Rates of Lymphogranuloma Venereum in Men
Explore rates of asymptomatic and symptomatic Lymphogranuloma Venereum (LGV) in men, comparing HIV-positive and HIV-negative individuals. Discover insights from a retrospective case note review conducted at 56 Dean Street, Chelsea and Westminster Hospital NHS Foundation Trust. Analyze data on LGV cases, HIV status, rectal symptoms, and concurrent STIs to assess risk factors for LGV infection.
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Presentation Transcript
R RATES ATES OF V VENEREUM ENEREUM IN IN MEN OF A ASYMPTOMATIC SYMPTOMATIC L LYMPHOGRANULOMA MEN WHO WHO HAVE HAVE SEX YMPHOGRANULOMA SEX WITH WITH MEN MEN Tristan Griffiths Neesha Rockwood Nneka Nwokolo 56 Dean Street, Chelsea and Westminster Hospital NHS Foundation Trust
B BACKGROUND ACKGROUND LGV testing is recommended in all HIV +ve MSM with rectal chlamydia, but not in asymptomatic HIV ve MSM1 There are anecdotal reports of asymptomatic LGV in HIV -ve MSM From 2015 we have tested all chlamydia +ve rectal samples in MSM for LGV 1. 2015 UK national guideline for the management of infection with Chlamydia trachomatis
M METHODS ETHODS A retrospective case note review was performed on all confirmed LGV cases from 56 Dean Street between June and December 2015 The following data were collected: age, HIV status, presence or absence of rectal symptoms, presence of other STIs
R RESULTS ESULTS Rates of LGV comparing HIV and symptom status 35 N = 105 HIV ve HIV +ve Total 30 Median age in years (range) 32 (17-50) 34 (23-57) 33 (17-57) Number of LGV cases 25 20 Symptomatic 38 Asymptomatic 13 (27%) 25 (44%) Symptomatic 15 *Asymptomatic 67 35 (73%) 32 (56%) 10 Total 48 57 5 0 *P=0.054 HIV Negative HIV Positive
R RESULTS ESULTS O OTHER THER STI STIS S 50 (48%) patients were diagnosed with one or more concurrent STIs Gonorrhoea - 34 (32%) (94% rectal; 71% asymptomatic) Syphilis - 18 (17%) (72% HIV positive) 13 (12%) reported being a contact of gonorrhoea and/or chlamydia
M MULTIVARIATE ULTIVARIATE L LOGISTIC FOR FOR A ASYMPTOMATIC SYMPTOMATIC R RECTAL OGISTIC R REGRESSION EGRESSION A ASSESSING ECTAL LGV LGV SSESSING R RISK ISK F FACTORS ACTORS Abbreviations GC Gonorrhoea HIV-1 - Human Immunodeficiency Virus LGV - Lymphogranuloma Venereum STI - Sexually Transmitted Infection STS - Syphilis Asymptomatic LGV infection Age over 40 Contact of STI Concurrent STS Concurrent GC HIV-1 infection 0 2 4 6 adjusted odds ratio Favours symptomatic infection Favours asymptomatic infection
D DISCUSSION ISCUSSION Proportion of patients with asymptomatic LGV was high in both groups Contacts of STIs more likely to be symptomatic Concurrent syphilis associated with being symptomatic
C CONCLUSIONS ONCLUSIONS High proportion of asymptomatic LGV in MSM regardless of HIV status No factors identified to enable selective screening in HIV ve MSM Consider routine LGV testing in all MSM with rectal chlamydia regardless of symptoms
