Characteristics of rectal chlamydia among men who have sex with men in southern Taiwan, 2020–2022: An emerging threat of rectal lymphogranuloma venereum L2b

Chin Shiang Tsai, Po Lin Chen, Nan Yao Lee, Huey Pin Tsai, Sung Hsi Huang, Szu Ying Chen, Yu Wen Tang, Yen Chun Lin, Pei Fang Tsai, Lin Wen Mao, Shu Li Su, Jiun Ling Wang, Wen Chien Ko

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Background: The prevalence of rectal chlamydia among men who have sex with men (MSM) without human deficiency virus infection (non-HIV) remains uncertain in Taiwan, and rectal lymphogranuloma venereum (LGV) among MSM has never been reported in the Far East. Material and methods: From January 2020 to April 2022, MSM coming for anonymous voluntary counseling and testing, for pre-exposure prophylaxis, and for antiretroviral therapy were enrolled. All participants submitted his fecal samples and completed a QR-code questionnaire. Medical records of those who took regular medical visits for HIV were recorded. Multiplex polymerase chain reaction (PCR) was performed for all fecal samples, and ompA gene sequencing was therefore performed for each Chlamydia-positive fecal sample. Results: Among 341 MSM during 2020–2022 in southern Taiwan, 21 (6.2%) had rectal chlamydia infection. Risk factors of rectal chlamydia included co-infection with rectal gonorrhea (adjusted odds ratio [AOR] 6.78, 95% confidence interval [CI] 1.44–31.91, P = 0.015) and multiple sexual partners (AOR 1.373, 95% CI 1.002–1.882, P = 0.048). Further ompA gene sequencing from 19 Chlamydia-positive fecal samples revealed that the prevalent genotypes or genovariants were Da (26.3%) and L2b (26.3%), followed by B (21.1%), J (14.3%), and G (9.5%). All cases of rectal LGV genovariant L2b presented as acute proctitis with diarrhea, anal pain, or discharge and were treated successfully with prolonged treatment of doxycycline. Conclusions: Rectal gonorrhea and multiple sexual partners are risk factors for rectal chlamydia. Clinicians in Taiwan should be aware of the emerging threat of rectal LGV among MSM with acute proctitis.

Original languageEnglish
Pages (from-to)408-415
Number of pages8
JournalJournal of Microbiology, Immunology and Infection
Volume56
Issue number2
DOIs
Publication statusPublished - 2023 Apr

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • General Immunology and Microbiology
  • Microbiology (medical)
  • Infectious Diseases

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