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P490 LGV in patients attending an STI outpatient clinic in berlin: an urban emergence with high proportion of HIV-coinfections
  1. Slobodan Ruzicic,
  2. Arne Jessen,
  3. Heiko Jessen
  1. Praxis Jessen, Berlin, Germany


Background Lymphogranuloma venereum (LGV) is the infection of the lymphatic system caused by Chlamydia trachomatis (CT) serovars L1-L3. The first emergence of LGV in networks of men, who have sex with men (MSM) began in Europe (2003), followed by a series of outbreaks worldwide. In the absence of national passive surveillance systems for LGV, we evaluated prevalence and characteristics of LGV in a high-risk population (MSM) attending a STI Outpatient Clinic in Berlin.

Methods We performed a retrospective analysis of all tested CT samples (pharyngeal, urethral, rectal) from 2012–2017. All positive rectal samples underwent additional testing for L1-L3 genotype. For this purpose a PCR was performed of a L-specific region (polymorphic H-gene).

Results A total of 12,390 samples (5,316 patients) were collected and resulted in 486 L+ swabs (191 patients). The number of tested swabs increased from 1,370 (2012) to 3,634 (2017). The proportion of CT+ swabs fluctuated between 10% and 15%. Among the CT+ patients, the proportion of L+ patients decreased continuously from 37% (2012) to 21% (2017). The majority of patients tested were male, between 26–35 years of age. We observed the highest rate of L-infections in older patients (maximum in the age-group 46–55 years, CT+/L+ 46%). The majority of patients infected with L+ came from central metropolitan districts. The HIV-coinfection rate among CT+ patients decreased continuously from 39% (2012) to 12% (2017). The proportion of HIV+ patients among L+ patients remained high and decreased from 80% (2012) to 50% (2017).

Conclusion Our data display the largest epidemiological development of LGV in Germany and demonstrate a high prevalence of genotype L1-L3, which require a prolonged antibiotic treatment compared to other CT serotypes. As the routine screening of anorectal swabs in high-risk population is still not recommended, our results strongly suggest a need for genotyping positive CT rectal specimens.

Disclosure No significant relationships.

  • HIV
  • co-infections
  • chlamydia

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