BACKGROUND & AIMS: :We report a case of Addison's disease presumed to be secondary to syphilis. The patient presented with adrenal failure and a maculopapular rash on his trunk and palms. Syphilis was suspected but the non-treponemal serological test used (the rapid plasma reagin test (RPR)) was falsely negative due to the prozone phenomenon. Treatment with benzathine penicillin resulted in normalization of adrenal function and resolution of the cutaneous findings. Repeat testing of the previously obtained serum sample showed the RPR to be positive on increasing dilutions of serum, consistent with the prozone effect.

背景与目标： : 我们报告了一例Addison病，推测是继发于梅毒的病例。患者出现肾上腺功能衰竭，躯干和手掌出现斑丘疹。梅毒被怀疑，但由于前区现象，使用的非梅毒血清学试验 (快速血浆反应素试验 (RPR)) 错误地呈阴性。用苄星青霉素治疗可使肾上腺功能正常化并消除皮肤发现。对先前获得的血清样品进行的重复测试表明，RPR对增加的血清稀释度呈阳性，与前带效应一致。

BACKGROUND & AIMS: :Epidemic increases in active syphilis have been reported in the geographic areas hit hard by acquired immunodeficiency syndrome. Although both epidemics have been associated with illicit substance abuse, the extent to which recent increases in syphilis are linked to the human immunodeficiency virus (HIV-1) epidemic is uncertain. In order to define the frequency of syphilis and HIV-1 coinfection in the pregnant patients seen at City Hospital Center at Elmhurst, we saved syphilis-positive serologic specimens from obstetrical patients for anonymous HIV-1 antibody testing. Of 120 women who tested positive for syphilis, 7/120 (5.8%) had antibodies to HIV-1; of the 44 women with VDRL titers greater than or equal to 1:16 (suggestive of a recent infection), 1/44 (2.3%) had antibodies to HIV-1.

背景与目标： : 据报道，在获得性免疫缺陷综合症严重打击的地理区域，活动性梅毒的流行病增加。尽管这两种流行病都与非法药物滥用有关，但梅毒最近的增加与人类免疫缺陷病病毒 (HIV-1) 流行病有关的程度尚不确定。为了确定在Elmhurst市医院中心看到的孕妇中梅毒和HIV-1合并感染的频率，我们从产科患者中保存了梅毒阳性血清学标本，以进行匿名HIV-1抗体检测。在120名梅毒检测呈阳性的妇女中，7/120名 (5.8% 名) 有HIV-1抗体; 在44名VDRL滴度大于或等于1:16 (提示近期感染) 的妇女中，1/44名 (2.3% 名) 有HIV-1抗体。

