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Yang Y, Gu X, Zhu L, Cheng Y, Lu H, Guan Z, Shi M, Ni L, Peng R, Zhao W, Wu J, Qi T, Long F, Chai Z, Gong W, Ye M, Zhou P. Clinical parameter-based prediction model for neurosyphilis risk stratification. Epidemiol Infect 2024; 152:e21. [PMID: 38224151 PMCID: PMC10894895 DOI: 10.1017/s0950268824000074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/16/2024] Open
Abstract
Accurately predicting neurosyphilis prior to a lumbar puncture (LP) is critical for the prompt management of neurosyphilis. However, a valid and reliable model for this purpose is still lacking. This study aimed to develop a nomogram for the accurate identification of neurosyphilis in patients with syphilis. The training cohort included 9,504 syphilis patients who underwent initial neurosyphilis evaluation between 2009 and 2020, while the validation cohort comprised 526 patients whose data were prospectively collected from January 2021 to September 2021. Neurosyphilis was observed in 35.8% (3,400/9,504) of the training cohort and 37.6% (198/526) of the validation cohort. The nomogram incorporated factors such as age, male gender, neurological and psychiatric symptoms, serum RPR, a mucous plaque of the larynx and nose, a history of other STD infections, and co-diabetes. The model exhibited good performance with concordance indexes of 0.84 (95% CI, 0.83-0.85) and 0.82 (95% CI, 0.78-0.86) in the training and validation cohorts, respectively, along with well-fitted calibration curves. This study developed a precise nomogram to predict neurosyphilis risk in syphilis patients, with potential implications for early detection prior to an LP.
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Affiliation(s)
- Yilan Yang
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xin Gu
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lin Zhu
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yuanyuan Cheng
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Haikong Lu
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhifang Guan
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Mei Shi
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Liyan Ni
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ruirui Peng
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wei Zhao
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Juan Wu
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Tengfei Qi
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Fuquan Long
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhe Chai
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Weiming Gong
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Meiping Ye
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Pingyu Zhou
- Institute of Sexually Transmitted Disease, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
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Abstract
A cross-sectional study was conducted on 83 fertile/infertile men to investigate the association between STDs and HIV and their effects on semen characteristics and seminal leucocytes. HIV antibodies in semen, andrological parameters and seminal leucocytes were analyzed. Of the 83 subjects, 36 were HIV+ and 47 were HIV- . Only 9 out of 36 HIV+ men and 25 out of 47 HIV- men had no history of STD. The most common type of STD was gonorrhea (65%) and 60% of those who had gonorrhea were HIV+ . HIV+ men had low sperm motility (p < 0.02). HIV+ men with a history of STD had leucocytospermia compared to HIV- men irrespective of history of STD (p < 0.001). Leucocytospermia was prevalent in HIV+ men even with no history of STD (p < 0.05). Non-ulcerative STDs was a risk factor for HIV infection. There was a significant association between HIV- and no history of STD. Impaired sperm motility in HIV+ men may be mediated by activated seminal leucocytes, which could induce oxidative stress on sperm. Leucocytospermia may be a reliable indicator of HIV+ .
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Affiliation(s)
- E Umapathy
- Department of Physiology, Faculty of Health Science, University of Transkei, Umtata, South Africa.
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