俄罗斯首次报告的性病性淋巴肉芽肿病例出现在男男性行为者就诊肛肠科的人群中。
First reported lymphogranuloma venereum cases in Russia discovered in men who have sex with men attending proctologists.
机构信息
Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, 599338Department of Healthcare, Moscow, Russia.
WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine, Microbiology, Faculty of Medicine and Health, 98836Örebro University, Örebro, Sweden.
出版信息
Int J STD AIDS. 2022 Apr;33(5):456-461. doi: 10.1177/09564624211072709. Epub 2022 Mar 18.
BACKGROUND
Several lymphogranuloma venereum (LGV) outbreaks among men who have sex with men (MSM) have been reported throughout the world since 2003. Nevertheless, no LGV cases have been internationally reported from Russia. We evaluated the prevalence of LGV among MSM attending proctologists in Moscow, Russia, and compared the LGV and non-LGV rectal (CT) infections.
METHODS
MSM ( = 534) attending for proctologic care were included. Rectal specimens were sampled for CT and (NG) by nucleic acid amplification tests (NAATs). All CT-positive patients were tested with an LGV-specific NAAT.
RESULTS
In total, 37.3% (95% CI 33.3-41.5; 199/534) of MSM were CT positive. Of these, 68.8% (95% CI 62.1-74.9; 137/199) had LGV and 31.2% (95% CI 25.1-37.9; 62/199) a non-LGV rectal CT infection. Older age (34 years vs. 31 years, = 0.035) and group-sex practices (67.2% (92/137) vs. 33.9% (21/62), < 0.0001) were associated with LGV. The LGV-positive MSM were also more likely to be HIV-positive (67.2% (92/137) vs. 41.9% (26/62), = 0.001). Proctoscopy revealed ulcerative proctitis/proctocolitis in 99.3% (136/137) of LGV-positive MSM. No ulcerative or erosive proctitis was found in the MSM with non-LGV CT infection, but 58.1% (36/62) of them had anorectal disorders. Finally, mild catarrhal or hemorrhagic proctitis was diagnosed in only 21.6% (8/37) of MSM with non-LGV CT infection lacking concomitant NG or syphilis ( < 0.0001).
CONCLUSIONS
LGV is widely spread among MSM attending proctologists in Moscow. Clinically, acute LGV proctitis/proctocolitis can be difficult to distinguish from inflammatory bowel disease that leads to mismanaged LGV infections. LGV diagnostic laboratory testing is essential, however, currently mainly lacking for MSM in Russia. All MSM with CT-positive rectal specimens should be subsequently tested for LGV.
背景
自 2003 年以来，全世界已报告了几起因男男性行为者（MSM）引起的性病淋巴肉芽肿（LGV）疫情。然而，俄罗斯尚未有国际上报道的 LGV 病例。我们评估了在俄罗斯莫斯科看直肠病专家的 MSM 中 LGV 的流行情况，并比较了 LGV 和非 LGV 直肠（CT）感染。
方法
我们纳入了（ = 534）名接受直肠护理的 MSM。通过核酸扩增试验（NAAT）对直肠标本进行 CT 和 （NG）检测。所有 CT 阳性患者均接受 LGV 特异性 NAAT 检测。
结果
共有 37.3%（95% CI 33.3-41.5；534/199）的 MSM 为 CT 阳性。其中，68.8%（95% CI 62.1-74.9；137/199）为 LGV，31.2%（95% CI 25.1-37.9；62/199）为非 LGV 直肠 CT 感染。年龄较大（34 岁 vs. 31 岁， = 0.035）和群交行为（67.2%（92/137） vs. 33.9%（21/62）， < 0.0001）与 LGV 有关。LGV 阳性的 MSM 也更有可能 HIV 阳性（67.2%（92/137） vs. 41.9%（26/62）， = 0.001）。LGV 阳性的 MSM 中，99.3%（137/137）存在溃疡性直肠炎/直肠结肠炎。在非 LGV CT 感染的 MSM 中未发现溃疡性或侵蚀性直肠炎，但其中 58.1%（36/62）存在肛肠疾病。最后，在缺乏伴随的 NG 或梅毒的非 LGV CT 感染的 MSM 中，仅诊断出 21.6%（8/37）为轻度卡他性或出血性直肠炎（ < 0.0001）。
结论
LGV 在莫斯科看直肠病专家的 MSM 中广泛传播。临床上，急性 LGV 直肠炎/直肠结肠炎与导致 LGV 感染管理不当的炎症性肠病难以区分。然而，目前俄罗斯主要缺乏 LGV 诊断实验室检测，所有 CT 阳性直肠标本的 MSM 均应随后进行 LGV 检测。
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