EClinicalMedicine · 2026
Clearance of Treponema pallidum from oral and anal sites after treatment of secondary syphilis: results from a multi-centre, prospective, cross-sectional study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Towns Janet M, Fernando Janath A, Wigan Rebecca, Krysiak Marcelina, Lewis David A, Varma Rick, McNulty Anna, Williamson Deborah A, Khaw Carole, Howard Jayne, Potappel Kate, Owen Louise, Thng Caroline, Ryder Nathan, Hickson Mitchell, Chow Eric P F, Fairley Christopher K, Graves Stephen R, Ong Jason J, Huffam Sarah, Pasricha Shivani, Chen Marcus Y
Аннотация
BACKGROUND: Syphilis is increasing worldwide, and secondary syphilis may represent its most infectious stage. Scarce data exist on Treponema pallidum clearance after treatment. We aimed to determine the frequency and load of T. pallidum mucosal shedding, and time to clearance following treatment of secondary syphilis.
METHODS: Men-who-have-sex-with-men (MSM) and transgender women with secondary syphilis were recruited from Australian clinics between January 27, 2023, and August 19, 2024. Oral, anal or genital lesions were swabbed, and non-lesion samples (blood, oral cavity and anal canal swabs were collected on the day of treatment (baseline). Non-lesion oral cavity and anal canal swabs were repeated 3, 7, 14 and 30 days post-treatment. T. pallidum bacterial load was determined by quantitative PCR.
FINDINGS: 78 cis-men and one trans-woman, who reported sex with men, were included. At baseline, T. pallidum was detected in the participants' oral cavity, anal canal and blood of 81% (64/79), 70% (55/79) and 24% (19/79), respectively. When detected at oral and anal sites, 22/64 (36%) had oral lesions and 31/55 (59%) had anal lesions, respectively. The median oral and anal bacterial loads decreased significantly from baseline to day 3, [cycle thresholds 35.7-37.7, (1.7-1.2 copies/μL), (p = 0.013), and 30.2-38.2 (3.3-1.0 copies/μL), (p < 0.001), respectively]. T. pallidum cleared from 99% (96/97) of non-lesion, paired samples from 58 participants by day 7, 95% confidence interval (94-100%).
INTERPRETATION: During secondary syphilis, most MSM had T. pallidum DNA detected in oral and anal mucosa. Bacterial load dropped markedly 3 days post-treatment and cleared in almost all samples by 7 days.
FUNDING: Australian National Health and Medical Research Council.
METHODS: Men-who-have-sex-with-men (MSM) and transgender women with secondary syphilis were recruited from Australian clinics between January 27, 2023, and August 19, 2024. Oral, anal or genital lesions were swabbed, and non-lesion samples (blood, oral cavity and anal canal swabs were collected on the day of treatment (baseline). Non-lesion oral cavity and anal canal swabs were repeated 3, 7, 14 and 30 days post-treatment. T. pallidum bacterial load was determined by quantitative PCR.
FINDINGS: 78 cis-men and one trans-woman, who reported sex with men, were included. At baseline, T. pallidum was detected in the participants' oral cavity, anal canal and blood of 81% (64/79), 70% (55/79) and 24% (19/79), respectively. When detected at oral and anal sites, 22/64 (36%) had oral lesions and 31/55 (59%) had anal lesions, respectively. The median oral and anal bacterial loads decreased significantly from baseline to day 3, [cycle thresholds 35.7-37.7, (1.7-1.2 copies/μL), (p = 0.013), and 30.2-38.2 (3.3-1.0 copies/μL), (p < 0.001), respectively]. T. pallidum cleared from 99% (96/97) of non-lesion, paired samples from 58 participants by day 7, 95% confidence interval (94-100%).
INTERPRETATION: During secondary syphilis, most MSM had T. pallidum DNA detected in oral and anal mucosa. Bacterial load dropped markedly 3 days post-treatment and cleared in almost all samples by 7 days.
FUNDING: Australian National Health and Medical Research Council.