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Rectal lymphogranuloma venereum in San Francisco in the 1980s

Abstract number: o390

Schachter  J., Moncada  J., Spaargaren  J.

Objective: 

To present the results of diagnostic testing for LGV proctitis in MSM in San Francisco in the 1980s, and the typing of the isolates, in the context of the "outbreak" of LGV proctitis described in 2003–2005, initially in The Netherlands, and then elsewhere.

Methods: 

Rectal swabs were collected from MSM being seen for proctitis in medical clinics in San Francisco. Attempts to isolate Chlamydia trachomatis were made in cycloheximide treated L cells. In the 1980s LGV strains were differentiated from the trachoma biovar by growth characteristics (not requiring centrifugation). In 2005, 51 LGV isolates that were still available were sent to Amsterdam, and tested by PCR, and by sequencing of ompA genes for typing.

Results: 

Isolation and typing results are shown in the Table. Early in the 1980s chlamydiae were commonly recovered from proctitis cases, but the isolation rate dropped from about 1/3 of cases to < 10% by 1984. Throughout this time, LGV strains were about 2/3 of the isolates. In 2005 modern molecular methods confirmed the earlier biological identification of LGV biovars. All 51 San Francisco isolates were positive for LGV variants by real-time PCR. By sequencing variable segment 2 of the ompA gene (VS-2), we identified 15 as L1, 18 as L2 prototype, and 18 as the L2b genovariant (Spaargaren, et al, Emerg Infect Dis, 2005).

Conclusions: 

Chlamydiae were commonly recovered from rectal swabs from MSM with proctitis in the early 1980s. But the isolation rate dropped from about 1/3 in the early 1980s to < 10% in 1984. Throughout the time, about 2/3 of the isolates were LGV. L2b, thought to be a "new" strain when it was first identified in The Netherlands, as the major cause of the recent outbreak was actually about 1/3 of the isolates obtained in San Francisco > 20 years ago. These results suggest that chlamydiae became less common as causes of proctitis as the gay community modified its behaviour in response to AIDS; that LGV proctitis was common then and likely maintained by a core group that continued risky behaviours, and may have expanded in recent years with the relaxation of safe-sex behaviours and the concomitant increase in STDs.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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