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Peuchant O, Laurier-Nadalié C, Albucher L, Balcon C, Dolzy A, Hénin N, Touati A, Bébéar C. Anorectal lymphogranuloma venereum among men who have sex with men: a 3-year nationwide survey, France, 2020 to 2022. Euro Surveill 2024; 29:2300520. [PMID: 38726697 PMCID: PMC11083974 DOI: 10.2807/1560-7917.es.2024.29.19.2300520] [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: 09/28/2023] [Accepted: 03/20/2024] [Indexed: 05/12/2024] Open
Abstract
BackgroundIn France, lymphogranuloma venereum (LGV) testing switched from universal to selective testing in 2016.AimTo investigate changes in LGV-affected populations, we performed a nationwide survey based on temporarily reinstated universal LGV testing from 2020 to 2022.MethodsEach year, during three consecutive months, laboratories voluntarily sent anorectal Chlamydia trachomatis-positive samples from men and women to the National Reference Centre for bacterial sexually transmitted infections. We collected patients' demographic, clinical and biological data. Genovars L of C. trachomatis were detected using real-time PCR. In LGV-positive samples, the ompA gene was sequenced.ResultsIn 2020, LGV positivity was 12.7% (146/1,147), 15.2% (138/907) in 2021 and 13.3% (151/1,137) in 2022 (p > 0.05). It occurred predominantly in men who have sex with men (MSM), with rare cases among transgender women. The proportion of HIV-negative individuals was higher than that of those living with HIV. Asymptomatic rectal LGV increased from 36.1% (44/122) in 2020 to 52.4% (66/126) in 2022 (p = 0.03). Among users of pre-exposure prophylaxis (PrEP), LGV positivity was 13.8% (49/354) in 2020, 15.6% (38/244) in 2021 and 10.9% (36/331) in 2022, and up to 50% reported no anorectal symptoms. Diversity of the LGV ompA genotypes in the Paris region increased during the survey period. An unexpectedly high number of ompA genotype L1 variant was reported in 2022.ConclusionIn rectal samples from MSM in France, LGV positivity was stable, but the proportion of asymptomatic cases increased in 2022. This underscores the need of universal LGV testing and the importance of continuous surveillance.
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Affiliation(s)
- Olivia Peuchant
- Bordeaux University Hospital Center, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France
- Univ. Bordeaux, UMR 5334 CNRS Microbiologie Fondamentale et Pathogénicité (MFP), ARMYNE, Bordeaux, France
| | - Cécile Laurier-Nadalié
- Bordeaux University Hospital Center, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Laura Albucher
- Bordeaux University Hospital Center, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Carla Balcon
- Bordeaux University Hospital Center, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Amandine Dolzy
- Bordeaux University Hospital Center, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Nadège Hénin
- Univ. Bordeaux, UMR 5334 CNRS Microbiologie Fondamentale et Pathogénicité (MFP), ARMYNE, Bordeaux, France
| | - Arabella Touati
- Bordeaux University Hospital Center, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Cécile Bébéar
- Bordeaux University Hospital Center, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France
- Univ. Bordeaux, UMR 5334 CNRS Microbiologie Fondamentale et Pathogénicité (MFP), ARMYNE, Bordeaux, France
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Ayerdi O, Orviz E, Valls Carbó A, Fernández Piñeiro N, Vera García M, Puerta López T, Ballesteros Martín J, Rodríguez Martín C, Baza Caraciolo B, Lejarraga Cañas C, Pérez-García JA, Carrió D, García Lotero M, Ferreras Forcada M, González Polo M, Raposo Utrilla M, Delgado-Iribarren A, Del Romero-Guerrero J, Estrada Pérez V. Incidence of sexually transmitted infections and screening models among pre-exposure prophylaxis users. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2024:S2529-993X(24)00065-0. [PMID: 38492988 DOI: 10.1016/j.eimce.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/02/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION There is discussion about the frequency of STI screening among pre-exposure prophylaxis (PrEP) users. The aim of this study was to analyse the incidence of STIs and to evaluate different screening models in order to optimise the follow-up. METHODOLOGY A prospective study was conducted between 2017 and 2023, including 138 PrEP users in a STI clinic. Participants were tested for STIs every three months. Unscheduled visits were performed for those with STI-related symptoms or for people who were notified for an STI by a sexual partner. We performed a survival analysis of repeated events, estimating the cumulative incidence (CI) and incidence rate (IR). RESULTS The overall CI by quarterly screening was 8.3 (95% CI: 7.6-9.1) infections per person over six years, with a decreasing trend. The most frequently diagnosed pathogen was Neisseria gonorrhoeae, with a IR of 0.76 (95% CI: 0.68-0.84). If the frequency of screening is reduced to every six months, the IR of STIs is reduced by (95% CI: 0.5-0.66) infections per user per year, and at 12 months by 0.82 (95% CI: 0.73-0.89). In the case of no pharyngeal or urethral screening, IR is reduced by 0.37 (95% CI: 0.32-0.42) infections per person per year and in those over 35 years of age by 0.33 (95% CI: 0.25-0.4). Eliminating unscheduled visits, the reduction in IR is 0.33 (95% CI: 0.24-0.42). CONCLUSIONS The incidence of STIs among PrEP users is high, especially in the rectum, but it does not increase over time. STI screening could be optimised reducing the frequency of pharyngeal and urethral testing, particularly in those over 35 years of age. It is essential to redistribute health resources for unscheduled visits, which have been shown to be the most cost-effective screening.
