Resum

Background: Quantify rates and describe epidemiological characteristics of patients infected with Chlamydia trachomatis (CT) lymphogranuloma venereum (LGV) associated serovars, in people with high-risk sexual practices, by directed or systematic search, of this pathogen, in people attended at a Sexually Transmitted Diseases (STDs) Clinic, in Madrid. Methods: Between June 2009 and August 2010, 1025 rectal swabs were processed for diagnosis of CT infection; commercial real-time PCR based methods were used. To specifically detect L1, L2 and L3 serovars, and in-house real-time PCR was used. Nested-PCR and sequencing of ompA gene was performed for confirmation of previous results. Epidemiological characteristics were collected following a structured questionnaire. Results: Of the 1025 samples tested, 156 (15%) were positive for CT, 34 (3% overall and 21.8% of positive samples) yielded a positive result for LGV. The average age of LGV cases was 34 years. They were all men who have sex with men (MSM) and 91% were HIV positive. 89% had previous history of STDs (syphilis 50%, gonococcal urethritis 41%, among more common). 73.6% had concomitant STDs, of these, 38% syphilis and 23,5% gonococcal proctitis. All of them had practiced unprotected anal intercourse and 3% fisting. 53% had practice sex under the influence of alcohol and non-injected drugs. Conclusion: Although LGV infection has been previously considered an infection from endemic areas, this work demonstrates that like in other Western countries, the L2b serovar of CT is present in population at risk in Madrid. Main group affected are homo / bisexual men with HIV infection. Systematic studies are needed to specifically detect LGV-associated serovars in patients with Chlamydia trachomatis infection. It is advisable to perform HIV serology and screening for other STIs in patients diagnosed with LGV. (Resumen de los autores)