{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T01:36:51Z","timestamp":1793929011659,"version":"4.8.0"},"reference-count":9,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["Emerging Leadership Investigator Grant (GNT 117287"],"award-info":[{"award-number":["Emerging Leadership Investigator Grant (GNT 117287"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["Emerging Leadership Investigator Grant (GNT 117455"],"award-info":[{"award-number":["Emerging Leadership Investigator Grant (GNT 117455"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["Leadership Investigator Grant (GNT1172900)"],"award-info":[{"award-number":["Leadership Investigator Grant (GNT1172900)"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["Partnership Project Grant (APP 2003399)"],"award-info":[{"award-number":["Partnership Project Grant (APP 2003399)"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001779","name":"Monash University","doi-asserted-by":"publisher","award":["Post-Doctoral Bridging Grant"],"award-info":[{"award-number":["Post-Doctoral Bridging Grant"]}],"id":[{"id":"10.13039\/501100001779","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to characterise patterns of anal and oral detection of<jats:italic>Treponema pallidum<\/jats:italic>among men who have sex with men (MSM) with early syphilis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>200 MSM with serologically confirmed primary, secondary and early latent syphilis were tested with<jats:italic>T. pallidum polA<\/jats:italic>PCR using an anal canal swab, oral rinse, plus swabs from any anal and oral lesions in a prospective, cross-sectional study. Anal and oral<jats:italic>T. pallidum<\/jats:italic>cycle threshold values were compared between subsets of men and according to rapid plasma reagin (RPR) titre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 200 men with early syphilis, 45 and 48 had anal and oral<jats:italic>T. pallidum<\/jats:italic>detected, respectively. Cycle threshold values were lower with anal compared with oral<jats:italic>T. pallidum<\/jats:italic>whether lesions were present or not. Among 27 and 42 men with anal and oral<jats:italic>T. pallidum<\/jats:italic>detected, respectively, and no anal or oral primary lesion, frequency of detection increased with increasing RPR titre, with 95% (25\/27) and 98% (41\/42) of shedding from respective sites occurring with RPR titres \u22651:16. 6.5% (13\/200) of men with syphilis had concurrent detection of<jats:italic>T. pallidum<\/jats:italic>from both anal and oral sites: 9\/13 with secondary syphilis, 7\/9 of whom had anal lesions with a median duration of 30 days (range 7\u2013180 days).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These data suggest<jats:italic>T. pallidum<\/jats:italic>load at the anus is higher than at the oral cavity and that a subset of men with secondary syphilis and prolonged anal lesions may be relatively infectious. Earlier detection and treatment of syphilis, when RPR titres are lower than 1:16, could potentially reduce infectiousness from anal and oral sites.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2021-055370","type":"journal-article","created":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T09:53:46Z","timestamp":1666605226000},"page":"570-574","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Anal and oral detection of<i>Treponema pallidum<\/i>in men who have sex with men with early syphilis infection"],"prefix":"10.1136","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2714-4680","authenticated-orcid":false,"given":"Janet M","family":"Towns","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1766-0657","authenticated-orcid":false,"given":"Eric P F","family":"Chow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Wigan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9081-1664","authenticated-orcid":false,"given":"Christopher K","family":"Fairley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7363-6665","authenticated-orcid":false,"given":"Deborah","family":"Williamson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Azzato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Graves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-084X","authenticated-orcid":false,"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus Y","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,5,26]]},"reference":[{"key":"2023100200001835000_98.8.570.1","doi-asserted-by":"crossref","first-page":"e1110","DOI":"10.1016\/S2214-109X(21)00221-7","article-title":"Prevalence of syphilis among men who have sex with men: a global systematic review and meta-analysis from 2000-20","volume":"9","author":"Tsuboi","year":"2021","journal-title":"Lancet Glob Health"},{"key":"2023100200001835000_98.8.570.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1907194"},{"key":"2023100200001835000_98.8.570.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30838-0"},{"key":"2023100200001835000_98.8.570.4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1613"},{"key":"2023100200001835000_98.8.570.5","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001476"},{"key":"2023100200001835000_98.8.570.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.04.018"},{"key":"2023100200001835000_98.8.570.7","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7005a1"},{"key":"2023100200001835000_98.8.570.8","unstructured":"Public Health Laboratory Network Australian Government Department of Health . Syphilis laboratory case definition, 2012. Available: https:\/\/www1.health.gov.au\/internet\/main\/publishing.nsf\/Content\/cda-phln-syphilis.htm"},{"key":"2023100200001835000_98.8.570.9","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01578-06"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2021-055370","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T07:00:54Z","timestamp":1696230054000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2021-055370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,26]]},"references-count":9,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,11,17]]},"published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1136\/sextrans-2021-055370"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2021-055370","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,26]]}}}