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Revue Medicale de Bruxelles Oct 1989Several anorectal diseases are described. Most are sexually transmitted (gay bowel syndrome or heterosexual transmission). The clinical aspect of nearly all of them is... (Review)
Review
Several anorectal diseases are described. Most are sexually transmitted (gay bowel syndrome or heterosexual transmission). The clinical aspect of nearly all of them is similar. Thus, the diagnosis usually cannot be done on clinical grounds alone: one has to request the help of the laboratory. Amebiasis, giardiasis, chancroid and donovanosis are frequent in Africa but rare in our countries, except in male homosexuals. Shigellosis, salmonellosis, pediculosis, scabies and campylobacter infections are seen in male homosexuals because of orofecal contacts. Condylomata acuminata are frequent in our country. The typical clinical aspect leads to an easy diagnosis. Electrocoagulation is the treatment of choice. Anorectal gonococcal are also frequent in our country, both homosexually and heterosexually transmitted. The clinical aspect suggests the diagnosis, but this must be confirmed by the laboratory.
Topics: Adult; Anus Diseases; Female; Homosexuality; Humans; Infections; Male; Rectal Diseases; Sexual Behavior; Sexually Transmitted Diseases
PubMed: 2682913
DOI: No ID Found -
Current Problems in Diagnostic Radiology 2012Patients infected with the human immunodeficiency virus, particularly male homosexuals, are prone to develop disorders involving the anorectal and perineal structures.... (Review)
Review
Patients infected with the human immunodeficiency virus, particularly male homosexuals, are prone to develop disorders involving the anorectal and perineal structures. Cross-sectional imaging techniques, such as multidetector computed tomography with multiplanar reformations and magnetic resonance imaging performed with phased-array coils, are increasingly adopted to detect and stage infectious and neoplastic diseases, and to assess posttreatment modifications. Pyogenic perianal sepsis may be usefully investigated with imaging, particularly to assess the presence and topography of abscess collections to allow a correct surgical choice. Rectal inflammatory involvement is frequently detected during intestinal opportunistic infections, such as cytomegalovirus, pseudomembranous, and amebic colitides, including primary and secondary imaging signs consistent with proctocolitis. Anal carcinoma and intestinal lymphoma are increasingly diagnosed; therefore, special attention should be paid to the identification of solid tissue consistent with tumor; furthermore, MRI provides optimal staging and posttreatment follow-up of neoplastic lesions. Knowledge of this varied spectrum of anorectal and perineal opportunistic abnormalities and their imaging appearances should help radiologists to propose appropriate differential diagnoses, suggest correlation with laboratory and microbiological assays or biopsy, and reliably assess therapeutic response.
Topics: AIDS-Related Opportunistic Infections; Acquired Immunodeficiency Syndrome; Adult; Anus Diseases; Female; Humans; Lymphoma, AIDS-Related; Magnetic Resonance Imaging; Male; Middle Aged; Proctitis; Rectal Diseases; Sepsis; Tomography, X-Ray Computed
PubMed: 23009772
DOI: 10.1067/j.cpradiol.2012.03.001 -
Clinical Microbiology and Infection :... Aug 2023Dysbiotic bacterial communities within the vagina are associated with Chlamydia trachomatis infection. We compared the effect of treatment with azithromycin and... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of azithromycin and doxycycline on the vaginal microbiota of women with urogenital Chlamydia trachomatis infection: a substudy of the Chlazidoxy randomized controlled trial.
OBJECTIVES
Dysbiotic bacterial communities within the vagina are associated with Chlamydia trachomatis infection. We compared the effect of treatment with azithromycin and doxycycline on the vaginal microbiota in a cohort of women with a urogenital C. trachomatis infection randomly assigned to one of these treatments (Chlazidoxy trial).
METHODS
We analysed vaginal samples from 284 women (135 in the azithromycin group and 149 in the doxycycline group) collected at baseline and 6 weeks after treatment initiation. The vaginal microbiota was characterized using 16S rRNA gene sequencing and classified into community state types (CSTs).
RESULTS
At baseline, 75% (212/284) of the women had a high-risk microbiota (CST-III or CST-IV). A cross-sectional comparison 6 weeks after treatment showed that 15 phylotypes were differentially abundant, but this difference was not reflected at the CST (p 0.772) or diversity level (p 0.339). Between baseline and the 6-week visit, α-diversity (p 0.140) and transition probabilities between CSTs were not significantly different between the groups, and no phylotype was differentially abundant.
DISCUSSION
In women with urogenital C. trachomatis infection, the vaginal microbiota does not seem to be affected by azithromycin or doxycycline 6 weeks after treatment. Because the vaginal microbiota remains susceptible to C. trachomatis infection (with CST-III or CST-IV) after antibiotic treatment, women remain at risk of reinfection, which could originate from unprotected sexual intercourse or untreated anorectal C. trachomatis infection. This last consideration advocates for the use of doxycycline instead of azithromycin because of its higher anorectal microbiological cure rate.
