1887
Surveillance Open Access
Like 0

Abstract

Background

In France, lymphogranuloma venereum (LGV) testing switched from universal to selective testing in 2016.

Aim

To investigate changes in LGV-affected populations, we performed a nationwide survey based on temporarily reinstated universal LGV testing from 2020 to 2022.

Methods

Each year, during three consecutive months, laboratories voluntarily sent anorectal -positive samples from men and women to the National Reference Centre for bacterial sexually transmitted infections. We collected patients’ demographic, clinical and biological data. Genovars L of were detected using real-time PCR. In LGV-positive samples, the A gene was sequenced.

Results

In 2020, LGV positivity was 12.7% (146/1,147), 15.2% (138/907) in 2021 and 13.3% (151/1,137) in 2022 (p > 0.05). It occurred predominantly in men who have sex with men (MSM), with rare cases among transgender women. The proportion of HIV-negative individuals was higher than that of those living with HIV. Asymptomatic rectal LGV increased from 36.1% (44/122) in 2020 to 52.4% (66/126) in 2022 (p = 0.03). Among users of pre-exposure prophylaxis (PrEP), LGV positivity was 13.8% (49/354) in 2020, 15.6% (38/244) in 2021 and 10.9% (36/331) in 2022, and up to 50% reported no anorectal symptoms. Diversity of the LGV genotypes in the Paris region increased during the survey period. An unexpectedly high number of genotype L1 variant was reported in 2022.

Conclusion

In rectal samples from MSM in France, LGV positivity was stable, but the proportion of asymptomatic cases increased in 2022. This underscores the need of universal LGV testing and the importance of continuous surveillance.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2024.29.19.2300520
2024-05-09
2024-12-21
/content/10.2807/1560-7917.ES.2024.29.19.2300520
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/29/19/eurosurv-29-19_2.html?itemId=/content/10.2807/1560-7917.ES.2024.29.19.2300520&mimeType=html&fmt=ahah

