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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
1R01AI099727-01
Application #
8289955
Study Section
Special Emphasis Panel (ZRG1-IDM-R (50))
Program Officer
David, Hagit S
Project Start
2012-08-01
Project End
2013-07-31
Budget Start
2012-08-01
Budget End
2013-07-31
Support Year
1
Fiscal Year
2012
Total Cost
$135,000
Indirect Cost
$10,000
Name
Universidad Peruana Cayetano Heredia
Department
Type
DUNS #
934798430
City
Lima
State
Country
Peru
Zip Code
LIMA -31
Allan-Blitz, Lao-Tzu; Konda, Kelika A; Calvo, Gino M et al. (2018) High incidence of extra-genital gonorrheal and chlamydial infections among high-risk men who have sex with men and transgender women in Peru. Int J STD AIDS 29:568-576
Bristow, Claire C; Kojima, Noah; Lee, Sung-Jae et al. (2018) HIV and syphilis testing preferences among men who have sex with men and among transgender women in Lima, Peru. PLoS One 13:e0206204
Kojima, Noah; Park, Hayoung; Konda, Kelika A et al. (2017) The PICASSO Cohort: baseline characteristics of a cohort of men who have sex with men and male-to-female transgender women at high risk for syphilis infection in Lima, Peru. BMC Infect Dis 17:255
Konda, Kelika A; Castillo, Rostislav; Leon, Segundo R et al. (2017) HIV Status Communication with Sex Partners and Associated Factors Among High-Risk MSM and Transgender Women in Lima, Peru. AIDS Behav 21:152-162
Chow, Jeremy Y; Konda, Kelika A; Calvo, Gino M et al. (2017) Demographics, Behaviors, and Sexual Health Characteristics of High Risk Men Who Have Sex With Men and Transgender Women Who Use Social Media to Meet Sex Partners in Lima, Peru. Sex Transm Dis 44:143-148
Joseph Davey, Dvora; Kojima, Noah; Konda, Kelika A et al. (2017) Transient aortitis documented by positron emission tomography in a case series of men and transgender women infected with syphilis. Sex Transm Infect 93:551-555
Bustamante, Maria Jose; Konda, Kelika A; Joseph Davey, Dvora et al. (2017) 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 28:133-137
Allan-Blitz, Lao-Tzu; Leon, Segundo R; Bristow, Claire C et al. (2017) 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 28:138-144
Herrera, M C; Konda, K A; Leon, S R et al. (2017) Do Subjective Alcohol Screening Tools Correlate with Biomarkers Among High-Risk Transgender Women and Men Who Have Sex with Men in Lima, Peru? AIDS Behav 21:253-261
Herbst de Cortina, Sasha; Bristow, Claire C; Humphries, Romney et al. (2017) Laboratory Evaluation of a Smartphone-Based Electronic Reader of Rapid Dual Point-of-Care Tests for Antibodies to Human Immunodeficiency Virus and Treponema pallidum Infections. Sex Transm Dis 44:412-416

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