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Affiliation(s)
- Oskar Ayerdi
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Eva Orviz
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain.
| | - Adrián Valls Carbó
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Nuria Fernández Piñeiro
- Servicio de Farmacia, Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Mar Vera García
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Teresa Puerta López
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | | | | | - Jorge-Alfredo Pérez-García
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain; Servicio Microbiología Clínica, Instituto Medicina del Laboratorio, Hospital Clínico San Carlos, Madrid, Spain
| | - Dulce Carrió
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | | | | | - Alberto Delgado-Iribarren
- Servicio Microbiología Clínica, Instituto Medicina del Laboratorio, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Vicente Estrada Pérez
- Hospital Clínico San Carlos, IdISSC, Universidad Complutense de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas CIBERINFEC, Madrid, Spain
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Sánchez D, Ferrer J, Giménez E, Torres I, Carretero D, Alcaraz MJ, Castaño MJ, Navarro D, Albert E. Genotypic study of Chlamydia trachomatis for lymphogranuloma venereum diagnosis in rectal specimens from men who have sex with men: a cost-effectiveness analysis. BMC Infect Dis 2024; 24:298. [PMID: 38454329 PMCID: PMC10918947 DOI: 10.1186/s12879-024-09185-4] [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: 07/27/2023] [Accepted: 02/29/2024] [Indexed: 03/09/2024] Open
Abstract
PURPOSE The significant proportion of asymptomatic patients and the scarcity of genotypic analysis of lymphogranuloma venereum (LGV), mainly among men who have sex with men (MSM), triggers a high incidence of underdiagnosed patients, highlighting the importance of determining the most appropriate strategy for LGV diagnosis, at both clinical and economical levels. MATERIALS AND METHODS We conducted L1-L3 serovar detection by molecular biology in stored Chlamydia trachomatis-positive samples from MSM patients with HIV, another STI or belonging to a Pre-exposure prophylaxis program, to make a cost effectiveness study of four diagnostic strategies with a clinical, molecular, or mixed approach. RESULTS A total of 85 exudates were analyzed: 35urethral (31 symptomatic/4 positive) and 50 rectal (22 symptomatic/25 positive), 70/85 belonging to MSM with associated risk factors. The average cost per patient was €77.09 and €159.55 for clinical (Strategy I) and molecular (Strategy IV) strategies respectively. For molecular diagnosis by genotyping of all rectal exudate samples previously positive for CT (Strategy II), the cost was €123.84. For molecular diagnosis by genotyping of rectal and/or urethral exudate samples from all symptomatic patients (proctitis or urethritis) with a previous positive result for CT (Strategy III), the cost was €129.39. The effectiveness ratios were 0.80, 0.95, 0.91, and 1.00 for each strategy respectively. The smallest ICER was €311.67 for Strategy II compared to Strategy I. CONCLUSIONS With 30% asymptomatic patients, the most cost-effective strategy was based on genotyping all rectal exudates. With less restrictive selection criteria, thus increasing the number of patients with negative results, the most sensitive strategies tend to be the most cost-effective, but with a high incremental cost-effectiveness ratio.
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Affiliation(s)
- David Sánchez
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research institute, Valencia, Spain
| | - Josep Ferrer
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research institute, Valencia, Spain
| | - Estela Giménez
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research institute, Valencia, Spain
| | - Ignacio Torres
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research institute, Valencia, Spain
| | - Diego Carretero
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research institute, Valencia, Spain
| | - María Jesús Alcaraz
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research institute, Valencia, Spain
| | - María Jesús Castaño
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research institute, Valencia, Spain
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research institute, Valencia, Spain
- Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
| | - Eliseo Albert
- Microbiology Service, Hospital Clínico Universitario, INCLIVA Research institute, Valencia, Spain.
