956462419871855","article-title":"Post-Treatment serological changes in some patients with early syphilis exhibit a parabolic trend","volume":"30","author":"Liu","year":"2019","journal-title":"Int J STD AIDS"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2020-054887","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,21]],"date-time":"2024-09-21T11:10:52Z","timestamp":1726917052000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2020-054887"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,19]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2,17]]},"published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1136\/sextrans-2020-054887"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2020-054887","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,19]]}}}