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Original article
Highly diverse MLVA-ompA genotypes of rectal Chlamydia trachomatis among men who have sex with men in Brighton, UK and evidence for an HIV-related sexual network
  1. Clare Labiran1,
  2. Peter Marsh2,
  3. Judith Zhou3,
  4. Alan Bannister3,
  5. Ian Nicholas Clarke1,
  6. Stephanie Goubet4,
  7. Suneeta Soni3
  1. 1Department of Molecular Microbiology, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
  2. 2Public Health England, Public Health Laboratory Southampton, Southampton General Hospital, Southampton, UK
  3. 3Claude Nicol Clinic, Royal Sussex County Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  4. 4Clinical Investigation Research Unit, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  1. Correspondence to Dr Peter Marsh, Public Health England, Public Health Laboratory Southampton, Mailpoint 13, Southampton General Hospital, Southampton SO16 6YD, UK; peter.marsh{at}uhs.nhs.uk

Abstract

Objectives In this prospective study, we aimed to determine the distribution of genotypes by multilocus variable number tandem repeat (VNTR) analysis plus analysis of the ompA gene (MLVA-ompA) of rectal Chlamydia trachomatis among men who have sex with men (MSM) attending Brighton Genitourinary Medicine (GUM) Clinic and to examine any correlations with clinical variables, including HIV status, and to isolate rectal C. trachomatis cultures maximising the possibility of obtaining complete genotyping data.

Methods Samples were assigned genotypes by PCR and sequencing of the markers of the MLVA-ompA genotyping system. Rectal C. trachomatis was isolated in cell culture using McCoy cells. Data regarding demographics, HIV status, rectal symptoms and history of sexually transmitted infections, including C. trachomatis, were collected.

Results 1809 MSM attending the clinic between October 2011 and January 2013 took part in the study, 112 (6.2%) of whom had rectal samples that tested positive for C. trachomatis. 85/112 (75.9%) C. trachomatis-positive rectal samples were assigned 66 different genotypes. Two distinct genotype subclusters were identified: subcluster 1 consisted of more HIV-negative men than subcluster 2 (p=0.025), and the MLVA-ompA genotypes in these subclusters reflected this. Isolates were successfully cultured from 37 of the 112 specimens, from which 27 otherwise unobtainable (from direct PCR) MLVA-ompA genotypes were gained.

Conclusions The most prevalent genotypes were G, E and D representing some overlap with the heterosexual distribution in UK. Subcluster 1 consisted of more ‘heterosexual genotypes’ and significantly more HIV-negative men than subcluster 2, associated with ‘MSM genotypes’. There was a higher diversity of C. trachomatis strains among MSM in Brighton than observed in other cities.

  • CHLAMYDIA TRACHOMATIS
  • SEXUAL BEHAVIOUR
  • HIV
  • MOLECULAR EPIDEMIOLOGY
  • GAY MEN

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