Univ. Bordeaux, USC EA3671, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France
INRA, USC EA3671, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.
Sex Transm Infect. 2020 Dec;96(8):615-617. doi: 10.1136/sextrans-2019-054346. Epub 2020 Apr 17.
We evaluated the prevalence of lymphogranuloma venereum (LGV) in anorectal -positive French men who have sex with men (MSM) using pre-exposure prophylaxis (PrEP) for HIV. Here, we describe the clinical, biological and behavioural characteristics of these patients.
Laboratories throughout French metropolitan areas performing routine testing for sent positive anorectal specimens to the National Reference Centre for bacterial STIs for LGV real-time PCR targeting the H gene. Identification of the genovar was performed by A gene sequencing. For each patient, clinical, biological and sexual behaviour data were collected after obtaining written informed consent.
In 2017, 486 anorectal -positive specimens from MSM PrEP users were analysed. A strain of genovar L was detected in 91 cases (18.7%). Patients with LGV were significantly more symptomatic, had more sexual partners and more concurrent syphilis compared with their non-LGV counterparts. A gene sequencing, successful in two-thirds of anorectal -positive specimens, showed that the LGV cases were mainly of variant L2b (n=33), followed by genovar L2 (n=27) and genetic L2b A variants (n=16). In 11 cases, the results indicated the occurrence of genetic exchange between L and non-L genovars.
LGV was diagnosed in 18.7% of anorectal -positive specimens from French MSM using PrEP. LGV testing should be carried out for MSM diagnosed with chlamydia and with a large number of sexual partners, high-risk practices and anorectal symptoms. These patients should be presumptively treated as having LGV. This is the first surveillance study of LGV among MSM PrEP users and monitoring should continue.
我们评估了使用艾滋病毒暴露前预防（PrEP）的肛门直肠阳性法国男男性行为者（MSM）中淋巴肉芽肿（LGV）的流行率。在此，我们描述了这些患者的临床、生物学和行为特征。
法国大都市地区的各个实验室对常规检测呈阳性的肛门直肠标本进行了检测，将这些标本送到国家细菌性性传播感染参考中心进行实时聚合酶链反应检测 H 基因，以确定 LGV。通过 A 基因测序确定 基因变种。对于每个患者，在获得书面知情同意后，收集临床、生物学和性行为数据。
2017 年，分析了 486 名使用 PrEP 的 MSM 肛门直肠阳性标本。在 91 例（18.7%）中检测到 L 型菌株。与非 LGV 患者相比，LGV 患者的症状明显更严重，性伴侣更多，同时患有梅毒的比例更高。成功对三分之二的肛门直肠阳性标本进行 A 基因测序后显示，LGV 病例主要为 L2b 变体（n=33），其次为 L2 变种（n=27）和遗传 L2b A 变体（n=16）。在 11 例中，结果表明 L 和非 L 变种之间发生了遗传交换。
在使用 PrEP 的法国 MSM 中，18.7%的肛门直肠阳性标本诊断为 LGV。对于诊断为衣原体感染且性伴侣多、高危行为和肛门直肠症状的 MSM，应进行 LGV 检测。这些患者应被假定患有 LGV。这是首例关于 PrEP 使用的 MSM 中 LGV 的监测研究，应继续监测。
