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. 2018 Feb 1;44(2):55-61.
doi: 10.14745/ccdr.v44i02a04.

Lymphogranuloma venereum in Quebec: Re-emergence among men who have sex with men

C A Boutin  1 , S Venne  2 , M Fiset  2 , C Fortin  1   3 , D Murphy  3 , A Severini  4 , C Martineau  1   3 , J Longtin  3 , A C Labbé  1   3
Affiliations

Lymphogranuloma venereum in Quebec: Re-emergence among men who have sex with men

C A Boutin et al. Can Commun Dis Rep. .

Abstract

Background: Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) caused by Chlamydia trachomatis genotypes L1, L2 and L3. This LGV is associated with significant morbidity and increased risk of HIV transmission. While fewer than two cases per year were reported in Quebec before 2005, LGV emerged in 2005-2006 with 69 cases, followed by a period of low incidence (2007-2012), and subsequent re-emergence since 2013.

Objectives: To describe the incidence of LGV in Quebec and the characteristics of the affected population, including demographics and risk factors, clinical manifestations, laboratory tests, treatments and reinfection rates.

Methods: Descriptive data were collected from the notifiable diseases records through the Institut national de santé publique du Québec (INSPQ) infocentre portal. Questionnaires were obtained through the enhanced surveillance system and transmitted anonymously to the Quebec Ministry of Health. In-depth analysis was performed on cases from 2013 to 2016.

Results: There were 338 cases of LGV over the four-year period in Quebec. All cases were male, excluding one transsexual. Mean age was 41 years. Most lived in Montréal (81%) and were men who have sex with men (MSM; 99%). The majority (83%) reported four sexual partners or more in the last year, met mostly through the Internet (77%) and in saunas (73%). Frequency of sexual intercourse with out-of-province residents decreased in 2013-2016 (27%) compared with 2005-2012 (38%). History of STIs was frequent: 83% were HIV-infected, 81% reported previous syphilis and 78% previous gonorrhea. Recreational drug use was frequent (57%), reaching 71% in 2016. Most cases were symptomatic, a proportion which decreased in 2016 (68%) compared with 2013-2015 (82%; p=0.006). Clinical presentations included proctitis (86%), lymphadenopathy (13%) and ulcer/papule (12%). Reinfections, mostly within two years of first infection, occurred in 35 individuals (10%).Conclusion: The re-emergence of LGV in Quebec involves an urban subpopulation composed almost exclusively of MSM with STIs, who have a high number of partners and often use drugs.

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Conflict of interest statement

Conflict of interest: None.

Figures

Figure 1
Figure 1. Lymphogranuloma venereum among men: annual adjusted rate per 100,000 person years in Quebec, Montréal and outside Montréal, 2005–2016
Abbreviation: p.y., person-year a 2005: Start of enhanced surveillance b September 2014: Asymptomatic cases inclusion c February 2016: Provincial genotyping d June 2016: Systematic genotyping of C. Trachomatis specimens e November 2016: Serology and micro-IF removed
Figure 2
Figure 2. Distribution of clinical manifestations among symptomatic lymphogranuloma venereum cases, Quebec, 2013–2016 (n=234)a
a Of 338 lymphogranuloma venereum cases, clinical presentation was known for 303, of which 69 cases were asymptomatic
See this image and copyright information in PMC

References

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