BACKGROUND & AIMS: OBJECTIVES:The Centers for Disease Control and Prevention provides guidance on sexually transmitted disease (STD) testing specifically for men who have sex with men (MSM) in STD treatment guidelines to address increasing rates of gonorrhoea and syphilis among MSM in the USA. The guidelines recommend at least annual syphilis, gonorrhoea and chlamydia testing for sexually active MSM. The implementation of these guidelines was evaluated. METHODS:Data from the 2003-5 MSM cycle of the National HIV Behavioural Surveillance System were used. The proportion of sexually active HIV-negative MSM reporting syphilis and gonorrhoea testing during the previous year was determined and multivariate logistic regression was used to identify factors associated with testing. RESULTS:Of 10 030 MSM, 39% and 36% reported having been tested for syphilis and gonorrhoea in the previous year, respectively. Four factors were associated with syphilis and gonorrhoea testing, respectively: age 18-24 years versus > or =45 years (odds ratio (OR) 2.2, 95% CI 1.8 to 2.5; OR 2.7, 95% CI 2.3 to 3.2), black versus white race (OR 1.3, 95% CI 1.1 to 1.4; OR 1.4, 95% CI 1.2 to 1.6), private insurance versus no insurance (OR 1.3, 95% CI 1.1 to 1.4; OR 1.3, 95% CI 1.1 to 1.4) and disclosing male-male sex to a healthcare provider (OR 2.2, 95% CI 2.0 to 2.5; OR 2.1, 95% CI 1.9 to 2.3). CONCLUSIONS:Syphilis and gonorrhoea testing among MSM was low, despite specific testing recommendations in the STD treatment guidelines. To increase STD testing among MSM, healthcare providers should assess the risks of STD for male patients through routine enquiries about sexual activity.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Although previous case-control studies have observed positive associations among gonorrhea, syphilis, clinical prostatitis, and prostate cancer, many may have been susceptible to recall and interviewer biases due to their retrospective designs. Therefore, to investigate these associations without concerns of recall and interviewer biases, we conducted a large, prospective investigation in the Health Professionals Follow-up Study. METHODS:In 1992, participants were asked to report their histories of gonorrhea, syphilis, and clinical prostatitis by mailed questionnaire. Prostate cancer diagnoses were ascertained by self-report on the 1994 and each subsequent biennial follow-up questionnaire and confirmed by medical record review. RESULTS:Of the 36,033 participants in this analysis, 2,263 were diagnosed with prostate cancer between the date of return of the 1992 questionnaire and 2002. No association was observed between gonorrhea [adjusted relative risk (RR), 1.04; 95% confidence interval (95% CI), 0.79-1.36] or syphilis (RR, 1.06; 95% CI, 0.44-2.59) and prostate cancer. Overall null results were also observed between clinical prostatitis and prostate cancer (RR, 1.08; 95% CI, 0.96-1.20), although a significant positive association was observed among younger men (<59 years) screened for prostate cancer (RR, 1.49; 95% CI, 1.08-2.06; P(interaction) = 0.006). CONCLUSIONS:Gonorrhea and syphilis do not seem to be risk factors for prostate cancer in this cohort of men with a lower burden of sexually transmitted infections. Clinical prostatitis is also unlikely to be a risk factor, although possible roles for prostatitis in younger men and asymptomatic prostatic infection and inflammation cannot be ruled out.

背景与目标：

BACKGROUND & AIMS: OBJECTIVES:Biological and behavioural surveillance of HIV and sexually transmitted infections (STIs) among populations at highest risk have been used to monitor trends in prevalence and in risk behaviours. Sex work in Panama is regulated through registration with the Social Hygiene Programme, Ministry of Health. We estimated prevalence of HIV and STIs, and factors associated with active syphilis among female sex workers (FSWs). METHODS:A cross-sectional study using venue-based, time-space sampling was conducted among FSWs in Panama from 2009 to 2010. FSWs were interviewed about sociodemographic characteristics, sexual risk behaviour, health history and drug use using an anonymous structured questionnaire. Blood was collected for serological testing of HIV and other STIs. Factors associated with active syphilis were studied using logistic regression analysis. RESULTS:The overall HIV-1 prevalence of 0.7% varied by FSW category; 1.6% in 379 unregistered, and 0.2% in 620 registered FSWs. Overall prevalence (and 95% CI) of STIs were: syphilis antibody, 3.8% (2.7% to 5.2%); herpes simplex virus type 2 antibody (anti-HSV-2), 74.2% (71.4% to 76.9%); hepatitis B surface antigen, 0.6% (0.2% to 1.3%); hepatitis B core antibody, 8.7% (7.0% to 10.6%); and hepatitis C antibody, 0.2% (0.0% to 0.7%). In multivariate analysis, registration (adjusted OR (AOR)=0.35; 95% CI 0.16 to 0.74), having a history of STI (AOR=2.37; 95% CI 1.01 to 5.58), forced sex (AOR=2.47; 95% CI 1.11 to 5.48), and anti-HSV-2 (AOR=10.05; 95% CI 1.36 to 74.38) were associated with active syphilis. CONCLUSIONS:Although HIV prevalence is low among FSWs in Panama, unregistered FSWs bear a higher burden of HIV and STIs than registered FSWs. Programmes aimed at overcoming obstacles to registration, and HIV, STI and harm reduction among unregistered FSWs is warranted to prevent HIV transmission, and to improve their sexual and reproductive health.