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Chromy D, Sadoghi B, Gasslitter I, Skocic M, Okoro A, Grabmeier-Pfistershammer K, Willinger B, Weninger W, Öllinger A, Sarcletti M, Stary G, Bauer WM. Lymphogranuloma venereum verläuft häufig asymptomatisch bei Männern, die Sex mit Männern haben, in Österreich. J Dtsch Dermatol Ges 2024; 22:389-398. [PMID: 38450885 DOI: 10.1111/ddg.15329_g] [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: 01/30/2023] [Accepted: 11/14/2023] [Indexed: 03/08/2024]
Abstract
ZusammenfassungHintergrund und ZieleLymphogranuloma venereum (LGV) ist eine sexuell übertragene Erkrankung verursacht durch Chlamydia trachomatis (CT), Serovar L1–L3. Eine Zunahme von LGV ist vorwiegend bei Männern, die Sex mit Männern haben (MSM), beobachtet worden. Die Unterscheidung zwischen LGV und Nicht‐LGV‐Serovaren hat therapeutische Konsequenzen, daher wurden Prävalenz und Charakteristika von LGV innerhalb aller CT‐Infektionen untersucht.Patienten und MethodikAlle CT‐positiven Befunde, erhoben an den vier größten österreichischen HIV‐ und STI‐Kliniken von 04/2014–12/2021, wurden hinsichtlich Charakteristika der Erkrankung und Demographie der Patienten ausgewertet.ErgebnisseInsgesamt wurden n = 2083 CT‐Infektionen bei n = 1479 Personen dokumentiert. Das mediane Alter betrug 31,4 Jahre, 81% waren männlich, 59% MSM, 44% HIV‐positiv, 13% nutzten HIV‐Prä‐Expositionsprophylaxe. Serovaranalysen waren bei 61% (1258/2083) verfügbar, wobei L1–L3 in 15% (192/1258) aller Fälle nachgewiesen wurde. Bei MSM mit rektaler CT‐Infektion waren 23% (101/439) LGV. LGV‐Fälle verglichen mit CT‐Infektionen traten vermehrt bei MSM (92% [177/192] vs. 62% [1179/1891], p < 0,001), HIV‐Positivität (64% [116/180] vs. 46% [631/1376]; p < 0,001) und konkomitanter Syphilisinfektion (18% [32/180] vs. 7% [52/749]; p < 0,001) auf. LGV‐Infektionen verliefen zumeist asymptomatisch (45% [87/192]), gefolgt von Proktitis (38% [72/192]).SchlussfolgerungenLymphogranuloma venereum machte 23% der rektalen CT‐Infektionen bei MSM aus und 45% aller LGV‐Fälle waren asymptomatisch. Bei fehlender CT‐Serovar‐Analyse sollte in Risikopopulationen eine erhöhte LGV‐Prävalenz in Betracht gezogen und bei der empirischen Therapiedauer berücksichtigt werden.
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Affiliation(s)
- David Chromy
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | - Birgit Sadoghi
- Universitätsklinik für Dermatologie, Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - Irina Gasslitter
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Mattias Skocic
- Universitätsklinik für Dermatologie und Venerologie, Kepler Universitätsklinikum, Linz, Österreich
| | - Anthony Okoro
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | | | - Birgit Willinger
- Abteilung für Klinische Mikrobiologie, Klinisches Institut für Labormedizin, Medizinische Universität Wien, Wien, Österreich
| | - Wolfgang Weninger
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | - Angela Öllinger
- Universitätsklinik für Dermatologie und Venerologie, Kepler Universitätsklinikum, Linz, Österreich
| | - Mario Sarcletti
- Universitätsklinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Georg Stary
- Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
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Chromy D, Sadoghi B, Gasslitter I, Skocic M, Okoro A, Grabmeier-Pfistershammer K, Willinger B, Weninger W, Öllinger A, Sarcletti M, Stary G, Bauer WM. Asymptomatic lymphogranuloma venereum is commonly found among men who have sex with men in Austria. J Dtsch Dermatol Ges 2024; 22:389-397. [PMID: 38308171 DOI: 10.1111/ddg.15329] [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: 01/30/2023] [Accepted: 11/14/2023] [Indexed: 02/04/2024]
Abstract
BACKGROUND AND OBJECTIVES Serovar L1-L3 of Chlamydia trachomatis (CT) causes lymphogranuloma venereum (LGV). A surge in LGV-cases has been observed among HIV-positive men who have sex with men (MSM). Discrimination between LGV and non-LGV is pivotal since it has major treatment implications. Here, we aimed to determine the prevalence and characteristics of LGV among CT-infections. PATIENTS AND METHODS All CT-positive results from 04/2014-12/2021 at the four largest Austrian HIV and STI clinics were evaluated. Disease characteristics and patient demographics were analyzed. RESULTS Overall, n = 2,083 infections of CT were documented in n = 1,479 individual patients: median age was 31.4 years, 81% were male, 59% MSM, 44% HIV-positive, 13% on HIV pre-exposure-prophylaxis. Available serovar analyses (61% [1,258/2,083]) showed L1-L3 in 15% (192/1,258). Considering only MSM with rectal CT-infection, LGV accounted for 23% (101/439). Cases of LGV vs. other CT-infections were primarily MSM (92% [177/192] vs. 62% [1,179/1,891], p < 0.001), more often HIV-positive (64% [116/180] vs. 46% [631/1,376]; p < 0.001) and had frequently concomitant syphilis infection (18% [32/180] vs. 7% [52/749]; p < 0.001). LGV commonly manifested as proctitis (38% [72/192]) whereas 45% (87/192) were asymptomatic. CONCLUSIONS Lymphogranuloma venereum accounted for 23% of rectal CT-infections in MSM. Furthermore, 45% of all LGV-cases were asymptomatic. In the absence of CT-serovar analysis, a high LGV prevalence should be considered in risk-populations and guide empiric treatment selection.
