Microbiology, DIMES, University of Bologna, Bologna, Emilia-Romagna, Italy.
Microbiology, DIMES, University of Bologna, Bologna, Emilia-Romagna, Italy
Sex Transm Infect. 2021 Sep;97(6):441-445. doi: 10.1136/sextrans-2020-054700. Epub 2020 Oct 26.
Lymphogranuloma venereum (LGV) is an STI caused by 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.
From 2016 to 2020, all the anorectal swabs collected from MSM attending the STI Clinic of St. Orsola-Malpighi Hospital in Bologna and positive for were stored. LGV infection was confirmed by a PCR, and, subsequently, a fragment of the gene was amplified and sequenced. Sequences were aligned to reference strains representing different LGV variants.
LGV 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 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).
In 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.
淋球菌性腹股沟肉芽肿（LGV）是一种由血清型 L1-L3 引起的性传播感染。在欧洲，目前的流行主要由 L2b 基因变体引起，尽管越来越多的与其他 L2 变体相关的病例报告。在这里，我们评估了意大利男男性行为者（MSM）中直肠 LGV 基因变体的分布。
2016 年至 2020 年，从博洛尼亚圣奥尔索拉-马尔皮吉医院性传播感染诊所采集的所有直肠拭子均收集并保存，这些拭子均来自于就诊的 MSM 并检测出。通过 PCR 确认 LGV 感染，随后扩增和测序 基因片段。将序列与代表不同 LGV 变体的参考株进行比对。
LGV 病例占所有直肠衣原体感染的三分之一，总流行率为 4.1%（76/1852）。每年 LGV 病例总数保持不变。LGV 主要发生在症状性患者（>65%）、年龄超过 30 岁且伴有其他性传播感染负担较重的患者（63.7% HIV 阳性、35.5%同时患有直肠淋病、19.7%早期梅毒）。随着时间的推移，HIV-LGV 合并感染呈下降趋势。检测到三种主要的 LGV 基因变体（L2f，46.1%；L2b，23.0%；L2-L2b/D-Da，16.9%），以及其他已知的 L2b 变体（主要是 L2bV2 和 L2bV4）。还发现了两种具有非同义单核苷酸多态性的新型 L2b 变体。随着时间的推移，L2f 病例的比例逐渐下降，而 L2-L2b/D-Da 病例的比例显著增加（p=0.04）。
在我们的地区，LGV 在 MSM 中流行，具有不同的循环基因变体。需要进行主动监测和基因分型计划，以减少 LGV 感染的重新建立。
