{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:59:15Z","timestamp":1783576755967,"version":"3.55.0"},"reference-count":86,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>\n                      Syphilis is an infectious disease caused by\n                      <jats:italic>T. pallidum<\/jats:italic>\n                      subsp.\n                      <jats:italic>Pallidum<\/jats:italic>\n                      . In high-income countries the main mode of transmission is sexual. Approximately half of infected patients are asymptomatic, which does not exclude the possibility of transmission. The aim of this study was to evaluate syphilis seroprevalence among asymptomatic persons in Gran Canaria (Canary Islands, Spain).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>\n                      Three different groups were studied from 2001 to 2020\n                      <jats:italic>: i)<\/jats:italic>\n                      a \u201cblood donor\u201d sample of 948,869 voluntary blood donations as a proxy of health population.;\n                      <jats:italic>ii)<\/jats:italic>\n                      undocumented African immigrants, including 1,873 recent arrivals in Gran Canaria; and\n                      <jats:italic>iii)<\/jats:italic>\n                      people living with HIV (PLWH), a group of 1,690 patients followed by our team. The evaluation included both treponemal and reaginic tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic>i)<\/jats:italic>\n                      among blood donors, the mean seroprevalence of positive treponemal tests was 0.25% (95% CI: 0.19\u20130.31). Non-treponemal test positivity (RPR) ranged from 0.05 to 0.06% with titers\u2009\u2264\u20091:4 in all cases;\n                      <jats:italic>ii)<\/jats:italic>\n                      thirty-four of 641 undocumented African migrants (5.30%; 95% CI: 3.82\u20137.32%) had a confirmed positive treponemal test but only 4 had a positive RPR, with titers ranging from 1:1\u20131:4;\n                      <jats:italic>iii)<\/jats:italic>\n                      46.51% (95% CI: 44.14\u201348.89) of PLWH patients had a confirmed positive treponemal test. For factors related to HIV-syphilis coinfection, multivariate analysis clearly showed the association with male sex and the MSM risk category. However, the results of this series call into question the overall role of immigration in the seroprevalence of syphilis among PLWH in our setting. Active syphilis (RPR\u2009&gt;\u20091:8) was found in 20.10% of PLWH.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In summary, syphilis is a re-emerging infection, and asymptomatic persons constitute a group that facilitates its transmission and spread. In our setting, seroprevalence was lowest in blood donors, higher in recently arrived African migrants, and highest in PLWH, especially MSM. The presence of active syphilis however is mainly restricted to MSM. This information is of relevance for the design of syphilis control strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0325073","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T13:22:26Z","timestamp":1751980946000},"page":"e0325073","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Treponema pallidum infection in asymptomatic persons: A puzzling scenario in the Canary Islands (Spain) (2001\u20132020)"],"prefix":"10.1371","volume":"20","author":[{"given":"Jose Luis","family":"P\u00e9rez-Arellano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Araceli","family":"Hern\u00e1ndez Betancor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Sanz Pel\u00e1ez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Curbelo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Hern\u00e1ndez Cabrera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Pisos \u00c1lamo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nieves","family":"Ja\u00e9n S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Su\u00e1rez Hormiga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Lavilla Salgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"L\u00f3pez Delgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Gonz\u00e1lez Linares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2768-0072","authenticated-orcid":true,"given":"Cristina","family":"Carranza-Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"issue":"10398","key":"pone.0325073.ref001","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/S0140-6736(22)02348-0","article-title":"Syphilis","volume":"402","author":"RW Peeling","year":"2023","journal-title":"Lancet"},{"issue":"10078","key":"pone.0325073.ref002","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1016\/S0140-6736(16)32411-4","article-title":"Syphilis","volume":"389","author":"EW Hook","year":"2017","journal-title":"Lancet"},{"issue":"6","key":"pone.0325073.ref003","first-page":"398","article-title":"Syphilis","volume":"37","author":"M Arando Lasagabaster","year":"2019","journal-title":"Enferm Infecc Microbiol Clin (Engl Ed)"},{"issue":"10","key":"pone.0325073.ref004","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1086\/429626","article-title":"History of syphilis","volume":"40","author":"BM Rothschild","year":"2005","journal-title":"Clin Infect Dis"},{"issue":"5","key":"pone.0325073.ref005","doi-asserted-by":"crossref","first-page":"444","DOI":"10.37201\/req\/038.2023","article-title":"Sexually transmitted infections in Spain: current status","volume":"36","author":"J Del Romero","year":"2023","journal-title":"Rev Esp Quimioter"},{"key":"pone.0325073.ref006","author":"World Health Organization","year":"2023"},{"key":"pone.0325073.ref007","article-title":"Syphilis.","volume-title":"Annual epidemiological report for 2022","author":"European Centre for Disease Prevention and Control","year":"2024"},{"key":"pone.0325073.ref008","author":"HIV","year":"2024"},{"issue":"14","key":"pone.0325073.ref009","first-page":"529","article-title":"Epidemiological surveillance of sexually-transmitted diseases. 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