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Affiliation(s)
- David Chromy
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Birgit Sadoghi
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Irina Gasslitter
- Dermatology, Venereology and Allergy, Medical University of Innsbruck, Innsbruck, Austria
| | - Mattias Skocic
- Department of Dermatology, Kepler University Hospital Linz, Linz, Austria
| | - Anthony Okoro
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | | | - Birgit Willinger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Weninger
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Angela Öllinger
- Department of Dermatology, Kepler University Hospital Linz, Linz, Austria
| | - Mario Sarcletti
- Dermatology, Venereology and Allergy, Medical University of Innsbruck, Innsbruck, Austria
| | - Georg Stary
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
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dos Santos LM, Vieira MRMDS, Vieira RC, Silva LBDL, de Macêdo GMM, Miranda AE, Brasiliense DM, e Guimarães RJDPS, Sousa EC, Ferrari SF, Pinheiro HHC, Ishikawa EAY, de Sousa MS. Prevalence and circulant genotypes of Chlamydia trachomatis in university women from cities in the Brazilian Amazon. PLoS One 2024; 19:e0287119. [PMID: 38165909 PMCID: PMC10760737 DOI: 10.1371/journal.pone.0287119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 05/30/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Approximately 80% of infected women infected by Chlamydia trachomatis are asymptomatic, although this infection can lead to serious complications in the female reproductive tract. Few data on Chlamydia infection and genotypes are available in Amazonian communities. OBJECTIVES To describe the prevalence of and associated factors and to identify the genotypes of sexual C. trachomatis infection in female university students in different urban centers (capital and interiors) in the Brazilian state of Pará, in the eastern Amazon region. METHODS A cross-sectional study was performed among young women attending public universities in four different urban centers in the eastern Amazon region. They were invited to participate in the studt and cervical secretions were collected for molecular diagnosis of C. trachomatis. We utilized amplification of the ompA gene by nested PCR. Positive samples were genotyped by nucleotide sequencing. Study participants completed a questionnaire on social, epidemiological, and reproductive health variables. A Qui-square and Binominal regression test were used to evaluate the degree of association of these variables with the infection. RESULTS A total of 686 female students was included in the study. The overall prevalence of C. trachomatis was 11.2% (77/686). The prevalence of this infection was higher in interiors (15.2% vs 9.5%/ p: 0.0443). Female university students who do not have a sexual partner (11.8%/p <0.008), who do not use a condom in their sexual relations (17.8%/p <0.0001) and who reported having suffered a miscarriage (32%/p <0.0001) have high chances of acquiring this sexual infection. The ompA gene was sequenced in only 33 (42.8%) samples, revealing the genotype J was the most frequent (27.2% [9/33]), followed by genotypes D (24.2% [8/33]), and then genotypes F (18.2% [6/33]), E (15.1% [5/33]) K (6.1% [2/33]), Ia (6.1% [2/33]), and G (3.1% [1/33]). CONCLUSIONS The high prevalence of sexual infection by C. trachomatis in the female university students from the interior of the state of Pará, individuals with no fixed sexual partner, those that had had a miscarriage, the students that do not use condoms in their sexual relations. The genotype J of C. trachomatis genotypes was the most frequent. These data are important to help defining the epidemiological effects of chlamydial infections in Amazonian populations.
