Hardick Justin, Conte Madison, Young Mattlyn, Ramdeep Nisha, Manabe Yukari C, Hamill Matthew M
From the Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD.
Sex Transm Dis. 2025 Jun 1;52(6):333-337. doi: 10.1097/OLQ.0000000000002133. Epub 2024 Dec 24.
Infection with Chlamydia trachomatis (CT) can have distinct clinical presentations, such as trachoma, or lymphogranuloma venereum (LGV). Certain populations are at greater risk for LGV acquisition and transmission, which may require a longer duration of therapy than other urogenital CT sexually transmitted infections (STIs). Commercial assays are not available in the United States to distinguish LGV from non-LGV genovars.
Lymphogranuloma venereum real-time polymerase chain reaction was performed on rectal CT-positive samples (N = 93) obtained from men (N = 80) who ordered from a mail-in self-collection STI service between April 2021 and February 2024. pmpH gene sequencing was performed on all samples to confirm LGV versus non-LGV, and multilocus sequence typing was performed on LGV-positive samples (n = 7) for additional confirmation.
Lymphogranuloma venereum was detected in 7.5% (7 of 93) of samples by real-time polymerase chain reaction, with pmpH sequencing and multilocus sequence typing confirming 100% (7 of 7) of these results. Overall, pmpH sequencing data were obtained for 92% (86 of 93) of samples with the following genovar distribution based on BLAST analysis: 54% (47 of 86) J, 28% (24 of 86) F, 9% (8 of 86) E, and 8% (7 of 86) L. No individual had more than 1 LGV-positive sample. No statistically significant associations with demographic factors were identified.
Lymphogranuloma venereum was detected in CT-positive rectal swabs from users of an online, mail-in, self-collect STI testing platform in Maryland. These data suggest that increased LGV reflexive testing may be warranted to better understand the cotemporary epidemiology of LGV. These data also illustrate that mail-in programs for routine STI testing may be leveraged for public health surveillance purposes.
沙眼衣原体（CT）感染可呈现不同的临床表现，如沙眼或性病性淋巴肉芽肿（LGV）。某些人群感染和传播LGV的风险更高，这可能需要比其他泌尿生殖系统CT性传播感染（STIs）更长的治疗时间。在美国，尚无商业检测方法可区分LGV和非LGV基因型。
对2021年4月至2024年2月期间从邮寄自取性传播感染检测服务处订购检测的男性（n = 80）的直肠CT阳性样本（N = 93）进行性病性淋巴肉芽肿实时聚合酶链反应检测。对所有样本进行pmpH基因测序以确认LGV与非LGV，并对LGV阳性样本（n = 7）进行多位点序列分型以进一步确认。
通过实时聚合酶链反应在7.5%（93例中的7例）的样本中检测到性病性淋巴肉芽肿，pmpH测序和多位点序列分型证实了所有这些结果（7例中的7例，100%）。总体而言，92%（93例中的86例）的样本获得了pmpH测序数据，基于BLAST分析的基因型分布如下：54%（86例中的47例）为J型，28%（86例中的24例）为F型，9%（86例中的8例）为E型，8%（86例中的7例）为L型。没有个体有超过1个LGV阳性样本。未发现与人口统计学因素有统计学意义的关联。
在马里兰州一个在线、邮寄自取的性传播感染检测平台的用户的CT阳性直肠拭子中检测到了性病性淋巴肉芽肿。这些数据表明，可能有必要增加LGV反射性检测，以更好地了解LGV的当代流行病学。这些数据还表明，常规性传播感染检测的邮寄项目可用于公共卫生监测目的。