背景与目标：

BACKGROUND & AIMS: :Congenital syphilis was rare in most affluent countries but there has been a slight resurgence recently in several European countries. In large parts of the world and particularly sub-Saharan Africa congenital syphilis is a significant public health problem. The cornerstone of congenital syphilis control is antenatal screening and treatment of mothers with penicillin, which is a cost-effective intervention. In affluent countries it should be strengthened among those at high risk. Clinicians should be more vigilant for the possibility of babies being born with congenital syphilis, which is often asymptomatic. In developing countries not only does antenatal care screening need to be strengthened by implementing point-of-care decentralised screening and treatment but alternative innovative approaches to controlling congenital syphilis should be explored. There is an urgent need for international health agencies to support focused approaches to tackling the tragedy of continuing congenital syphilis. This could be a part of a pro-poor strategy to meet the Millennium Development Goals.

背景与目标： 先天性梅毒在大多数富裕国家很少见，但最近在几个欧洲国家略有复苏。在世界大部分地区，特别是撒哈拉以南非洲，先天性梅毒是一个重大的公共卫生问题。先天性梅毒控制的基石是对母亲进行产前筛查和青霉素治疗，这是一种具有成本效益的干预措施。在富裕国家，应在高风险国家中加强这一水平。临床医生应提高警惕婴儿出生时患有先天性梅毒的可能性，这种梅毒通常没有症状。在发展中国家，不仅需要通过实施护理点分散的筛查和治疗来加强产前保健筛查，而且还应探索控制先天性梅毒的替代创新方法。迫切需要国际卫生机构支持采取有针对性的方法来应对持续的先天性梅毒的悲剧。这可能是实现千年发展目标的扶贫战略的一部分。

BACKGROUND & AIMS: :Syphilis is a sexually transmitted infection caused by the Treponema pallidum subspecies pallidum spirochete bacterium. The killer cell immunoglobulin-like receptors (KIR), interacting with human leukocyte antigens (HLA), regulate the activations of natural killer (NK) cells and certain T-cell subsets in response to microbe infection. The objective of this study was to explore whether KIR and HLA-C gene polymorphisms were associated with syphilis in a Chinese Han population. Polymerase chain reaction with sequence-specific primers (PCR-SSP) method was used to genotype KIR and HLA-C genes in 231 syphilis patients and 247 healthy controls. Framework genes KIR2DL4, KIR3DL2, KIR3DL3 and KIR3DP1 were present in all individuals. The frequencies of KIR2DS3 and KIR3DS1 were higher in syphilis patients than in healthy controls (p = 0.030 and p = 0.038, respectively), while the frequency of KIR2DS5 was higher in healthy controls than in syphilis patients (p = 0.015; OR = 0.575). The homozygote for HLA-C1 allele (HLA-C1C1) was more common in controls compared with syphilis patients (p = 0.030; OR = 0.667). The frequency of individuals with HLA-C1C1 and KIR2DL3 genotype was higher in control group relative to syphilis patient group (p = 0.018; OR = 0.647). These data indicated that KIR2DS3 and KIR3DS1 were more prevalent in syphilis patients than in controls, and that KIR2DS5, HLA-C1C1 and HLA-C1C1-KIR2DL3 were more prevalent in controls than in syphilis patients, respectively. These will require further investigation using functional studies.