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Affiliation(s)
| | | | | | | | | | - Angélica Espinosa Miranda
- Department of Social Medicine, Health Sciences Center, Federal University of Espirito Santo, Vitória, Espirito Santo, Brazil
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Gravett RM, Marrazzo J. An Ulcer by Any Other Name. Infect Dis Clin North Am 2023; 37:369-380. [PMID: 37005160 DOI: 10.1016/j.idc.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
The myriad presentations of ulcerative sexually transmitted infections, other than genital herpes and syphilis, challenge even the most astute clinician given the considerable overlap in clinical presentation and lack of widely available diagnostic resources, such as nucleic acid testing, to confirm the diagnosis. Even so, case prevalence is relatively low, and incidence of chancroid and granuloma inguinale are declining. These diseases still cause substantial morbidity and increased chance for HIV acquisition, and with the recent advent of mpox as a cause, it remains imperative to identify and treat accurately.
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Affiliation(s)
- Ronnie M Gravett
- Division of Infectious Diseases, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, THT 215, 1900 University Boulevard, Birmingham, AL 35294, USA.
| | - Jeanne Marrazzo
- Division of Infectious Diseases, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, THT 215, 1900 University Boulevard, Birmingham, AL 35294, USA
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8
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Hughes Y, Chen MY, Fairley CK, Hocking JS, Williamson D, Ong JJ, De Petra V, Chow EPF. Universal lymphogranuloma venereum (LGV) testing of rectal chlamydia in men who have sex with men and detection of asymptomatic LGV. Sex Transm Infect 2022; 98:582-585. [PMID: 35217591 DOI: 10.1136/sextrans-2021-055368] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/06/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Lymphogranuloma venereum (LGV) is caused by Chlamydia trachomatis serovars L1-L3. This study determined the positivity for LGV testing before and after introduction of universal LGV testing of positive rectal Chlamydia trachomatis samples in men who have sex with men (MSM). METHODS From March 2015 to February 2018, MSM with rectal C. trachomatis were not routinely tested for LGV at the Melbourne Sexual Health Centre unless they had HIV or symptoms of proctitis. From February 2018, universal testing for LGV of all positive rectal C. trachomatis specimens in men over the age of 25 years, regardless of symptoms was undertaken. LGV positivity was defined as the detection of LGV-associated C. trachomatis serovars. RESULTS There were 3429 and 4020 MSM who tested positive for rectal chlamydia in the selective and universal LGV-testing periods, respectively. Of the total 3027 assessable specimens in both periods, 97 (3.2%; 95% CI 2.6% to 3.9%) specimens tested positive for LGV. LGV positivity in the selective testing period was higher than in the universal testing period (6.6% (33/502) vs 2.5% (64/2525), p<0.001). The proportion of LGV cases that were asymptomatic increased from 15.2% (5/33) in the selective testing period to 34.4% (22/64) in the universal testing period (p=0.045). Of the 70 symptomatic LGV cases symptoms included rectal discharge (71.4%, n=45) and rectal pain (60.0%, n=42). CONCLUSION Universal LGV testing of all positive rectal chlamydia samples in MSM compared with selective testing led to the detection of asymptomatic rectal LGV, which constituted 34% of rectal LGV cases.
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Affiliation(s)
- Yasmin Hughes
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Marcus Y Chen
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Jane S Hocking
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Deborah Williamson
- Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.,Department of Microbiology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Microbiological Diagnostic Unit Public Health Laboratory, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Jason J Ong
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Vesna De Petra
- Microbiological Diagnostic Unit Public Health Laboratory, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
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9
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Gravett RM, Marrazzo J. What’s Old Is New: the Evolution of Lymphogranuloma Venereum Proctitis in Persons Living with HIV. Curr Infect Dis Rep 2022. [DOI: 10.1007/s11908-022-00781-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Zucker R, Gaisa M, Sigel K, Singer I, Adler A, Turner D, Ben Ami R, Nissan I, Chan C, Halperin T. Triple site sexually transmitted infection testing as a crucial component of surveillance for men who have sex with men: A prospective cohort study. Int J STD AIDS 2021; 33:114-122. [PMID: 34676780 DOI: 10.1177/09564624211047477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are common among men who have sex with men (MSM). Many oropharyngeal and anorectal infections remain asymptomatic. We aimed to evaluate triple-site screening following PrEP introduction. We enrolled a prospective cohort study including 210 asymptomatic MSM during 2019-2020, analyzed by groups: HIV positive (HIV+), HIV-uninfected using PrEP (HIV-/PrEP+), or HIV-uninfected not using PrEP (HIV-/PrEP-). A self-administered questionnaire captured demographic information and sexual risk-taking behaviors. CT/NG testing results were compared between study groups and predictors of infection were evaluated. We included 59 HIV+, 70 HIV-/PrEP+, and 81 HIV-/PrEP- subjects. 30% (n = 62) of participants tested positive for CT/NG. HIV-/PrEP+ group had highest proportion of infections (n = 33, 47%) followed by HIV-/PrEP- (n = 16, 22%) and HIV+ (n=13, 20%; p < .001). Importantly, 98% (80/82) of pharyngeal/anorectal CT/NG infections were missed in genitourinary tract screening alone. PrEP use and previous syphilis infection were the strongest risk factor for CT/NG. Extra-genital asymptomatic CT/NG infections were prevalent among MSM. These data highlight the importance of routine extra-genital CT/NG testing in asymptomatic sexually active MSM. The study describes the consequences for three-site testing lack of implementation in the PrEP era.
