Sexually transmitted diseases · 2026
Clinical Characteristics and Trends of Lymphogranuloma Venereum Versus Non-LGV Chlamydia trachomatis Anorectal Infections: A Six-Year Retrospective Study.
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Sangorrin-Lapieza Loreto, Castaño-Amores María Victoria, Rial-Crestelo David, De Lagarde María, Bisbal Otilia, Martín-Torres Juan, López-Roa Paula
Аннотация
BACKGROUND: Chlamydia trachomatis (CT) is a common cause of anorectal infections, with L1-L3 serovars leading to lymphogranuloma venereum (LGV), a more severe invasive clinical syndrome. This study aimed to estimate the prevalence and temporal trends of LGV and non-LGV anorectal CT infections, and to compare their clinical and epidemiological characteristics in a high-risk population.
METHODS: We conducted a retrospective analysis of anorectal CT infections diagnosed at Hospital Universitario 12 de Octubre, a high-complexity healthcare center in Madrid, Spain, between January 2019 and December 2024. All CT-positive samples were further tested to differentiate LGV from non-LGV serovars. Demographic, clinical, and behavioral data were collected and compared between groups.
RESULTS: Throughout the study period, the number of tests performed increased substantially, whereas the overall CT positivity rate declined. Among 8690 samples, 719 (8.3%) were CT-positive, with 236 (32.8%) confirmed as LGV. The proportion of LGV among CT-positive cases increased over time. Most LGV cases occurred in men who have sex with men (92.4%) and people living with human immunodeficiency virus (72.0%). LGV infections were more frequently symptomatic compared to non-LGV cases (58.4% vs 19.0%, P < 0.001), and were more commonly associated with co-infections such as Neisseria gonorrhoeae (38.1%) and syphilis (22.4%). High-risk behaviors, including chemsex and multiple concurrent sexual partners, were significantly more prevalent among individuals with LGV.
CONCLUSIONS: This study highlights that, despite a decline in overall CT positivity with increased testing, the proportion of LGV cases has risen in high-risk populations. LGV is more common among men who have sex with men and people living with human immunodeficiency virus, and is linked to more symptoms, co-infections, and risky sexual behaviors.
METHODS: We conducted a retrospective analysis of anorectal CT infections diagnosed at Hospital Universitario 12 de Octubre, a high-complexity healthcare center in Madrid, Spain, between January 2019 and December 2024. All CT-positive samples were further tested to differentiate LGV from non-LGV serovars. Demographic, clinical, and behavioral data were collected and compared between groups.
RESULTS: Throughout the study period, the number of tests performed increased substantially, whereas the overall CT positivity rate declined. Among 8690 samples, 719 (8.3%) were CT-positive, with 236 (32.8%) confirmed as LGV. The proportion of LGV among CT-positive cases increased over time. Most LGV cases occurred in men who have sex with men (92.4%) and people living with human immunodeficiency virus (72.0%). LGV infections were more frequently symptomatic compared to non-LGV cases (58.4% vs 19.0%, P < 0.001), and were more commonly associated with co-infections such as Neisseria gonorrhoeae (38.1%) and syphilis (22.4%). High-risk behaviors, including chemsex and multiple concurrent sexual partners, were significantly more prevalent among individuals with LGV.
CONCLUSIONS: This study highlights that, despite a decline in overall CT positivity with increased testing, the proportion of LGV cases has risen in high-risk populations. LGV is more common among men who have sex with men and people living with human immunodeficiency virus, and is linked to more symptoms, co-infections, and risky sexual behaviors.