Evolution of syphilis incidence in Sibiu county (Romania) over a period of 10 years (2009‑2018)

Syphilis is the most common sexually transmitted disease that mainly affects socially active people, with a fluctuating worldwide incidence over the years. A retrospective study was conducted over a period of 10 years (2009-2018) that included 396 patients with syphilis diagnosed and monitored by Sibiu County Emergency Clinical Hospital, Romania. During this period (2009-2018), we observed a decrease in the new cases of syphilis by 35.90%, and the average syphilis incidence was 9.90 new cases per 100,000 inhabitants. Syphilis was diagnosed more frequently in men with an average age of 35.39 years, from urban areas, with and educational level of grades 9-12, unmarried, workers, or without occupation. Out of the 396 patients with syphilis, about 6% were HIV coinfected. Over half of the HIV coinfected cases were declared MSM (men who have sex with men), and 40% of these cases were registered in 2018. The most common clinical stage of syphilis was the latent form (67.93%). Regarding the syphilis treatment regimen, we noted the transition from the classic regimen with benzathine-penicillin G (100% in 2009) to alternative therapies (mainly with cephalosporins) in 2018 (56.86%). Our findings showed that in the last 10 years in our county, the incidence of syphilis had a downward trend, but with an increase in syphilis-HIV co-infection and neurosyphilis cases.