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Affiliation(s)
- Roy Zucker
- Crusaid Kobler AIDS Center, 26738Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Gaisa
- 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Keith Sigel
- 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ilan Singer
- Crusaid Kobler AIDS Center, 26738Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Amos Adler
- Crusaid Kobler AIDS Center, 26738Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dan Turner
- Crusaid Kobler AIDS Center, 26738Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronen Ben Ami
- Crusaid Kobler AIDS Center, 26738Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Israel Nissan
- Ministry of Health, 26737National Public Health Laboratory, Tel Aviv, Israel
| | - Courtney Chan
- 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tamar Halperin
- Crusaid Kobler AIDS Center, 26738Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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11
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Prochazka M, Charles H, Allen H, Cole M, Hughes G, Sinka K. Rapid Increase in Lymphogranuloma Venereum among HIV-Negative Men Who Have Sex with Men, England, 2019. Emerg Infect Dis 2021; 27:2695-2699. [PMID: 34545797 PMCID: PMC8462343 DOI: 10.3201/eid2710.210309] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Incidence of lymphogranuloma venereum increased in England during 2018–2019, after a period of decline. Our retrospective analysis of national surveillance data identified a rapid increase in diagnoses among HIV-negative men who have sex with men. These findings indicate a need for sustained surveillance and targeted public health action.
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12
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Martínez-García L, Rodríguez-Domínguez M, Lejarraga C, Rodríguez-Jiménez MC, González-Alba JM, Puerta T, Sánchez-Conde M, Hermida JM, Romero-Hernández B, Galán JC. The silent epidemic of lymphogranuloma venereum inside the COVID-19 pandemic in Madrid, Spain, March 2020 to February 2021. ACTA ACUST UNITED AC 2021; 26. [PMID: 33960288 PMCID: PMC8103729 DOI: 10.2807/1560-7917.es.2021.26.18.2100422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Despite social distancing measures implemented in Madrid to prevent the propagation of SARS-CoV-2, a significant increase (57.1%; 28.5 to 38.5 cases/month) in cases of lymphogranuloma venereum was detected during the COVID-19 pandemic. This unusual scenario might have accelerated a shift in Chlamydia trachomatis (CT) epidemiology towards a higher proportion of L genotypes compared with non-L genotypes in CT-positive samples. Our data underscore the importance of surveillance of sexually transmitted infections during the pandemic, in particular among vulnerable populations.
