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Chlamydia trachomatis genovariant L2b in men who have sex with men in Taiwan, 2020–2023
  1. Chin-Shiang Tsai1,
  2. Bo-Yang Tsai2,
  3. Sung-Hsi Huang3,
  4. Miao-Hui Huang4,
  5. Guan-Jou Chen5,
  6. Chi-Ying Lin6,
  7. Chien-Ching Hung7,
  8. Wen-Chien Ko1
  1. 1Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  2. 2Institute of Basic Medical Sciences, National Cheng Kung University, College of Medicine, Tainan, Taiwan
  3. 3Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
  4. 4Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
  5. 5Division of Infectious Diseases and Infection Control Room, Min Sheng General Hospital, Taoyuan, Taiwan
  6. 6Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
  7. 7Departmentof Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  1. Correspondence to Dr Wen-Chien Ko; winston3415{at}gmail.com

Abstract

Objectives Lymphogranuloma venereum (LGV) caused by Chlamydia trachomatis genotypes L1–L3 has been resurging among men who have sex with men (MSM) and people with HIV (PWH) in Western countries. While historically attributed to tropical regions, rectal LGV has been rarely recognised in Asia, with Taiwan recently becoming the second Asian country to report cases.

Methods A multicentre, laboratory-based surveillance was conducted from January 2020 to December 2023 in Taiwan. Specimens were collected from MSM through syndromic testing and screening of high-risk populations. C. trachomatis was identified using commercial multiplex PCR assays, with genotyping performed through ompA gene sequencing. LGV-positive samples underwent multilocus sequence typing (MLST) following established protocols.

Results Among 446 C. trachomatis-positive samples, 391 (87.7%) underwent successful ompA sequencing. Genovariant L2b accounted for 9.7% of cases, predominantly among PWH with rectal chlamydia (18.2%). PWH accounted for 85.7% of all genovariant L2b cases. Of 38 genovariant L2b samples from 35 cases, 34 (84.2%) samples completed MLST, revealing sequence type (ST) 53 as the predominant strain (74%). ST39 and ST63 were identified as unreported STs in Western countries, along with previously reported ST58. The four identified STs formed a cluster.

Conclusions Our findings indicate the clonal spread of C. trachomatis L2b-ST53 among MSM in Taiwan, primarily affecting PWH. The predominance of ST53 suggests potential international and domestic spread, indicative of the need for enhanced surveillance.

  • LYMPHOGRANULOMA VENEREUM
  • Chlamydia Infections
  • Homosexuality, Male
  • MOLECULAR TYPING

https://doi.org/10.1136/sextrans-2024-056477

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    Footnotes

    • Handling editor Vita Willemijn Jongen

    • C-CH and W-CK contributed equally.

    • Contributors C-ST is the first author. C-CH and W-CK had equal contributions and they planned the study. B-YT completed the experiment. S-HH, G-JC and M-HH collected the samples and clinical information. C-ST wrote the manuscript. C-CH and W-CK reviewed the article. All authors approved the final manuscript. C-ST submitted the manuscript. W-CK is the author responsible for the overall content as the guarantor.

    • Funding This research was supported by the National Science and Technology Council, Taiwan (NSTC111-2629-B-006-003-MY2 and 113-2321-B-006-007).

    • Competing interests None declared.

    • Patient and public involvement statement This research did not directly involve patients or the public in its design or conduct phases. The study was a laboratory-based surveillance project focusing on molecular epidemiology of C. trachomatis among MSM and PWH. The research questions and outcome measures were developed based on clinical observations and gaps in regional epidemiological knowledge rather than through patient consultation. Participants were recruited through routine clinical care and surveillance at participating hospitals, but were not involved in the study design or implementation. The burden of participation was not specifically assessed with patients, as samples were collected as part of routine clinical care or existing surveillance programmes. The outcomes of this research will be shared with relevant patient groups and healthcare providers through appropriate channels.

    • Provenance and peer review Not commissioned; externally peer reviewed.