Hughes Yasmin, Chen Marcus Y, Fairley Christopher K, Hocking Jane S, Williamson Deborah, Ong Jason J, De Petra Vesna, Chow Eric P F
Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.
Sex Transm Infect. 2022 Dec;98(8):582-585. doi: 10.1136/sextrans-2021-055368. Epub 2022 Feb 25.
Lymphogranuloma venereum (LGV) is caused by serovars L1-L3. This study determined the positivity for LGV testing before and after introduction of universal LGV testing of positive rectal samples in men who have sex with men (MSM).
From March 2015 to February 2018, MSM with rectal 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 specimens in men over the age of 25 years, regardless of symptoms was undertaken. LGV positivity was defined as the detection of LGV-associated serovars.
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).
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.
性病性淋巴肉芽肿（LGV）由L1-L3血清型引起。本研究确定了在男男性行为者（MSM）中对直肠阳性样本进行普遍LGV检测前后LGV检测的阳性率。
2015年3月至2018年2月，墨尔本性健康中心对有直肠症状的MSM不常规进行LGV检测，除非他们感染了HIV或有直肠炎症状。从2018年2月起，对所有25岁以上男性的直肠阳性标本进行普遍的LGV检测，无论有无症状。LGV阳性定义为检测到与LGV相关的血清型。
在选择性LGV检测期和普遍LGV检测期，分别有3429例和4020例MSM直肠衣原体检测呈阳性。在两个时期的总共3027份可评估标本中，97份（3.2%；95%CI 2.6%至3.9%）标本LGV检测呈阳性。选择性检测期的LGV阳性率高于普遍检测期（6.6%（33/502）对2.5%（64/2525），p<0.001）。无症状LGV病例的比例从选择性检测期的15.2%（5/33）增加到普遍检测期的34.4%（22/64）（p=0.045）。在70例有症状的LGV病例中，症状包括直肠分泌物（71.4%，n=45）和直肠疼痛（60.0%，n=42）。
与选择性检测相比，对MSM中所有直肠衣原体阳性样本进行普遍LGV检测可检测到无症状直肠LGV，其占直肠LGV病例的34%。