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Affiliation(s)
- Laura Martínez-García
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Mario Rodríguez-Domínguez
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Clara Lejarraga
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - María Concepción Rodríguez-Jiménez
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - José María González-Alba
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Teresa Puerta
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Matilde Sánchez-Conde
- Servicio de Enfermedades Infecciosas. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - José Manuel Hermida
- Servicio de Enfermedades Infecciosas. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Beatriz Romero-Hernández
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Juan Carlos Galán
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
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13
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Carrer M, de Barbeyrac B, Laurier-Nadalié C, Bébéar C, Touati A, Peuchant O. Towards the spread of the new L2b/D-Da hybrid Chlamydia trachomatis strain in men who have sex with men in France? Clin Infect Dis 2021; 73:1130-1131. [PMID: 33744938 DOI: 10.1093/cid/ciab253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mathilde Carrer
- CHU Bordeaux, Infectious and Tropical Diseases Department, Bordeaux, France
| | - Bertille de Barbeyrac
- CHU Bordeaux, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France.,Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,INRA, USC EA 3671 Mycoplasma and Chlamydial Infections in Humans, Bordeaux, France
| | - Cécile Laurier-Nadalié
- CHU Bordeaux, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Cécile Bébéar
- CHU Bordeaux, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France.,Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,INRA, USC EA 3671 Mycoplasma and Chlamydial Infections in Humans, Bordeaux, France
| | - Arabella Touati
- CHU Bordeaux, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Olivia Peuchant
- CHU Bordeaux, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France.,Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,INRA, USC EA 3671 Mycoplasma and Chlamydial Infections in Humans, Bordeaux, France
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14
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De Vincentis S, Tartaro G, Rochira V, Santi D. HIV and Sexual Dysfunction in Men. J Clin Med 2021; 10:jcm10051088. [PMID: 33807833 PMCID: PMC7961513 DOI: 10.3390/jcm10051088] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 12/12/2022] Open
Abstract
Sexual issues tend to go unaddressed in human immunodeficiency virus (HIV) management, although overt sexual dysfunctions are more prevalent in people living with HIV than uninfected people. Erectile dysfunction is the most frequent sexual problem, with a prevalence of 30–50% even in men <40 years of age, but other issues such as loss of libido and ejaculatory disorders should not be overlooked. Peculiar factors related to HIV infection (e.g., fear of virus transmission, changes in body image, HIV-related comorbidities, HIV distress and stigma), alongside classical factors non-related to HIV, should be considered when approaching sexual problems in HIV patients. For this reason, the diagnostic and therapeutic workout of sexual dysfunction in the context of HIV requires a multidisciplinary approach, involving specialists in both infectious diseases and sexual medicine. This narrative review presents an overview of current knowledge on sexual dysfunction in HIV men, deepening the factors driving and taking part in these issues, providing advice for the clinical approach, and underlining the importance of caring for sexual health to improve the quality of life of HIV patients.
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Affiliation(s)
- Sara De Vincentis
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Giulia Tartaro
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Vincenzo Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
- Correspondence: ; Tel.: +39-059-396-2453; Fax: +39-059-396-1335
| | - Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
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15
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Borges V, Isidro J, Correia C, Cordeiro D, Vieira L, Lodhia Z, Fernandes C, Rodrigues AM, Azevedo J, Alves J, Roxo J, Rocha M, Côrte-Real R, Toscano C, Pessanha MA, Nissan I, Pilo S, Rorman E, Dveyrin Z, Paitan Y, Paran H, Wagner-Kolasko G, Beirnes J, Gibbons S, Severini A, Borrego MJ, Gomes JP. Transcontinental Dissemination of the L2b/D-Da Recombinant Chlamydia trachomatis Lymphogranuloma venereum (LGV) Strain: Need of Broad Multi-Country Molecular Surveillance. Clin Infect Dis 2021; 73:e1004-e1007. [PMID: 33512482 DOI: 10.1093/cid/ciab067] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/25/2021] [Indexed: 11/13/2022] Open
Abstract
Previously, we identified a Chlamydia trachomatis lymphogranuloma venereum (LGV) recombinant strain possessing a non-LGV ompA genotype. Here, culture-independent genome sequencing confirms its circulation in Europe, Middle East, and North America, and unveils emergence of antibiotic resistance. Broad surveillance is needed.
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Affiliation(s)
- Vítor Borges
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Joana Isidro
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Cristina Correia
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Dora Cordeiro
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Luís Vieira
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Zohra Lodhia
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Cândida Fernandes
- Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal
| | | | | | | | - João Roxo
- CheckpointLX, Grupo de Ativistas em Tratamentos, Lisbon, Portugal
| | - Miguel Rocha
- CheckpointLX, Grupo de Ativistas em Tratamentos, Lisbon, Portugal
