TY - JOUR
T1 - Challenges presented by re-emerging sexually transmitted infections in HIV positive men who have sex with Men
T2 - An observational study of lymphogranuloma venereum in the UK
AU - Rönn, Minttu
AU - Hughes, Gwenda
AU - Simms, Ian
AU - Ison, Cathy
AU - Alexander, Sarah
AU - White, Peter J.
AU - Ward, Helen
N1 - Publisher Copyright:
© 2014 Rönn M, et al.
PY - 2014/8/1
Y1 - 2014/8/1
N2 - Background: United Kingdom has reported the largest documented outbreak of lymphogranuloma venereum (LGV), a re-emerging sexually transmitted infection (STI) which is primarily seen in HIV-positive men who have sex with men (MSM). A diagnostic service was established in response to the outbreak linked to a voluntary LGV Enhanced Surveillance system. We examined the performance of this novel surveillance system to identify utility in tracking a re-emerging infection.Methods: We described laboratory data on samples and surveillance data from case reports for LGV from 2004- 2010. We performed a cross-sectional analysis comparing clinical and behavioural characteristics of HIV-positive and HIV-negative/unknown LGV cases diagnosed in MSM using multivariable logistic regression models with generalised estimating equations to control for repeat infections.Results: LGV Surveillance data were available for 87% (1,370/1,581) of LGV cases (after de-duplication). There were 1,342 episodes in 1,281 MSM, most of whom were known to be HIV-positive (1,028/1,281, 80.2%,). HIV-positive men reported a shorter duration of symptoms (aOR 0.5; 95%CI 0.3, 0.8 for reporting more than a week compared to a week or less) in comparison to HIV-negative/unknown MSM, and were more likely to report unprotected receptive anal intercourse (aOR 2.7; 95% CI 1.3, 5.8).Conclusion: The surveillance identified the population at greater risk of infection based on higher levels of risk behaviour in HIV-positive LGV cases. However, there was diagnostic bias towards HIV-positive LGV cases who presented with a shorter duration of symptoms when compared to HIV-negative/unknown LGV cases.
AB - Background: United Kingdom has reported the largest documented outbreak of lymphogranuloma venereum (LGV), a re-emerging sexually transmitted infection (STI) which is primarily seen in HIV-positive men who have sex with men (MSM). A diagnostic service was established in response to the outbreak linked to a voluntary LGV Enhanced Surveillance system. We examined the performance of this novel surveillance system to identify utility in tracking a re-emerging infection.Methods: We described laboratory data on samples and surveillance data from case reports for LGV from 2004- 2010. We performed a cross-sectional analysis comparing clinical and behavioural characteristics of HIV-positive and HIV-negative/unknown LGV cases diagnosed in MSM using multivariable logistic regression models with generalised estimating equations to control for repeat infections.Results: LGV Surveillance data were available for 87% (1,370/1,581) of LGV cases (after de-duplication). There were 1,342 episodes in 1,281 MSM, most of whom were known to be HIV-positive (1,028/1,281, 80.2%,). HIV-positive men reported a shorter duration of symptoms (aOR 0.5; 95%CI 0.3, 0.8 for reporting more than a week compared to a week or less) in comparison to HIV-negative/unknown MSM, and were more likely to report unprotected receptive anal intercourse (aOR 2.7; 95% CI 1.3, 5.8).Conclusion: The surveillance identified the population at greater risk of infection based on higher levels of risk behaviour in HIV-positive LGV cases. However, there was diagnostic bias towards HIV-positive LGV cases who presented with a shorter duration of symptoms when compared to HIV-negative/unknown LGV cases.
KW - HIV
KW - Lymphogranuloma venereum
KW - Men who have sex with men
KW - Surveillance
UR - http://www.scopus.com/inward/record.url?scp=84907513615&partnerID=8YFLogxK
U2 - 10.4172/2155-6113.1000329
DO - 10.4172/2155-6113.1000329
M3 - Article
AN - SCOPUS:84907513615
SN - 2155-6113
VL - 5
SP - 1
EP - 7
JO - Journal of AIDS and Clinical Research
JF - Journal of AIDS and Clinical Research
IS - 8
ER -