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The lymphogranuloma venereum (LGV) outbreak described in the Netherlands in 2003, increased the interest in the genotyping of Chlamydia trachomatis. Although international surveillance programmes were implemented, these studies slowly decreased in the following years. Now data have revealed a new accumulation of LGV cases in those European countries with extended surveillance programmes. Between March 2009 and November 2011, a study was carried out to detect LGV cases in Madrid. The study was based on screening of C. trachomatis using commercial kits, followed by real-time pmpH-PCR discriminating LGV strains, and finally ompA gene was sequenced for phylogenetic reconstruction. Ninety-four LGV infections were identified. The number of cases increased from 10 to 30 and then to 54 during 2009-2011. Incidence of LGV was strongly associated with men who have sex with men; but in 2011, LGV cases were described in women and heterosexual men. Sixty-nine patients were also human immunodeficiency virus (HIV) positive, with detectable viral loads at the moment of LGV diagnosis, suggesting a high-risk of co-transmission. In fact, in four patients the diagnosis of HIV was simultaneous with LGV infection. The conventional treatment with doxycycline was prescribed in 75 patients, although in three patients the treatment failed. The sequencing of the ompA gene permitted identification of two independent transmission nodes. One constituted by 25 sequences identical to the L2b variant, and a second node including 37 sequences identical to L2. This epidemiological situation characterized by the co-circulation of two LGV variants has not been previously described, reinforcing the need for screening and genotyping of LGV strains.

Background The preventive effect which tenofovir/emtricitabine could have against SARS-CoV-2 in HIV-negative people is unknown. The objective of this study was to analyse the seroprevalence and clinical manifestations of COVID-19 among users of PrEP, TDF/FTC or TAF/FTC, and to compare it to that of a control group. Methods Observational descriptive study of the seroprevalence of antibodies for SARS-CoV-2 among men who have sex with men and transgender women without use of PrEP(Group1;n=250) and PrEP users with TDF/FTC(n=409) or TAF/FTC(n=91) (Group2;n=500), conducted from 11-May-2020 to 27-Jun-2020. All were provided with a structured questionnaire which collected information on the variables to be analysed and testing for IgG antibodies to SARS-CoV-2 (CMIA) was then carried out. Results The seroprevalence of SARS-CoV-2 was 9·2%(95% CI: 5·9-13·5) in the group without PrEP and 15.0%(95% CI: 12·0-18·4) in the group with PrEP(p=0·026). Among users of TDF/FTC it was 14.7%(95% CI: 11·4-18·5) and in users of TAF/FTC it was 16·5%(95% CI: 9·5-25·7)(p=0·661). In those positive for SARS-CoV-2 receiving PrEP, 57·4% manifested symptoms compared to 78·3% in the control group (p=0·070). In users of TDF/FTC the figure was 53·3% and TAF/FTC 73·3%(p=0·100). The duration of symptoms was 11·5 days in the control group, 9·0 in PrEP users(p=0·116), 7·0 in users of TDF/FTC and 13·0 in users of TAF/FTC(p = 0·100). Conclusion Users of PrEP, TDF/FTC or TAF/FTC presented a higher seroprevalence to SARS-CoV-2 than the control group. No statistically significant differences were found in relation to clinical manifestations. PrEP users should use the same prevention measures as those indicated for the general population.

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