| | - Rita Côrte-Real
- Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal
| | | | | | - Israel Nissan
- National Public Health Laboratories, Tel Aviv, Israel
| | - Shlomo Pilo
- National Public Health Laboratories, Tel Aviv, Israel
| | - Efrat Rorman
- National Public Health Laboratories, Tel Aviv, Israel
| | - Zeev Dveyrin
- National Public Health Laboratories, Tel Aviv, Israel
| | - Yossi Paitan
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine & Tel Aviv University, Tel Aviv, Israel.,Clinical Microbiology Lab, Meir Medical Center, Kfar Saba, Israel
| | - Haim Paran
- Department of General Surgery A, Meir Medical Center, Kfar Saba, Israel
| | - Gal Wagner-Kolasko
- Department of Family Medicine, Clalit Gan-Meir LGBT Clinic, Tel Aviv, Israel
| | | | | | - Alberto Severini
- Public Health Agency of Canada, Winnipeg, Manitoba, Canada.,Department of Medical Microbiology, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - João Paulo Gomes
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
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16
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De Baetselier I, Tsoumanis A, Florence E, Van den Berghe W, Crucitti T, Van den Bossche D, Kenyon C. Did Pre-exposure Prophylaxis Roll-Out Influence the Epidemic of Rectal Lymphogranuloma Venereum in Belgium? Results From the National Surveillance System. J Acquir Immune Defic Syndr 2021; 86:e1-e5. [PMID: 33044320 DOI: 10.1097/qai.0000000000002524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND An increase of lymphogranuloma venereum (LGV) in HIV negative men who have sex with men is reported in several European countries including Belgium before the implementation of pre-exposure prophylaxis (PrEP). SETTING The epidemiological characteristics of the male rectal LGV epidemic in Belgium were explored before and after the introduction of PrEP. METHODS Segmented regression models were used to examine a change in trends before and after the introduction of PrEP in the male rectal LGV epidemic in Belgium and among men attending a large HIV/sexually transmitted infection clinic in Antwerp, Belgium. RESULTS Although an increase of 69% was noted in absolute numbers in 2019 compared with 2018 (140 vs 83 cases) in Belgium, models showed that the rate of increase did not change after the introduction of PrEP. More than half of the cases were found in HIV-negative men (56.2%) in 2019, but no difference in the magnitude of the trend was found after the introduction of PrEP. Nevertheless, the data reveal that a statistical significant increase of LGV prevalence was noted among non-HIV-positive men in an HIV/sexually transmitted infection clinic after the implementation of PrEP. Indeed, LGV prevalence in the Antwerp male PrEP cohort increased from 0.8% in 2017 to 2.4% in 2019. CONCLUSIONS The trend of LGV increase did not accelerate after the introduction of PrEP. Continued surveillance in men who have sex with men irrespective of their HIV status is required for the management and control of the LGV epidemic.
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Affiliation(s)
- Irith De Baetselier
- Department of Clinical Sciences, Institute of Tropical Medicine, Clinical Reference Laboratory, STI National Reference Center, Antwerp, Belgium
| | - Achilleas Tsoumanis
- Department of Clinical Sciences, Institute of Tropical Medicine, HIV/STI Unit, Antwerp, Belgium
| | - Eric Florence
- Department of Clinical Sciences, Institute of Tropical Medicine, HIV/STI Unit, Antwerp, Belgium
| | | | | | - Dorien Van den Bossche
- Department of Clinical Sciences, Institute of Tropical Medicine, Clinical Reference Laboratory, STI National Reference Center, Antwerp, Belgium
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, HIV/STI Unit, Antwerp, Belgium
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17
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Marangoni A, Foschi C, Tartari F, Gaspari V, Re MC. Lymphogranuloma venereum genovariants in men having sex with men in Italy. Sex Transm Infect 2020; 97:441-445. [DOI: 10.1136/sextrans-2020-054700] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/02/2020] [Accepted: 09/27/2020] [Indexed: 11/03/2022] Open
Abstract
ObjectivesLymphogranuloma venereum (LGV) is an STI caused by Chlamydia trachomatis serovars L1-L3. In Europe, the current epidemic is caused mainly by L2b genovariant, although increasing cases associated with other L2 variants have been reported. Here, we assessed the distribution of rectal LGV genovariants among men having sex with men (MSM) in Italy.MethodsFrom 2016 to 2020, all the anorectal swabs collected from MSM attending the STI Clinic of St. Orsola-Malpighi Hospital in Bologna and positive for C. trachomatis were stored. LGV infection was confirmed by a pmpH PCR, and, subsequently, a fragment of the ompA gene was amplified and sequenced. Sequences were aligned to reference strains representing different LGV variants.ResultsLGV cases accounted for one-third of all chlamydial rectal infections with a total prevalence of 4.1% (76/1852). Total number of LGV cases per year remained constant. LGV was mainly found in symptomatic patients (>65%), older than 30 years, with a high burden of other STIs (63.7% HIV-positive, 35.5% with concurrent rectal gonorrhoea, 19.7% with early syphilis). A decreasing trend in HIV-LGV co-infection was noticed over time. Three main LGV genovariants were detected (L2f, 46.1%; L2b, 23.0%; L2-L2b/D-Da, 16.9%), together with other known L2b variants (mainly L2bV2 and L2bV4). Two novel L2b ompA variants with non-synonymous single-nucleotide polymorphisms were found. Over time, the percentage of L2f cases dropped gradually, with a significant increase in L2-L2b/D-Da cases (p=0.04).ConclusionsIn our area, LGV is endemic among MSM with different circulating genovariants. Active surveillance and genotyping programmes are needed to reduce re-establishing of LGV infection.
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