References

  1. European Centre for Disease Prevention and Control. Lymphogranuloma venereum. In: ECDC Annual epidemiological report for 2019. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/en/publications-data/lymphogranuloma-venereum-annual-epidemiological-report-2019
  2. de Vries HJC, de Barbeyrac B, de Vrieze NHN, Viset JD, White JA, Vall-Mayans M, et al. 2019 European guideline on the management of lymphogranuloma venereum. J Eur Acad Dermatol Venereol. 2019;33(10):1821-8.  https://doi.org/10.1111/jdv.15729  PMID: 31243838 
  3. Prochazka M, Charles H, Allen H, Cole M, Hughes G, Sinka K. Rapid Increase in lymphogranuloma venereum among HIV-negative men who have sex with men, England, 2019. Emerg Infect Dis. 2021;27(10):2695-9.  https://doi.org/10.3201/eid2710.210309  PMID: 34545797 
  4. Saxon C, Hughes G, Ison C, UK LGV Case-Finding Group. Asymptomatic lymphogranuloma venereum in men who have sex with men, United Kingdom. Emerg Infect Dis. 2016;22(1):112-6.  https://doi.org/10.3201/EID2201.141867  PMID: 26691688 
  5. van Aar F, Kroone MM, de Vries HJ, Götz HM, van Benthem BH. Increasing trends of lymphogranuloma venereum among HIV-negative and asymptomatic men who have sex with men, the Netherlands, 2011 to 2017. Euro Surveill. 2020;25(14):1900377.  https://doi.org/10.2807/1560-7917.ES.2020.25.14.1900377  PMID: 32290900 
  6. de Barbeyrac B, Laurier-Nadalié C, Touati A, Le Roy C, Imounga L, Hénin N, et al. Observational study of anorectal Chlamydia trachomatis infections in France through the lymphogranuloma venereum surveillance network, 2010-2015. Int J STD AIDS. 2018;29(12):1215-24.  https://doi.org/10.1177/0956462418785266  PMID: 29973128 
  7. Manning C, O’Neill C, Clarke IN, Rebec M, Cliff PR, Marsh P. High-resolution genotyping of lymphogranuloma venereum (LGV) strains of Chlamydia trachomatis in London using multi-locus VNTR analysis-ompA genotyping (MLVA-ompA). PLoS One. 2021;16(7):e0254233.  https://doi.org/10.1371/journal.pone.0254233  PMID: 34237111 
  8. Peuchant O, Touati A, Sperandio C, Hénin N, Laurier-Nadalié C, Bébéar C, et al. Changing pattern of Chlamydia trachomatis strains in lymphogranuloma venereum outbreak, France, 2010-2015. Emerg Infect Dis. 2016;22(11):1945-7.  https://doi.org/10.3201/eid2211.160247  PMID: 27767927 
  9. Marangoni A, Foschi C, Tartari F, Gaspari V, Re MC. Lymphogranuloma venereum genovariants in men having sex with men in Italy. Sex Transm Infect. 2021;97(6):441-5.  https://doi.org/10.1136/sextrans-2020-054700  PMID: 33106439 
  10. Borges V, Isidro J, Correia C, Cordeiro D, Vieira L, Lodhia Z, et al. Transcontinental dissemination of the L2b/D-Da recombinant Chlamydia trachomatis Lymphogranuloma venereum (LGV) strain: need of broad multi-country molecular surveillance. Clin Infect Dis. 2021;73(4):e1004-7.  https://doi.org/10.1093/cid/ciab067  PMID: 33512482 
  11. Dessus-Babus S, Bébéar CM, Charron A, Bébéar C, de Barbeyrac B. Sequencing of gyrase and topoisomerase IV quinolone-resistance-determining regions of Chlamydia trachomatis and characterization of quinolone-resistant mutants obtained In vitro. Antimicrob Agents Chemother. 1998;42(10):2474-81.  https://doi.org/10.1128/AAC.42.10.2474  PMID: 9756744 
  12. Morré SA, Spaargaren J, Fennema JS, de Vries HJ, Coutinho RA, Peña AS. Real-time polymerase chain reaction to diagnose lymphogranuloma venereum. Emerg Infect Dis. 2005;11(8):1311-2.  https://doi.org/10.3201/eid1108.050535  PMID: 16110579 
  13. Lan J, Ossewaarde JM, Walboomers JM, Meijer CJ, van den Brule AJ. Improved PCR sensitivity for direct genotyping of Chlamydia trachomatis serovars by using a nested PCR. J Clin Microbiol. 1994;32(2):528-30.  https://doi.org/10.1128/jcm.32.2.528-530.1994  PMID: 8150967 
  14. de Vries HJC, Pannekoek Y, Dean D, Bavoil PM, Borel N, Greub G, et al. Call for consensus in Chlamydia trachomatis nomenclature: moving from biovars, serovars, and serotypes to genovariants and genotypes. Clin Microbiol Infect. 2022;28(6):761-3.  https://doi.org/10.1016/j.cmi.2022.02.013  PMID: 35202789 
  15. Tamura K. Estimation of the number of nucleotide substitutions when there are strong transition-transversion and G+C-content biases. Mol Biol Evol. 1992;9(4):678-87. PMID: 1630306 
  16. Kumar S, Stecher G, Tamura K. MEGA7: molecular evolutionary genetics analysis version 7.0 for bigger datasets. Mol Biol Evol. 2016;33(7):1870-4.  https://doi.org/10.1093/molbev/msw054  PMID: 27004904 
  17. Letunic I, Bork P. Interactive Tree Of Life (iTOL) v5: an online tool for phylogenetic tree display and annotation. Nucleic Acids Res. 2021;49(W1):W293-6.  https://doi.org/10.1093/nar/gkab301  PMID: 33885785 
