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The Resurgence of Lymphogranuloma Venereum: Changing Presentation of Lymphogranuloma Venereum in the Era of HIV Preexposure Prophylaxis, 2004 to 2022.

Authors :
Gupta, Amit K.
Lyons, Brody
Hunter, Ian
Arnold, Barbra
Gilbert, Mark
Hoang, Linda
Malleson, Sarah
Ryan, Venessa
Romney, Marc G.
Severini, Alberto
Jason Wong
Grennan, Troy
Source :
Sexually Transmitted Diseases. Apr2024, Vol. 51 Issue 4, p233-238. 6p.
Publication Year :
2024

Abstract

Background: Before the early 2000s, the sexually transmitted infection lymphogranuloma venereum (LGV) was rare in high-income countries. Initially, most cases in these countries were among symptomatic men who have sex with men (MSM) living with HIV. In the context of widespread HIV preexposure prophylaxis (PrEP), LGV's epidemiology may be changing. We aimed to characterize the epidemiology and clinical presentation of LGV in the PrEP era. Methods: Aretrospective chart reviewwas performed on all LGVcases occurring between November 2004 to October 2022 in British Columbia (BC), Canada. Cases were stratified by having occurred before (2004-2017) or after widespread PrEP availability in BC (2018-2022). Annual rates and test positivity percentages were calculated. Bivariate logistic regression was performed to identify drivers of asymptomatic infection in the PrEP era. Results: Among 545 cases identified, 205 (37.6%) occurred pre-PrEP and 340 (62.4%) occurred during the PrEP era. Most cases were among MSM (97.2%). The estimated rate of LGV has doubled from 2018 to 2022, reaching 1535.2 cases per 100,000 PrEP users. Most PrEP-era cases were among HIV-negative individuals (65.3%), particularly those on PrEP (72.6%). Cases in the PrEP era were often asymptomatic compared with pre-PrEP (38.6% vs. 19.3%; P < 0.001). Users of PrEP were more likely to experience asymptomatic infection compared with HIV-negative PrEP nonusers (odds ratio, 2.07; 95% confidence interval, 1.07-3.99). Conclusions: In the context of increased asymptomatic testing, LGV may be increasing in BC. Most infections now occur among HIV-negative MSM. A high proportion of infections are asymptomatic. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
01485717
Volume :
51
Issue :
4
Database :
Academic Search Index
Journal :
Sexually Transmitted Diseases
Publication Type :
Academic Journal
Accession number :
176969262
Full Text :
https://doi.org/10.1097/OLQ.0000000000001944