Resurgence of lymphogranuloma venereum in western Europe:: An outbreak of Chlamydia trachomatis serovar L2 proctitis in The Netherlands among men who have sex with men
Resurgence of lymphogranuloma venereum in western Europe:: An outbreak of Chlamydia trachomatis serovar L2 proctitis in The Netherlands among men who have sex with men
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DOI：
10.1086/423966
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发表时间：
2004-10-01
影响因子：
11.8
通讯作者：
van der Meijden, WI
中科院分区：
文献类型：
--
作者：
Nieuwenhuis, RF;Ossewaarde, JM;van der Meijden, WI
背景。性病淋巴肉芽肿 (LGV) 是一种性传播疾病 (STD)，在西方世界很少见。最近，荷兰鹿特丹伊拉斯谟医疗中心有 3 名男男性行为者出现 LGV 直肠炎。我们调查了男男性行为者 (MSM) 性网络中可能爆发的情况。方法。经过积极的病例发现后，共有 15 名男子出现并接受了调查。测定针对沙眼衣原体的血清抗体滴度。通过聚合酶链反应（PCR）分析尿液和直肠标本中是否存在沙眼衣原体。沙眼衣原体 - 对阳性标本进行基因分型以检测特定的沙眼衣原体血清型。所有受试者均接受常规 STD 筛查。评估了社会人口学、临床和内窥镜特征。结果。 13 名受试者的沙眼衣原体免疫球蛋白 (Ig) G 和 IgA 滴度较高，表明存在侵袭性感染。 12 名受试者的直肠标本呈沙眼衣原体 PCR 阳性。所有尿液样本均为阴性。基因分型显示血清型 L-2 (n=8) 和 L-1 (n=1)。所有接受乙状结肠镜检查的受试者均发现溃疡性直肠炎（n=9）。 13 名 LGV 诊断受试者中，有 11 名受试者的人类免疫缺陷病毒 (HIV) 血清呈阳性，6 名受试者同时患有另一种性传播疾病，1 名受试者最近感染了丙型肝炎病毒。荷兰、德国、比利时、英国和法国报告了进一步的性接触。结论。我们发现荷兰 MSM 中爆发了 LGV 直肠炎。溃疡特征有利于艾滋病毒、其他性传播疾病和血源性疾病的传播。从公共卫生的角度来看，提高对患有症状性直肠炎的 MSM 中可能存在 LGV 的认识似乎很重要。
Background. Lymphogranuloma venereum ( LGV) is a sexually transmitted disease ( STD) and is rare in the Western world. Recently, 3 men who have sex with men presented with LGV proctitis at the Erasmus Medical Center, Rotterdam, The Netherlands. We investigated a possible outbreak in a sexual network of men who have sex with men ( MSM).Methods. After active case finding, a total of 15 men presented and were investigated. Serum antibody titers to Chlamydia trachomatis were determined. Urine and rectum specimens were analyzed by polymerase chain reaction (PCR) for the presence of C. trachomatis. C. trachomatis - positive specimens were genotyped to detect the specific C. trachomatis serovars. All subjects underwent routine STD screening. Sociodemographic, clinical, and endoscopic characteristics were evaluated.Results. Thirteen subjects had high immunoglobulin (Ig) G and IgA titers to C. trachomatis, suggesting an invasive infection. Rectal specimens of 12 subjects were PCR- positive for C. trachomatis. All urine specimens were negative. Genotyping revealed serovars L-2 (n=8) and L-1 (n=1). An ulcerative proctitis was found in all subjects obtaining sigmoidoscopy (n=9). Eleven of 13 subjects with an LGV diagnosis were seropositive for human immunodeficiency virus (HIV), 6 had another concomitant STD, and 1 had recently acquired a hepatitis C virus infection. Further sexual contacts were reported from The Netherlands, Germany, Belgium, the United Kingdom, and France.Conclusions. We revealed an outbreak of LGV proctitis among MSM in The Netherlands. The ulcerous character favors transmission of HIV, other STDs, and blood- borne diseases. From a public health perspective, it seems important to increase the awareness of possible LGV in MSM with symptomatic proctitis.