背景与目标： : 梅毒是由梅毒螺旋体亚种梅毒螺旋体细菌引起的性传播感染。杀伤细胞免疫球蛋白样受体 (KIR) 与人类白细胞抗原 (HLA) 相互作用，调节自然杀伤 (NK) 细胞和某些T细胞亚群对微生物感染的激活。这项研究的目的是探讨KIR和hla-c基因多态性是否与中国汉族人群的梅毒有关。采用序列特异性引物聚合酶链反应 (pcr-ssp) 方法对231例梅毒患者和247健康对照者进行KIR和hla-c基因的分型。框架基因KIR2DL4、KIR3DL2、KIR3DL3和KIR3DP1存在于所有个体中。梅毒患者的KIR2DS3和KIR3DS1频率高于健康对照组 (分别为p = 0.030和p = 0.038)，而健康对照组的KIR2DS5频率高于梅毒患者 (p = 0.015; OR = 0.575)。与梅毒患者相比，HLA-C1等位基因 (HLA-C1C1) 的纯合子在对照组中更为常见 (p = 0.030; OR = 0.667)。与梅毒患者组相比，对照组中具有HLA-C1C1和KIR2DL3基因型的个体的频率更高 (p = 0.018; OR = 0.647)。这些数据表明，KIR2DS3和KIR3DS1在梅毒患者中比在对照组中更为普遍，而KIR2DS5，HLA-C1C1和HLA-C1C1-KIR2DL3在对照组中比在梅毒患者中更为普遍。这些将需要使用功能研究进行进一步的研究。

BACKGROUND & AIMS: :The study aims were to determine the prevalence of positive syphilis serology and meningovascular neurosyphilis (NS) in patients admitted with transient ischaemic attack (TIA) and stroke to a tertiary hospital serving a culturally diverse community. A retrospective cohort analysis was conducted using routinely collected administrative data and medical records to identify patients admitted with TIA, stroke and other conditions, with positive syphilis serology, between 2005 and 2009. Direct medical record review confirmed diagnoses of meningovascular NS. Syphilis serology was requested in 27% (893/3270) of all patients with TIA and stroke (2005-09) of whom 4% (38/893) were positive. Thirty-seven patients with positive serology had clinical characteristics consistent with meningovascular NS. Their mean age was 72±13 years; 65% were male and 68% had a recorded place of birth in South-East Asia or the Pacific Islands. One of 12 patients with suspected meningovascular NS with cerebrospinal fluid (CSF) analysis had a positive CSF Venereal Disease Research Laboratory (VDRL) test. Three patients (8%) met diagnostic criteria for "definite or probable" meningovascular NS. All three patients with a "definite or probable" meningovascular NS and 15 (44%) of the remainder who had positive serology without confirmation of NS were treated with intravenous or intramuscular penicillin. Lumbar puncture (LP) and penicillin were underutilised in patients with TIA and stroke with positive serology. In conclusion, syphilis testing should be considered part of the diagnostic work-up of TIA and stroke, particularly in ethnically diverse populations. In patients with TIA and stroke with positive syphilis serology, it would seem appropriate to further pursue diagnosis and treatment and in patients unable to undergo LP, empiric treatment for NS should be considered.

背景与目标： : 该研究旨在确定患有短暂性脑缺血发作 (TIA) 和中风的患者到服务于文化多元化社区的三级医院的梅毒血清学阳性和脑膜血管性神经梅毒 (NS) 的患病率。使用常规收集的管理数据和病历进行回顾性队列分析，以识别患有TIA，中风和其他疾病，梅毒血清学阳性，2005年和2009的患者。直接病历审查证实了脑膜血管神经系统的诊断。所有TIA和中风患者 (2005-09) 的27% (893/3270) 均要求梅毒血清学检查，其中4% (38/893) 为阳性。37例血清学阳性患者的临床特征与脑膜血管神经系统一致。他们的平均年龄为72 ± 13岁; 65% 是男性，68% 有记录的出生地在东南亚或太平洋岛屿。12例疑似脑脊液 (CSF) 分析的脑膜血管NS患者中，有一例CSF性病研究实验室 (VDRL) 测试呈阳性。三名患者 (8%) 符合 “确定或可能” 的脑膜血管神经系统的诊断标准。所有三名具有 “确定的或可能的” 脑膜血管NS的患者以及其余15名 (44% 名) 血清学阳性而未确认NS的患者均接受静脉或肌内青霉素治疗。血清学阳性的TIA和中风患者未充分利用腰椎穿刺 (LP) 和青霉素。总之，梅毒测试应被视为TIA和中风的诊断工作的一部分，尤其是在不同种族的人群中。对于梅毒血清学阳性的TIA和中风患者，进一步进行诊断和治疗似乎是适当的，对于无法接受LP的患者，应考虑对NS进行经验性治疗。