  18. De Baetselier I, Tsoumanis A, Florence E, Van den Berghe W, Crucitti T, Van den Bossche D, et al. Did pre-exposure prophylaxis roll-out influence the epidemic of rectal lymphogranuloma venereum in Belgium? Results from the national surveillance system. J Acquir Immune Defic Syndr. 2021;86(1):e1-5.  https://doi.org/10.1097/QAI.0000000000002524  PMID: 33044320 
  19. Peuchant O, Touati A, Laurier-Nadalié C, Hénin N, Cazanave C, Bébéar C, et al. Prevalence of lymphogranuloma venereum among anorectal Chlamydia trachomatis-positive MSM using pre-exposure prophylaxis for HIV. Sex Transm Infect. 2020;96(8):615-7.  https://doi.org/10.1136/sextrans-2019-054346  PMID: 32303577 
  20. De Baetselier I, Tsoumanis A, Verbrugge R, De Deken B, Smet H, Abdellati S, et al. Lymphogranuloma venereum is on the rise in Belgium among HIV negative men who have sex with men: surveillance data from 2011 until the end of June 2017. BMC Infect Dis. 2018;18(1):689.  https://doi.org/10.1186/s12879-018-3600-0  PMID: 30572839 
  21. Kounta CH, Drewniak N, Cazein F, Chazelle E, Lot F. Dépistage du VIH et des infections sexuellement transmissibles bactériennes en France, 2014-2021. [Screening for HIV and bacterial sexually transmitted infections in France, 2014-2021]. Bull Epidemiol Hebd. 2022;(24-25):456-62. French. Available from: http://beh.santepubliquefrance.fr/beh/2022/24-25/2022_24-25_4.html
  22. Neves JM, Ramos Pinheiro R, Côrte-Real R, Borrego MJ, Rodrigues A, Fernandes C. Lymphogranuloma venereum: a retrospective analysis of an emerging sexually transmitted disease in a Lisbon tertiary center. J Eur Acad Dermatol Venereol. 2021;35(8):1712-6.  https://doi.org/10.1111/jdv.17302  PMID: 33896044 
  23. Seth-Smith HMB, Bénard A, Bruisten SM, Versteeg B, Herrmann B, Kok J, et al. Ongoing evolution of Chlamydia trachomatis lymphogranuloma venereum: exploring the genomic diversity of circulating strains. Microb Genom. 2021;7(6):000599.  https://doi.org/10.1099/mgen.0.000599  PMID: 34184981 
  24. Cole MJ, Field N, Pitt R, Amato-Gauci AJ, Begovac J, French PD, et al. Substantial underdiagnosis of lymphogranuloma venereum in men who have sex with men in Europe: preliminary findings from a multicentre surveillance pilot. Sex Transm Infect. 2020;96(2):137-42.  https://doi.org/10.1136/sextrans-2019-053972  PMID: 31235527 
  25. Martínez-García L, González-Alba JM, Puerta T, Comunión A, Rodríguez-Jiménez MC, Orviz E, et al. Specific high-resolution scheme to improve understanding of the spatio-temporal dispersion of lymphogranuloma venereum epidemic. Front Microbiol. 2022;13:1056216.  https://doi.org/10.3389/fmicb.2022.1056216  PMID: 36605505 
  26. Borges V, Cordeiro D, Salas AI, Lodhia Z, Correia C, Isidro J, et al. Chlamydia trachomatis: when the virulence-associated genome backbone imports a prevalence-associated major antigen signature. Microb Genom. 2019;5(11):e000313.  https://doi.org/10.1099/mgen.0.000313  PMID: 31697227 
  27. Carrer M, de Barbeyrac B, Laurier-Nadalié C, Bébéar C, Touati A, Peuchant O. Toward the spread of the new L2b/D-Da hybrid Chlamydia trachomatis strain in men who have sex with men in France? Clin Infect Dis. 2021;73(6):1130-1.  https://doi.org/10.1093/cid/ciab253  PMID: 33744938 
  28. Bauwens JE, Lampe MF, Suchland RJ, Wong K, Stamm WE. Infection with Chlamydia trachomatis lymphogranuloma venereum serovar L1 in homosexual men with proctitis: molecular analysis of an unusual case cluster. Clin Infect Dis. 1995;20(3):576-81.  https://doi.org/10.1093/clinids/20.3.576  PMID: 7756478 
  29. Fermepin MR, Entrocassi AC, Büttner KA, Caffarena D, Aquino DL, La Rosa L, et al. More than L2b in rectal lymphogranuloma venereum. Lancet Microbe. 2021;2(2):e55.  https://doi.org/10.1016/S2666-5247(20)30225-1  PMID: 35544242 
  30. Touati A, Bébéar C, Peuchant O. Update on the availability of commercialized real-time PCR assays for the diagnosis of Lymphogranuloma venereum. Clin Microbiol Infect. 2023;29(4):548-9.  https://doi.org/10.1016/j.cmi.2022.12.013  PMID: 36572103 
  31. Martínez-García L, Rodríguez-Domínguez M, Lejarraga C, Rodríguez-Jiménez MC, González-Alba JM, Puerta T, et al. The silent epidemic of lymphogranuloma venereum inside the COVID-19 pandemic in Madrid, Spain, March 2020 to February 2021. Euro Surveill. 2021;26(18):2100422.  https://doi.org/10.2807/1560-7917.ES.2021.26.18.2100422  PMID: 33960288 
/content/10.2807/1560-7917.ES.2024.29.19.2300520
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error