Substantial underdiagnosis of lymphogranuloma venereum in men who have sex with men in Europe: preliminary findings from a multicentre surveillance pilot
| Autor: | Gianfranco Spiteri, Michelle J Cole, Nigel Field, Horst Schalk, Katharina Pöcher, Angelika Stary, Snjezana Zidovec Lepej, Gwenda Hughes, Josip Begovac, Darja Keše, Patrick French, Irena Klavs, Andrew J Amato-Gauci, Rachel Pitt |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Ompa gene Epidemiology Croatia Slovenia Chlamydia trachomatis HIV Infections Pilot Projects Dermatology Sociodemographic data medicine.disease_cause Real-Time Polymerase Chain Reaction Men who have sex with men 03 medical and health sciences Gonorrhea Sexual and Gender Minorities 0302 clinical medicine Internal medicine Medicine Humans Proctitis 030212 general & internal medicine lymphogranuloma venereum 0303 health sciences 030306 microbiology business.industry Coinfection Public health Lymphogranuloma venereum Rectum Chlamydia Infections Middle Aged medicine.disease Anogenital conditions surveillance United Kingdom Europe Infectious Diseases anogenital conditions Austria Epidemiological Monitoring business Bacterial Outer Membrane Proteins |
| Zdroj: | Sexually Transmitted Infections |
| ISSN: | 1472-3263 1368-4973 |
| Popis: | ObjectivesUnderstanding the public health impact of lymphogranuloma venereum (LGV) in Europe is hampered by inadequate diagnostics and surveillance systems in many European countries. We developed and piloted LGV surveillance in three European countries without existing systems and performed a preliminary investigation of LGV epidemiology, where little evidence currently exists.MethodsWe recruited STI or dermatovenereology clinics and associated laboratories serving men who have sex with men (MSM) in Austria, Croatia and Slovenia, using the UK for comparison. We undertook centralised LGV testing of Chlamydia trachomatis (CT)-positive rectal swabs collected between October 2016 and May 2017 from MSM attending these clinics. Stored specimens from Austria (2015–2016) and Croatia (2014) were also tested. Clinical and sociodemographic data were collected using a standardised proforma. The ompA gene of LGV-positive specimens was sequenced.ResultsIn total, 500 specimens from CT-positive MSM were tested, and LGV positivity was 25.6% (128/500; 95% CI 22.0% to 29.6%) overall, and 47.6% (79/166; 40.1% to 55.2%) in Austria, 20.0% (3/15; 7.1% to 45.2%) in Croatia, 16.7% (1/6; 3.0% to 56.4%) in Slovenia and 14.4% (45/313; 10.9% to 18.7 %) in the UK. Proformas were completed for cases in Croatia, Slovenia and in the UK; proformas could not be completed for Austrian cases, but limited data were available from line listings. Where recorded, 83.9% (78/93) of LGV-CT cases were HIV-positive compared with 65.4% (149/228) of non-LGV-CT cases; MSM with LGV-CT were more likely to have proctitis (Austria, 91.8% vs 40.5%, pompA sequences were identified, including three new variants; the L2 ompA sequence predominated (58.6%, 51/87).ConclusionsLGV is substantially underdiagnosed in MSM across Europe. Unified efforts are needed to overcome barriers to testing, establish effective surveillance, and optimise diagnosis, treatment and prevention. |
| Databáze: | OpenAIRE |
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