BACKGROUND & AIMS: :A stenosing antral lesion was diagnosed in a patient with previous ulcer dyspepsia. Radiology, gastroscopy and serology made the diagnosis of gastric syphilis. The lesion disappeared with specific therapy. We present this case because of its rare gastric onset (0.3%) among visceral syphilis, though sexual transmission diseases are increasing nowadays.

背景与目标： : 在先前患有溃疡性消化不良的患者中诊断出狭窄的窦病变。放射学，胃镜和血清学诊断为胃梅毒。经特殊治疗后病变消失。我们提出这种情况是因为其在内脏梅毒中罕见的胃发作 (0.3%)，尽管如今性传播疾病正在增加。

BACKGROUND & AIMS: BACKGROUND AND OBJECTIVES:Treponemal tests provide advantage of better detection during early, late and latent stages of syphilis with equal or higher sensitivity & specificity in comparison to non-treponemal tests. The objective of the present study was to analyse the level of concordance between treponemal and non-treponemal tests for donor screening and to correlate them with donor history. MATERIALS AND METHODS:Retrospective analysis of syphilis screening by treponemal (Chemiluminescence & TPHA) and non-treponemal tests (RPR) was done and donor history for high-risk behaviour and factors associated with false positivity were collected from post-donation counselling and collected data was coded and analysed. RESULTS:Amongst the 12,000 donors screened, reactivity rate by RPR, TPHA and Chemiluminescence was 0.45%, 0.8% and 1.17% respectively. There was discordance of 62% and 32% for reactive results by RPR and TPHA respectively when compared with Chemiluminescence. History of high-risk behaviour was present in ∼ 50% and 15% of donors with discordant results by RPR and TPHA respectively. Of 34 donors who were reactive only by Chemiluminescence and were followed up, 15% had history of high-risk behaviour and 56% had factors associated with false reactivity. CONCLUSION:Treponemal tests showed high syphilis reactivity amongst blood donors as compared to non-treponemal tests most likely due to their ability to detect early, late and latent syphilis cases. This may confer added transfusion safety in centres dependent on replacement donors without NAT testing by identifying donors with high-risk history with negligible increase in discard rate due to false reactivity.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Despite widespread availability of rapid plasma reagin (RPR) for syphilis screening at sex worker (SW)-dedicated project clinics, uptake of syphilis testing remains low and prevalence of syphilis remains high among SWs in Maharashtra, India. The primary reasons given for refusal of RPR were fear of venipuncture and long waiting times for results. METHODS:Between December 2007 and February 2008, rapid point of contact diagnostic tests (Syphicheck-WB, Qualpro Diagnostics, India) using finger-prick samples were introduced for syphilis screening, with RPR confirmation test of positives. RESULTS:Uptake of syphilis screening among clinic attenders increased to 63.1% compared with an average of 14.3% before the intervention. Among the 19,809 SWs who were screened, 598 tested positive (3% prevalence of lifetime infection). Of these, 395 (66.1%) accepted RPR confirmation test; 337 (88.3%) were seroreactive, 160 (40.5%) had titers ≥1:8 (active syphilis). The projected overall prevalence of active syphilis among all SWs screened was 1.2% but varied by site and typology of sex work (brothel-based, 2.4%; bar-based, 0.5%; street-based, 2.3%; male SWs, 0.2%; transgender, 11.3%; home-based, 0.6%). CONCLUSIONS:The introduction of rapid tests dramatically increased the uptake of syphilis screening in this large-scale intervention among a high-risk population in India. However, only two-thirds of SWs with a positive rapid test accepted a confirmatory RPR test. The high proportion (40.5%) of active syphilis among those testing positive on the rapid screening test justifies treatment even if confirmatory testing is declined. A commercially available, simple, rapid nontreponemal test is needed to further strengthen syphilis screening.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:This paper presents the prevalence of human immunodeficiency virus (HIV) and syphilis infections among women attending antenatal clinics (ANC) in Tanzania obtained during the 2003/2004 ANC surveillance. METHODS:Ten geographical regions; six of them were involved in a previous survey, while the remaining four were freshly selected on the basis of having the largest population among the remaining 20 regions. For each region, six ANC were selected, two from each of three strata (urban, peri-urban and rural). Three of the sites did not participate, resulting into 57 surveyed clinics. 