魁北克的性病性淋巴肉芽肿：在男男性行为者中再度出现。

Lymphogranuloma venereum in Quebec: Re-emergence among men who have sex with men.

作者信息

Boutin C A, Venne S, Fiset M, Fortin C, Murphy D, Severini A, Martineau C, Longtin J, Labbé A C

机构信息

Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, QC.

Ministère de la santé et des services sociaux du Québec, Montréal, QC.

出版信息

Can Commun Dis Rep. 2018 Feb 1;44(2):55-61. doi: 10.14745/ccdr.v44i02a04.

DOI:10.14745/ccdr.v44i02a04

PMID:29770100

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5864252/

Abstract

BACKGROUND

Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) caused by genotypes L, L and L. This LGV is associated with significant morbidity and increased risk of HIV transmission. While fewer than two cases per year were reported in Quebec before 2005, LGV emerged in 2005-2006 with 69 cases, followed by a period of low incidence (2007-2012), and subsequent re-emergence since 2013.

OBJECTIVES

To describe the incidence of LGV in Quebec and the characteristics of the affected population, including demographics and risk factors, clinical manifestations, laboratory tests, treatments and reinfection rates.

METHODS

Descriptive data were collected from the notifiable diseases records through the Institut national de santé publique du Québec (INSPQ) infocentre portal. Questionnaires were obtained through the enhanced surveillance system and transmitted anonymously to the Quebec Ministry of Health. In-depth analysis was performed on cases from 2013 to 2016.

RESULTS

There were 338 cases of LGV over the four-year period in Quebec. All cases were male, excluding one transsexual. Mean age was 41 years. Most lived in Montréal (81%) and were men who have sex with men (MSM; 99%). The majority (83%) reported four sexual partners or more in the last year, met mostly through the Internet (77%) and in saunas (73%). Frequency of sexual intercourse with out-of-province residents decreased in 2013-2016 (27%) compared with 2005-2012 (38%). History of STIs was frequent: 83% were HIV-infected, 81% reported previous syphilis and 78% previous gonorrhea. Recreational drug use was frequent (57%), reaching 71% in 2016. Most cases were symptomatic, a proportion which decreased in 2016 (68%) compared with 2013-2015 (82%; =0.006). Clinical presentations included proctitis (86%), lymphadenopathy (13%) and ulcer/papule (12%). Reinfections, mostly within two years of first infection, occurred in 35 individuals (10%). The re-emergence of LGV in Quebec involves an urban subpopulation composed almost exclusively of MSM with STIs, who have a high number of partners and often use drugs.

摘要

背景

性病性淋巴肉芽肿（LGV）是一种由L、L和L基因型引起的性传播感染（STI）。这种LGV与严重发病及HIV传播风险增加相关。在2005年之前，魁北克每年报告的病例少于两例，LGV在2005 - 2006年出现，有69例，随后是低发病率时期（2007 - 2012年），自2013年起再次出现。

目的

描述魁北克LGV的发病率以及受影响人群的特征，包括人口统计学和风险因素、临床表现、实验室检查、治疗及再感染率。

方法

通过魁北克国家公共卫生研究所（INSPQ）信息中心门户从法定传染病记录中收集描述性数据。通过强化监测系统获取问卷并匿名传输给魁北克卫生部。对2013年至2016年的病例进行深入分析。

结果

在四年期间，魁北克有338例LGV病例。所有病例均为男性，除了一名变性人。平均年龄为41岁。大多数人居住在蒙特利尔（81%），是男男性行为者（MSM；99%）。大多数（83%）报告在过去一年有四个或更多性伴侣，大多通过互联网（77%）和桑拿浴室（73%）结识。与2005 - 2012年（38%）相比，2013 - 2016年与省外居民发生性行为的频率有所下降（27%）。性传播感染病史很常见：83%感染了HIV，据报告81%曾患梅毒，78%曾患淋病。经常使用消遣性药物（57%），2016年达到71%。大多数病例有症状，与2013 - 2015年（82%）相比，2016年这一比例有所下降（68%；P = 0.006）。临床表现包括直肠炎（86%）、淋巴结病（13%）和溃疡/丘疹（12%）。35人（10%）发生再感染，大多在首次感染后两年内。魁北克LGV的再次出现涉及一个几乎完全由患有性传播感染的男男性行为者组成的城市亚人群，他们有大量性伴侣且经常使用药物。