Joanne Peel1, Eric P F Chow1,2,3, Ian Denham1, Tina Schmidt1, Andrew Buchanan1, Christopher Fairley1,2, Deborah A Williamson4,5,6, Melanie Bissessor1, Marcus Y Chen1,2. 1. Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. 2. Central Clinical School, Monash University, Melbourne, Victoria, Australia. 3. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia. 4. Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia. 5. Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia. 6. Department of Microbiology, Royal Melbourne Hospital, Victoria, Australia.
Abstract
BACKGROUND: Current international guidelines on HIV Pre-Exposure Prophylaxis (PrEP) recommend serological screening for syphilis at routine three-monthly PrEP appointments. The aim of our study was to describe the pattern of clinical presentation of syphilis among men who have sex with men (MSM) taking PrEP. We were interested in whether syphilis is detected through screening at scheduled three-monthly PrEP clinic appointments or whether primary or secondary syphilis presented at unscheduled interval visits. METHODS: This was a retrospective study of MSM attending the PrEP clinic at the Melbourne Sexual Health Centre between February 2016 and March 2019. Serological screening for syphilis was routinely undertaken at three-monthly PrEP clinic appointments. Diagnoses of early syphilis were identified from PrEP clinic visits and from interim walk-in STI clinic attendances. RESULTS: There were 69 cases of early syphilis among 61 MSM taking PrEP during the study period. There were 24 (35%) primary, 16 (23%) secondary and 29 (42%) early latent infections. The incidence of early syphilis was 8.6 per 100 person-years. A substantial proportion of primary (58%) and secondary (44%) syphilis diagnoses were made at interim STI clinic attendances, between PrEP appointments. CONCLUSIONS: Syphilis screening at routine three-monthly PrEP visits alone fails to detect a proportion of primary and secondary syphilis infections and may be insufficient in preventing onward transmission. Education of MSM taking PrEP regarding the risk of syphilis and symptom recognition is necessary together with access to syphilis testing between PrEP visits.
BACKGROUND: Current international guidelines on HIV Pre-Exposure Prophylaxis (PrEP) recommend serological screening for syphilis at routine three-monthly PrEP appointments. The aim of our study was to describe the pattern of clinical presentation of syphilis among men who have sex with men (MSM) taking PrEP. We were interested in whether syphilis is detected through screening at scheduled three-monthly PrEP clinic appointments or whether primary or secondary syphilis presented at unscheduled interval visits. METHODS: This was a retrospective study of MSM attending the PrEP clinic at the Melbourne Sexual Health Centre between February 2016 and March 2019. Serological screening for syphilis was routinely undertaken at three-monthly PrEP clinic appointments. Diagnoses of early syphilis were identified from PrEP clinic visits and from interim walk-in STI clinic attendances. RESULTS: There were 69 cases of early syphilis among 61 MSM taking PrEP during the study period. There were 24 (35%) primary, 16 (23%) secondary and 29 (42%) early latent infections. The incidence of early syphilis was 8.6 per 100 person-years. A substantial proportion of primary (58%) and secondary (44%) syphilis diagnoses were made at interim STI clinic attendances, between PrEP appointments. CONCLUSIONS: Syphilis screening at routine three-monthly PrEP visits alone fails to detect a proportion of primary and secondary syphilis infections and may be insufficient in preventing onward transmission. Education of MSM taking PrEP regarding the risk of syphilis and symptom recognition is necessary together with access to syphilis testing between PrEP visits.
Authors: Ei T Aung; Christopher K Fairley; Jason J Ong; Tiffany R Phillips; Marcus Y Chen; Julien Tran; Kate Maddaford; Elena R Rodriguez; Eric P F Chow Journal: Sci Rep Date: 2022-05-27 Impact factor: 4.996
Authors: Eric P F Chow; Darren Lee; Stephanie Bond; Christopher K Fairley; Kate Maddaford; Rebecca Wigan; Glenda Fehler; Sigrid A Lange; Vesna De Petra; Melanie Bissessor; Catriona S Bradshaw; Benjamin P Howden; Jane S Hocking; Deborah A Williamson; Marcus Y Chen Journal: Open Forum Infect Dis Date: 2021-03-19 Impact factor: 3.835
Authors: Ei T Aung; Eric P F Chow; Christopher K Fairley; Tiffany R Phillips; Marcus Y Chen; Julien Tran; Kate Maddaford; Elena R Rodriguez; Jason J Ong Journal: Lancet Reg Health West Pac Date: 2022-02-23
Authors: Ei T Aung; Christopher K Fairley; Jason J Ong; Tiffany P Phillips; Julien Tran; Marcus Y Chen; Kate Maddaford; Eric P F Chow Journal: Front Med (Lausanne) Date: 2022-08-01