Proctitis and Chlamydia trachomatis and Neisseria gonorrhoeae Anorectal Infection in MSM – A Retrospective Study
Abstract
Introduction: Sexually transmitted infections (STI) among men who have sex with men (MSM) have increased in recent years, particularly those caused by Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), both responsible for proctitis and anorectal infections.
Methods: Retrospective analysis of the frequency of proctitis and NG and CT anorectal infection in 2420 MSM observed in Outpatient Clinic of STD of Lapa Health Center in Lisbon, Portugal, between January 2008 and December 2013. Sociodemographic, behavioral, clinical and laboratory data were assessed.
Results: proctitis was identified in 1.6% (38 / 2420) of MSM. In 39.4% (15/38) of these patients, no infectious agent was identified. In 38 (16%) of the 238 MSM with NG infection, this agent had an anorectal location; this anatomical site was infected by CT in 23 (14.6%) of the 158 positive MSM. L2b genotype was identified in 7 of these 23 patients (30.4%). Anorectal infections were more frequent in immigrants, patients with a previous STI and with multiple sexual partners. The high frequency of MSM with anorectal infection that are asymptomatic or have no signs of proctitis should be emphasized: 55.3% (21/38) and 47.8% (11/23) of patients with NG and CT infection, respectively.
Conclusions: The frequency of asymptomatic anorectal infection by CT and NG among MSM in Lapa Health Center is similar to that described in other countries and emphasizes the importance of screening these agents (including LGV strains) in anorectal swabs in MSM with receptive anal intercourse.
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