17,813 women who were attending the chosen clinics for the first time for any pregnancy between October 2003 and January 2004. Patient particulars were obtained by interview and blood specimens were drawn for HIV and syphilis testing. HIV testing was done anonymously and the results were unlinked. RESULTS:Of the 17,813 women screened for HIV, 1,545 (8.7% (95% CI = 8.3-9.1)) tested positive with the highest prevalence in women aged 25-34 years (11%), being higher among single women (9.7%) than married women (8.6%) (p < 0.07), and increased with level of education from 5.2% among women with no education to 9.3% among those at least primary education (p < 0.001). Prevalence ranged from 4.8% (95% CI = 3.8%-9.8%) in Kagera to 15.3% (95% CI = 13.9%-16.8%) in Mbeya and was; 3.7%, 4.7%, 9.1%, 11.2% and 15.3% for rural, semi-urban, road side, urban and 15.3% border clinics, respectively (p < 0.001). Of the 17,323 women screened for syphilis, 1265 (7.3% (95%CI = 6.9-7.7)) were positive, with highest prevalence in the age group 35-49 yrs (10.4%) (p < 0.001), and being higher among women with no education than those with some education (9.8% versus 6.8%) (p < 0.0001), but marital status had no influence. Prevalence ranged from 2.1% (95% CI = 1.4%-3.0%) in Kigoma to 14.9% (95% CI = 13.3%-16.6%) in Kagera and was 16.0% (95% CI = 13.3-18.9), 10.5% (95% CI = 9.5-11.5) and 5.8% (95% CI = 5.4-6.3) for roadside, rural and urban clinics, respectively. Syphilis and HIV co-infection was seen in 130/17813 (0.7%). CONCLUSION:The high HIV prevalence observed among the ANC clinic attendees in Tanzania call for expansion of current voluntary counselling and testing (VCT) services and access to antiretroviral drugs (ARV) in the clinics. There is also a need for modification of obstetric practices and infant feeding options in HIV infection in order to prevent mother to child transmission of HIV. To increase uptake to HIV testing the opt-out strategy in which all clients are offered HIV testing is recommended in order to meet the needs of as many pregnant women as possible.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:To assess the trends and determinants of maternal and congenital syphilis in Shanghai, China. METHODS:We conducted a prospective cohort study of maternal and congenital syphilis from 2002 to 2006 in Shanghai, China. We presented the trends of maternal syphilis and congenital syphilis rates and compared outcomes in infants born to mothers with complete versus incomplete treatment for maternal syphilis. We also assessed the determinants of compliance to treatment of maternal syphilis and examined the associations of initial maternal RPR antibody level and gestational age at initiation of treatment with occurrence of congenital syphilis. RESULTS:A total of 535 537 pregnant women were included in the analysis. During this period of time, 1471 maternal syphilis cases (298.7 per 100 000 live births) and 334 congenital syphilis cases (62.4 per 100 000 live births) were identified. Both maternal and congenital syphilis rates increased from 2002 until 2005, with a slight decrease in 2006. The rate of maternal syphilis was 156.2 per 100 000 live births in Shanghai residents and 371.7 per 100 000 live births in the migrating population (p<0.001). The compliance to treatment for maternal syphilis was poorer in women with a lower level of education. The rate of congenital syphilis in infants born to mothers with incomplete treatment (50.8%) was much higher than in infants born to mothers with complete treatment (12.5%). Rates of fetal death, neonatal death, and major birth defects were 30.4%, 11.0%, and 3.8%, respectively, in the incomplete treatment group; the corresponding figures were 5.5%, 0.56%, and 0.46%, respectively, in the complete treatment group. Infant outcome was also affected by initial maternal RPR antibody level and time of treatment, with much better outcomes in mothers with low antibody levels and earlier treatment. CONCLUSION:There has been a resurgence of congenital syphilis in Shanghai, China, especially in the migrating population and other populations with a lower socioeconomic status.

