{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T05:42:01Z","timestamp":1788586921199,"version":"build-2803163510"},"reference-count":30,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2020,9,27]]},"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Lymphogranuloma venereum (LGV) is an STI caused by<jats:italic>Chlamydia trachomatis<\/jats:italic>serovars L1-L3. In Europe, the current epidemic is caused mainly by L2b genovariant, although increasing cases associated with other L2 variants have been reported. Here, we assessed the distribution of rectal LGV genovariants among men having sex with men (MSM) in Italy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 2016 to 2020, all the anorectal swabs collected from MSM attending the STI Clinic of St. Orsola-Malpighi Hospital in Bologna and positive for<jats:italic>C. trachomatis<\/jats:italic>were stored. LGV infection was confirmed by a<jats:italic>pmpH<\/jats:italic>PCR, and, subsequently, a fragment of the<jats:italic>ompA<\/jats:italic>gene was amplified and sequenced. Sequences were aligned to reference strains representing different LGV variants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LGV cases accounted for one-third of all chlamydial rectal infections with a total prevalence of 4.1% (76\/1852). Total number of LGV cases per year remained constant. LGV was mainly found in symptomatic patients (&gt;65%), older than 30 years, with a high burden of other STIs (63.7% HIV-positive, 35.5% with concurrent rectal gonorrhoea, 19.7% with early syphilis). A decreasing trend in HIV-LGV co-infection was noticed over time. Three main LGV genovariants were detected (L2f, 46.1%; L2b, 23.0%; L2-L2b\/D-Da, 16.9%), together with other known L2b variants (mainly L2bV2 and L2bV4). Two novel L2b<jats:italic>ompA<\/jats:italic>variants with non-synonymous single-nucleotide polymorphisms were found. Over time, the percentage of L2f cases dropped gradually, with a significant increase in L2-L2b\/D-Da cases (p=0.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In our area, LGV is endemic among MSM with different circulating genovariants. Active surveillance and genotyping programmes are needed to reduce re-establishing of LGV infection.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2020-054700","type":"journal-article","created":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T21:26:21Z","timestamp":1603747581000},"page":"441-445","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Lymphogranuloma venereum genovariants in men having sex with men in Italy"],"prefix":"10.1136","volume":"97","author":[{"given":"Antonella","family":"Marangoni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7253-8799","authenticated-orcid":false,"given":"Claudio","family":"Foschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Tartari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Gaspari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Carla","family":"Re","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,10,26]]},"reference":[{"key":"2024092104100707000_97.6.441.1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e31815d6df8"},{"key":"2024092104100707000_97.6.441.2","doi-asserted-by":"crossref","DOI":"10.1186\/1756-0500-7-225","article-title":"Prevalence and predictors of lymphogranuloma venereum in a high risk population attending a STD outpatients clinic in Italy","volume":"7","author":"Foschi","year":"2014","journal-title":"BMC Res 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prevalence-associated major antigen signature","volume":"5","author":"Borges","year":"2019","journal-title":"Microb Genom"},{"key":"2024092104100707000_97.6.441.16","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2008.032862"},{"key":"2024092104100707000_97.6.441.17","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052178"},{"key":"2024092104100707000_97.6.441.18","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000781"},{"key":"2024092104100707000_97.6.441.19","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1099\/jmm.0.000261","article-title":"Chlamydia trachomatis infection prevalence and serovar distribution in a high-density urban area in the North of Italy","volume":"65","author":"Foschi","year":"2016","journal-title":"J Med 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Emergence of the lymphogranuloma venereum L2c genovariant, Hungary, 2012 to 2016. Euro Surveill 2017;22.doi:10.2807\/1560-7917.ES.2017.22.5.30455","DOI":"10.2807\/1560-7917.ES.2017.22.5.30455"},{"key":"2024092104100707000_97.6.441.25","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-017-2484-8","article-title":"Inguinal and anorectal lymphogranuloma venereum: a case series from a sexually transmitted disease center in Rome, Italy","volume":"17","author":"Latini","year":"2017","journal-title":"BMC Infect Dis"},{"key":"2024092104100707000_97.6.441.26","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2015-052453"},{"key":"2024092104100707000_97.6.441.27","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2019-054346"},{"key":"2024092104100707000_97.6.441.28","unstructured":"European Centre for Disease Prevention and Control . Annual epidemiological report 2015\u2013Lymphogranuloma venereum. 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