Sorbonne Université, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies Infectieuses et Tropicales, Department of Infectious and Tropical Diseases, Paris 75013, France.
Department of Infectious Diseases, Victor Dupouy Hospital, Argenteuil, France.
J Travel Med. 2019 Dec 23;26(8). doi: 10.1093/jtm/taz090.
The incidence of sexually transmitted infections (STI) is increasing in Western countries whilst travel plays a major role in STI dissemination worldwide. However, there is no study distinguishing HIV-positive and HIV-negative travellers.
We retrospectively evaluated the epidemiological, clinical and biological characteristics of the patients diagnosed with a travel-related STI between 2008 and 2016. We describe and compare the spectrum of STI diagnosed amongst HIV-positive and negative travellers.
Overall, 163 travel-related STI were identified in 140 patients (89% male, 54% men having sex with men, 40% HIV-positive). Symptoms occurred during travel in 39% of them, otherwise the median time between return and symptoms' onset was 13 days. Amongst the 84 HIV-negative travellers, the main STI were primary HIV infections (n = 36, 38%), Neisseria gonorrhoeae (NG) infections (17%) and primary herpes infection (14, vs 1.5% amongst HIV-positive travellers, P = 0.01). The regions of exposure to HIV were concordant with the known geographical distribution of HIV subtypes. Amongst the 56 HIV-positive travellers, the main STI were syphilis (43, vs 6% amongst HIV-negative travellers, P = 0.01), Chlamydia trachomatis (CT) infections (22, vs 13% amongst HIV-negative travellers, P = 0.08), NG infections (13%) and acute hepatitis C (12, vs 1% amongst HIV-negative travellers, P = 0.01), with a predominance of anal forms for both CT and NG infections.
The spectrum of STI diagnosed in returning travellers is broad with important differences according to HIV status. In our setting, primary HIV infection was the leading STI in non-HIV infected patients, which suggests that pre-exposure prophylaxis may have a role in HIV prevention in at-risk travellers.
在西方国家，性传播感染（STI）的发病率正在上升，而旅行在全球 STI 的传播中起着重要作用。然而，目前还没有研究区分 HIV 阳性和 HIV 阴性旅行者。
我们回顾性评估了 2008 年至 2016 年间诊断出的与旅行相关的 STI 的患者的流行病学、临床和生物学特征。我们描述并比较了 HIV 阳性和阴性旅行者中诊断出的 STI 谱。
总共在 140 名患者中发现了 163 例与旅行相关的 STI（89%为男性，54%为男男性行为者，40%为 HIV 阳性）。39%的患者在旅行期间出现症状，否则从返回至出现症状的中位时间为 13 天。在 84 名 HIV 阴性旅行者中，主要的 STI 是原发性 HIV 感染（n=36，38%）、淋病奈瑟菌（NG）感染（17%）和原发性疱疹感染（14%，而 HIV 阳性旅行者中为 1.5%，P=0.01）。暴露于 HIV 的地区与 HIV 亚型的已知地理分布一致。在 56 名 HIV 阳性旅行者中，主要的 STI 是梅毒（43%，而 HIV 阴性旅行者中为 6%，P=0.01）、沙眼衣原体（CT）感染（22%，而 HIV 阴性旅行者中为 13%，P=0.08）、NG 感染（13%）和急性丙型肝炎（12%，而 HIV 阴性旅行者中为 1%，P=0.01），CT 和 NG 感染均以肛门形式为主。
返回旅行者中诊断出的 STI 谱广泛，根据 HIV 状况存在重要差异。在我们的环境中，原发性 HIV 感染是未感染 HIV 的患者中主要的 STI，这表明暴露前预防可能在有风险的旅行者的 HIV 预防中发挥作用。