背景与目标：

BACKGROUND & AIMS: :There has been speculation that trends in syphilis have been fueled by crack cocaine use. This study examined the data on syphilis notifications and arrestee drug abuse monitoring (ADAM) to ascertain the relationships between syphilis and cocaine use trends in three racial/ethnic groups. Syphilis notifications and data from the ADAM project were compared in Houston/Harris County, Texas, from 1991-1998 using a linear regression equation. Data indicated significant relationships between the data for cocaine use and syphilis in African Americans but not Hispanics or non-Hispanic whites. For African Americans, 58% of the variance between cocaine use and syphilis was explained. When data limited to jail syphilis notifications and ADAM cocaine in African Americans were examined, the association was stronger for males than for females. For African Americans, cocaine (probably crack cocaine) use trends were significantly associated with syphilis trends in this population. These data suggest that control of crack cocaine may have an impact on syphilis rates and that there may be close relationships between some STDs and drug abuse.

背景与目标： : 有人猜测，可卡因的使用助长了梅毒的趋势。这项研究检查了梅毒通知和被捕药物滥用监测 (ADAM) 的数据，以确定三个种族/族裔群体中梅毒与可卡因使用趋势之间的关系。使用线性回归方程从1991-1998比较了德克萨斯州休斯顿/哈里斯县的梅毒通知和ADAM项目的数据。数据表明，非裔美国人而不是西班牙裔或非西班牙裔白人的可卡因使用数据与梅毒之间存在显着关系。对于非裔美国人，解释了可卡因使用和梅毒之间差异的58%。当检查非裔美国人中仅限于监狱梅毒通知和亚当可卡因的数据时，男性的关联比女性强。对于非裔美国人，可卡因 (可能是可卡因) 的使用趋势与该人群的梅毒趋势显着相关。这些数据表明，控制可卡因可能会影响梅毒率，并且某些性病与药物滥用之间可能存在密切关系。

BACKGROUND & AIMS: Sera of all male donors appearing at the blood bank of a regional hospital in Northwest Ethiopia in 1994 (n = 1022) and 1995 (n = 1164), were screened for the presence of human immunodeficiency virus (HIV-1) and treponemal antibodies. Additionally, screening for hepatitis B surface antigen (HBsAg) was carried out on 549 consecutive sera. In 1995, the crude seroprevalence of HIV-1 infection and syphilis was 16.7% and 12.8%. Seroprevalence of HBsAg was 14.4%. HIV and syphilis seroprevalence was highest in soldiers (30.6% and 20.9%) and daily workers (18.8% and 13.5%), and lowest in farmers (8% and 6.7%). However, farmers had the highest rate of HBsAg (18.8%). HIV-positive donors had an increased risk for being positive for syphilis antibodies (OR = 3.69, 95% CI = 2.69-4.96), but not for HBsAg (OR = 0.79, 95% CI = 0.36-1.67). The data indicate that (i) the HIV epidemic has not yet reached a plateau phase in Ethiopia, and (ii) the transmission and epidemiology of HBsAg in Ethiopia is different from that of HIV and syphilis.

