Syphilis remains an uncontrolled infectious disease globally, with high prevalence and incidence in certain high risk populations, affecting more than 20% of men who have sex with men (MSM) in Peru. Syphilis is also an important cause of neonatal morbidity and mortality, and is associated with an increased risk of acquisition and transmission of the human immunodeficiency virus. Despite its public health importance and easy medical management, the control of syphilis represents a challenge in many low and middle income countries. We have shown recently that syphilis remains poorly controlled with high rates of treatment failure and repeat infection. The incidence of syphilis in MSM in Peru is about 9 cases per 100 person-years. We are proposing a study to improve our understanding of syphilis epidemiology and molecular biology, particularly among MSM. Key in our study will be access to a population with high prevalence, incidence and repeat infection, and the collaboration of our institution with first level researchers and academic centers in the U.S.
In Aim 1, we will recruit a cohort of MSM and transgender persons at high risk for syphilis, for follow-up over 24 months, to measure incidence rates of syphilis. Molecular and immunological factors will also be assessed.
In Aim 2, we will determine the molecular and immunologic correlates of persistent reactivity and treatment failure by characterizing the host, pathogen and environment, and comparing measures over time and between groups.
In Aim 3 we will use the findings from Aims 1 and 2 to develop an improved system/algorithm to enhance the diagnosis and management of syphilis infection, fine-tune through input from technical and community stakeholders, and design a new study to assess its effectiveness.

Public Health Relevance

Syphilis is a very common but not well-controlled infection affecting most at risk populations worldwide. People with this disorder are at substantially higher risk of developing complications that include neurological and other organ involvement and acquisition of other serious diseases, including HIV. This project investigates the interrelationship of the host, pathogen and environment to understand re-infection, treatment failure and persistent serological reactivity after treatment. One of its aims is the identificatio of potential changes in present management of syphilis to be discussed with stakeholders and included in a new application for effectiveness assessment.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Research Project (R01)
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Special Emphasis Panel ()
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David, Hagit S
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Universidad Peruana Cayetano Heredia
Zip Code
LIMA -31
Bristow, Claire C; Leon, Segundo R; Huang, Emily et al. (2016) Field evaluation of a dual rapid diagnostic test for HIV infection and syphilis in Lima, Peru. Sex Transm Infect 92:182-5
Leon, S R; Ramos, L B; Vargas, S K et al. (2016) Laboratory Evaluation of a Dual-Path Platform Assay for Rapid Point-of-Care HIV and Syphilis Testing. J Clin Microbiol 54:492-4
Billings, Joshua D; Joseph Davey, Dvora L; Konda, Kelika A et al. (2016) Factors associated with previously undiagnosed human immunodeficiency virus infection in a population of men who have sex with men and male-to-female transgender women in Lima, Peru. Medicine (Baltimore) 95:e5147
Allan-Blitz, Lao-Tzu; Leon, Segundo R; Bristow, Claire C et al. (2016) High prevalence of extra-genital chlamydial or gonococcal infections among men who have sex with men and transgender women in Lima, Peru. Int J STD AIDS :
Bristow, Claire C; Leon, Segundo R; Huang, Emily et al. (2016) Field Evaluation of a Dual Rapid Immunodiagnostic Test for HIV and Syphilis Infection in Peru. Sex Transm Dis 43:57-60
Herbst de Cortina, S; Bristow, C C; Vargas, S K et al. (2016) Laboratory Evaluation of a Point-of-Care Downward-Flow Assay for Simultaneous Detection of Antibodies to Treponema pallidum and Human Immunodeficiency Virus. J Clin Microbiol 54:1922-4
Herrera, M C; Konda, K A; Leon, S R et al. (2016) Impact of alcohol use on sexual behavior among men who have sex with men and transgender women in Lima, Peru. Drug Alcohol Depend 161:147-54
Bustamante, Maria Jose; Konda, Kelika A; Joseph Davey, Dvora et al. (2016) HIV self-testing in Peru: questionable availability, high acceptability but potential low linkage to care among men who have sex with men and transgender women. Int J STD AIDS :
Leon, Segundo R; Segura, Eddy R; Konda, Kelika A et al. (2016) High prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in anal and pharyngeal sites among a community-based sample of men who have sex with men and transgender women in Lima, Peru. BMJ Open 6:e008245
Chow, Jeremy Y; Konda, Kelika A; Borquez, Annick et al. (2016) Peru's HIV care continuum among men who have sex with men and transgender women: opportunities to optimize treatment and prevention. Int J STD AIDS :

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