Syphilis burden higher among men who have sex with men, study reveals

Men who have sex with men more at risk of syphilis. Image source: thebhutanesse

A new study has highlighted the unacceptably high global prevalence of syphilis among men who have sex with men.

The study titled, Prevalence of syphilis among men who have sex with men: A global systematic review and meta-analysis from 2000 to 2020, underscores the need to advance stalled progress toward eliminating syphilis as a public health threat by 2030.  

Syphilis, a sexually transmitted infection is caused by the bacteria Treponema pallidum. 

The study lead by the London School of Hygiene and Tropical Medicine, London, UK and published in The Lancet Global Health presents the first global syphilis prevalence estimate among men who have sex with men. 

Findings from this global review show that men who have sex with men have a high burden of syphilis infection, with significant variation across countries and regions. 

The global pooled prevalence of syphilis among men who have sex with men was 7.5 percent during 2000-2020 (95 percent CI: 7.0-8.0), as compared to the most recent estimate of syphilis among men in the general population in 2016, 0.5 percent (95 percent UI: 0.4-0.6). 

The proportion of men who have sex with men with syphilis was highest in settings where HIV prevalence was greater than five percent and in low and middle-income countries. 

The sub-analysis showed that pooled prevalence estimates were higher between 2015-2020 compared to the prior five years in half of the global regions assessed and several countries are reporting a high and sustained increase in syphilis infection among men who have sex with men.

Globally, there were an estimated seven million new syphilis infections in 2020. 

The World Health Organisation noted that it has set ambitious targets to reduce the incidence of syphilis by 90 percent by 2030, but the global response has been slow. 

“While there have been modest reductions in congenital syphilis as a result of the scale-up of interventions in antenatal care, such as syphilis screening and treatment for pregnant women, there is an urgent need to galvanise momentum and better serve other priority populations disproportionally impacted by the disease. 

“Syphilis is preventable and curable, with cost-effective and, in certain contexts, cost-saving interventions. 

“Easy to use and inexpensive point-of-care tests include blood-based rapid tests that produce results in less than 20 minutes and products that test syphilis and HIV using a single platform. Treatment with injectable benzathine penicillin is simple to administer and inexpensive. 

“A major challenge is that populations at higher risk for syphilis, particularly in LMIC, are often not able to access services due to structural barriers, including criminalization, policy and legal barriers, discrimination and violence. 

“As recommended by WHO, governments should address these structural barriers as a priority,” it said.

According to the Director of WHO’s Department of Global HIV, Hepatitis and STI Programmes, Dr. Meg Doherty this first review of global syphilis prevalence among men who have sex with men highlights the urgent need to improve access to syphilis testing, treatment and prevention services.

“Stakeholders must address structural barriers, like discrimination and violence; improve sexuality education, and expand access and delivery of syphilis testing and immediate treatment for all populations at higher risk of infection,” Doherty said. 

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Oxford scientists begin HIV vaccine clinical trial

HIV Vaccine

Scientists at Oxford University, United Kingdom, have commenced a clinical trial for a novel HIV vaccine.

The trial known as HIV-CORE 0052 began on Monday.

The goal of the trial, according to Oxford, is to evaluate the safety, tolerability, and immunogenicity of the HIVconsvX vaccine – a mosaic vaccine targeting a broad range of HIV-1 variants, making it potentially applicable for HIV strains in any geographical region.

For this clinical trial, 13 healthy adults aged between 18–65 who were considered not to be at high risk of infection received one dose of the vaccine which will be followed by a further booster dose at four weeks.

Speaking on the trial, Professor of Vaccine Immunology at the Jenner Institute, University of Oxford and lead researcher for the trial, Tomáš Hankeof in a statement said, “An effective HIV vaccine has been elusive for 40 years.

“This trial is the first in a series of evaluations of this novel vaccine strategy in both HIV-negative individuals for prevention and in people living with HIV for a cure.”

Describing how this vaccine would work on Oxford University’s official website, the researchers said “While most HIV vaccine candidates work by inducing antibodies generated by B-cells, HIVconsvX induces the immune system’s potent, pathogen obliterating T cells, targeting them to highly conserved and therefore vulnerable regions of HIV – an “Achilles’ heel” common to most HIV variants.”