The sera of all 2186 male blood donors presenting to the blood bank of the Gondar College of Medical Sciences, a regional hospital in Northwest Ethiopia, during 1994-95 were screened for HIV-1 and treponemal antibodies; in addition, a subset of 549 donors from 1995 was tested for hepatitis B surface antigen (HBsAg). In 1994, 12% of blood donors were HIV-positive and 13.1% had treponemal antibodies. Seroprevalence rates in 1995 were 16.7% for HIV, 12.8% for syphilis, and 14.4% for HBsAg. HIV and syphilis seroprevalence rates were highest among soldiers (30.6% and 20.9%, respectively) and daily workers (18.8% and 13.5%, respectively) and lowest among farmers (8.0% and 6.7%, respectively). In contrast, the highest rate of HBsAg was found among farmers (18.8%). HIV-infected donors were significantly more likely than HIV-negative donors to be positive for syphilis as well (odds ratio, 3.69; 95% confidence interval, 2.69-4.96), but there was no such pattern for HBsAg (odds ratio, 0.79; 95% confidence interval, 0.36-1.67). The increasing rate of HIV infection observed in the different occupational groups indicates that the HIV epidemic has not yet reached a plateau in Ethiopia. Moreover, the finding that HBsAg is not associated with HIV infection suggests that, in Ethiopia, hepatitis B has a different set of risk factors than have sexually transmitted diseases.

背景与目标： 在埃塞俄比亚西北部一家地区医院的血库中出现的所有男性供体的血清1994年 (n = 1022) 和1995 (n = 1164) 被筛查是否存在人类免疫缺陷病毒 (HIV-1) 和梅毒螺旋体抗体。此外，对549连续血清进行乙型肝炎表面抗原 (HBsAg) 的筛选。1995年，HIV-1感染和梅毒的粗血清阳性率为16.7% 和12.8%。14.4% HBsAg的血清阳性率。HIV和梅毒血清阳性率在士兵 (30.6% 和20.9%) 和日常工作人员 (18.8% 和13.5%) 中最高，在农民 (8% 和6.7%) 中最低。然而，农民的HBsAg率最高 (18.8%)。HIV阳性供体具有梅毒抗体阳性的风险增加 (OR = 3.69，95% CI = 2.69-4.96)，但HBsAg则没有 (OR = 0.79，95% CI = 0.36-1.67)。数据表明 :( i) 埃塞俄比亚的艾滋病毒流行尚未达到平台期，(ii) 埃塞俄比亚HBsAg的传播和流行病学与HIV和梅毒不同。
所有2186名男性献血者的血清在埃塞俄比亚西北部的一家地区医院Gondar医学院的血库中，在1994-95年期间，筛选了HIV-1和梅毒抗体; 此外，对549个供体1995年的子集进行了乙型肝炎表面抗原 (HBsAg) 测试。1994年，12% 献血者为HIV阳性，13.1% 具有梅毒螺旋体抗体。HIV的血清阳性率1995年为16.7%，梅毒为12.8%，HBsAg为14.4%。艾滋病毒和梅毒血清阳性率在士兵 (分别为30.6% 和20.9%) 和日常工作人员 (分别为18.8% 和13.5%) 中最高，在农民 (分别为8.0% 和6.7%) 中最低。相反，在农民中发现最高的HBsAg率 (18.8%)。HIV感染的捐献者比HIV阴性捐献者更有可能对梅毒呈阳性 (比值比，3.69; 95% 置信区间，2.69-4.96)，但HBsAg没有这种模式 (比值比，0.79; 95% 置信区间，0.36-1.67)。在不同职业群体中观察到的艾滋病毒感染率不断上升，这表明埃塞俄比亚的艾滋病毒流行尚未达到平稳状态。此外，HBsAg与HIV感染无关的发现表明，在埃塞俄比亚，乙型肝炎与性传播疾病具有不同的危险因素。