Objective: To determine the prevalence of lymphogranuloma venereum (LGV) and non-LGV associated serovars of urethral and rectal Chlamydia trachomatis (CT) infection in men who have sex with men (MSM).
Design: Multicentre cross-sectional survey.
Setting: Four genitourinary medicine clinics in the United Kingdom from 2006–7.
Subjects: 4825 urethral and 6778 rectal samples from consecutive MSM attending for sexual health screening.
Methods: Urethral swabs or urine and rectal swabs were tested for CT using standard nucleic acid amplification tests. Chlamydia-positive specimens were sent to the reference laboratory for serovar determination.
Main outcome: Positivity for both LGV and non-LGV associated CT serovars; proportion of cases that were symptomatic.
Results: The positivity (with 95% confidence intervals) in rectal samples was 6.06% (5.51% to 6.66%) for non-LGV CT and 0.90% (0.69% to 1.16%) for LGV; for urethral samples 3.21% (2.74% to 3.76%) for non-LGV CT and 0.04% (0.01% to 0.16%) for LGV. The majority of LGV was symptomatic (95% of rectal, one of two urethral cases); non-LGV chlamydia was mostly symptomatic in the urethra (68%) but not in the rectum (16%).
Conclusions: Chlamydial infections are common in MSM attending for sexual health screening, and the majority are non-LGV associated serovars. We did not identify a large reservoir of asymptomatic LGV in the rectum or urethra. Testing for chlamydia from the rectum and urethra should be included for MSM requesting a sexual health screen, but serovar-typing is not indicated in the absence of symptoms. We have yet to identify the source of most cases of LGV in the UK.
Statistics from Altmetric.com
See Editorial, p 157
Funding: This work was funded through the Health Protection Agency and local NHS trusts as part of the investigation of the outbreak of LGV.
Competing interests: HW is editor of the journal, Sexually Transmitted Infections. All other authors declare no conflicts of interest.
Presentation: Some of these data were presented at the 17th International Society for Sexually Transmitted Disease Research (ISSTDR) conference in Seattle, Washington, USA, on 29 July–1 August 2007.
Contributors: HW, SA, PF, JW and CAI conceived of and planned the study; SA and CAI oversaw testing at the STBRL; CC, CL, JP and WT oversaw testing and processing of specimens in local laboratories; GD, PF, DI and JW oversaw the clinical investigation and retrieved patient data; HW produced the initial draft of the manuscript; all authors revised and approved the manuscript.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.