This trial is part of the European Aids Vaccine Initiative (EAVI2020), an international collaborative research project funded by the European Commission under Horizon 2020 Health Programme for Research and Innovation.

The researchers said they hope to be able to report the results of the HIV-CORE 0052 trial by April 2022.

There are also plans to start similar trials in Europe, Africa and the US, the site reports.

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HIV findings in DR Congo 'give hope for cure'

 

The researchers were surprised by their findings

The discovery of a large group of people whose bodies naturally control HIV without taking medication is leading to hopes of an eventual cure, scientists say.

The study found as many as 4% of HIV carriers in the Democratic Republic of Congo were able to suppress the virus.

Typically less than 1% of people with HIV are able to do so.

This could serve as springboard for further research to develop a vaccine or new treatments to tackle the virus that causes Aids, researchers say.

"When we first started to see the data coming in from the study we were surprised, but we were also elated," Mary Rodgers, the study's lead scientist, told the BBC.

"This could mean that this is something that we can actually cure," she said.

The findings, published in eBioMedicine which is part of The Lancet family of medical journals, looked at samples taken FROM people living with HIV between 1987 and 2019.

The team included scientists from pharmaceutical company Abbott, Université Protestante au Congo, Johns Hopkins, the US National Institute of Allergy and Infectious Diseases, and University of Missouri - Kansas City.

 

Mary Rodgers: "This group of people gives us hope"

Dr Rodgers, head of Abbott's global viral surveillance programme, said the group in DR Congo was the biggest detected in one country - between 2.7% and 4.3% . Another 1% of people living with HIV in Cameroon were also identified as controlling the virus well without medication.

"This has never really been seen before, typically we would find less than 1% of all people with HIV who are able to suppress the virus naturally."

Currently, most people living with HIV have to take anti-retroviral medicines daily to suppress the virus and reduce their viral load.

It is not yet known how the so-called "elite controllers" discovered in DR Congo are able to suppress their HIV infection.

But Dr Rodgers said understanding how the group was able to maintain low or undetectable viral loads would be crucial to controlling the virus.

However, she stressed the need for more research, while pointing to previous studies that showed this group of people potentially lose their protection as the disease progresses.

HIV came to global attention in the 1980s. It has infected 76 million people since then and 38 million people are living with the virus, Abbott says.

It is believed to have originated in what is now DR Congo a century ago, and today HIV disproportionately affects women in sub-Saharan Africa.

 

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Rwanda 'to replace oral HIV drugs with injection'

ARV drugs Image: FILE

Rwanda is set to begin trials with an injection that will replace daily, oral antiretroviral (ARV) HIV drugs, according to the pro-government New Times website.

The injection slowly and continuously releases HIV medication into the blood for eight weeks, the report says.

If successful, HIV patients will no longer have to take the oral treatment, which they have to remember to take every day.

The jab is regarded as an improved and more sustainable treatment, Rwanda's Biomedical Centre head Dr Sabin Nsanzimana is quoted as saying.

Details of the drug are yet to be made public, but the trial is set to be discussed at the International Conference on Aids Sexually Transmitted Diseases in Africa (Icasa) in Kigali this week.

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Uganda launches oral rapid HIV self-testing kits

Source: Xinhua|

KAMPALA, Sept. 28 (Xinhua) -- Uganda's ministry of health has launched oral rapid HIV self-testing kits, a move aimed at increasing testing rates as part of efforts to stem new infections in the country, a senior official said on Saturday.

Diana Atwine, permanent secretary at the ministry of health, told Xinhua by telephone that the initiative is aimed at enabling more Ugandans to know their virus HIV status.

The current prevalence of HIV among people aged 15-49 years in the east African country stands at 6 percent, according to the 2016 Uganda Population HIV Impact Assessment.

"We (ministry of health) have officially launched the HIV self-test kit. The kits will be available for free in our (public) health facilities and on sale in private pharmacies," said Atwine.

With the kit, people can use oral fluid or blood-finger-pricks to test in a private and convenient setting. Results will be shown within 20 to 40 minutes.

In 2017, World Health Organization and United Nations AIDS recommended HIV self-testing, as an additional option for people to test and know their status.

Evidence from many countries has shown that HIV self-testing is highly acceptable and can reach people who may not otherwise test, including young people aged 15-24 years.

Uganda has been using the health provider or client-initiated HIV counselling and testing model recommended by the country's national HIV strategy.

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