Prevalence of lymphogranuloma venereum among anorectal Chlamydia trachomatis-positive MSM using pre-exposure prophylaxis for HIV. Issue 8 (17th April 2020)

• Record Type: Journal Article
• Authors: Peuchant, Olivia; Touati, Arabella; Laurier-Nadalié, Cécile; Hénin, Nadege; Cazanave, Charles; Bébéar, Cécile; de Barbeyrac, Bertille
• Is Part Of: Sexually transmitted infections. Volume 96:Issue 8(2020)
• Page Start: 615
• Page End: 617
• Publication Date: 2020-04-17
• Subjects: chlamydia trachomatis -- HIV pre-exposure prophylaxis -- lymphogranuloma venereum -- molecular epidemiology; Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2019-054346
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Objectives: We evaluated the prevalence of lymphogranuloma venereum (LGV) in anorectal Chlamydia trachomatis -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. Methods: Laboratories throughout French metropolitan areas performing routine testing for C. trachomatis sent positive anorectal specimens to the National Reference Centre for bacterial STIs for LGV real-time PCR targeting the pmp H gene. Identification of the C. trachomatis genovar was performed by omp A gene sequencing. For each patient, clinical, biological and sexual behaviour data were collected after obtaining written informed consent. Results: In 2017, 486 anorectal C. trachomatis -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. Omp A gene sequencing, successful in two-thirds of anorectal C. trachomatis -positive specimens, showed that the LGV cases were mainly of variant L2b (n=33), followed by genovar L2 (n=27) and genetic L2b omp A variants (n=16). In 11 cases, the results indicated the occurrence of genetic exchange between L and non-L genovars. Conclusions: LGV was diagnosed in 18.7% of anorectal C. trachomatis -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.