Topics: Female; Humans; Azithromycin; Doxycycline; Chlamydia trachomatis; RNA, Ribosomal, 16S; Cross-Sectional Studies; Chlamydia Infections; Anti-Bacterial Agents; Vagina; Microbiota; Urinary Tract Infections
PubMed: 37100225
DOI: 10.1016/j.cmi.2023.04.020 -
Genes & Genomics Mar 2022Anorectal condyloma is the representative venereal disease caused by human papilloma virus (HPV), which has more 180 subtypes. Although there are various known risk...
BACKGROUND
Anorectal condyloma is the representative venereal disease caused by human papilloma virus (HPV), which has more 180 subtypes. Although there are various known risk factors for recurrence, few studies have investigated the influence of HPV subtypes.
OBJECTIVE
We aimed to investigate the correlation between the recurrence of anorectal condyloma and HPV subtypes.
METHODS
We analyzed the clinical and histopathological information of 143 patients who underwent surgery for anorectal condyloma at the National Medical Center between March 2016 and September 2020. PCR analyses were performed to confirm the HPV subtype in 24 patients.
RESULTS
Recurrence was confirmed in 63 patients through outpatient follow-up over a median of 31.7 months (range: 0-56.2) after surgery. Recurrence was significantly associated with anorectal condyloma severity (p < 0.001), but there were no differences between the primary and recurrent groups, CD4-positive cell counts, or human immunodeficiency virus loads. The high-risk HPV subtype was associated with a high recurrence rate. Furthermore, the overall recurrence rate in anorectal condyloma patients was 44.1%.
CONCLUSION
These results suggest that recurrence of anorectal condyloma has a significant association with high-risk HPV subtypes. Therefore, it is necessary to check for recurrences during follow-up after surgery.
Topics: Alphapapillomavirus; Condylomata Acuminata; Humans; Papillomaviridae; Papillomavirus Infections; Risk Factors
PubMed: 35150400
DOI: 10.1007/s13258-022-01221-4 -
Japanese Journal of Infectious Diseases 2011To investigate the prevalence and genotype distribution of Chlamydia trachomatis infection among men who have sex with men (MSM), 145 MSM from two sauna settings in...
To investigate the prevalence and genotype distribution of Chlamydia trachomatis infection among men who have sex with men (MSM), 145 MSM from two sauna settings in Shenzhen, China were invited to participate in this study during September 2008 and May 2009. Anorectal swab and urine samples were collected and tested for chlamydial infection, and positive samples were genotyped. The prevalence of anorectal chlamydial infection was 24% in the study population and was significantly associated with proctitis symptoms. Up to 50% of the anorectal infections were asymptomatic. The most prevalent genotypes were G (39%) and D (37%), followed by J (11%). Genotypes related to lymphogranuloma venereum were not found in the study population. The high prevalence of anorectal infection in MSM suggests the importance of detecting and treating the infection in this population.
Topics: Adult; Anal Canal; Asymptomatic Diseases; Bacterial Typing Techniques; Carrier State; China; Chlamydia Infections; Chlamydia trachomatis; Genotype; Homosexuality, Male; Humans; Male; Middle Aged; Molecular Typing; Prevalence; Proctitis; Rectum; Urine
PubMed: 21519129
DOI: No ID Found -
AIDS (London, England) Sep 2017Oral preexposure prophylaxis (PrEP) has been established as a pivotal strategy in HIV prevention. However, bacterial sexually transmitted infections (STIs), such as...
BACKGROUND
Oral preexposure prophylaxis (PrEP) has been established as a pivotal strategy in HIV prevention. However, bacterial sexually transmitted infections (STIs), such as Chlamydia trachomatis and Neisseria gonorrhoeae, are also highly prevalent. Although the presence of STI-related mucosal lesions is a known risk factor for HIV acquisition, the potential increase in risk associated with asymptomatic STIs is not completely understood. Recent data demonstrated higher T-cell activation is a risk factor for sexually acquired HIV-1 infection. We examined the effect of asymptomatic C. trachomatis and N. gonorrhoeae anorectal infection on systemic immune activation, potentially increasing the risk of HIV acquisition.
METHODS
We analyzed samples from participants of PrEP Brasil, a demonstration study of daily oral emtricitabine/tenofovir disoproxil fumarate HIV PrEP among healthy MSM, for T-cell activation by flow cytometry. We included 34 asymptomatic participants with anorectal swab for C. trachomatis and/or N. gonorrhoeae infection, whereas negative for other STIs, and 35 controls.
RESULTS
We found a higher frequency of human leukocyte antigen DRCD38 CD8 T cells (1.5 vs. 0.9%, P < 0.005) and with memory phenotype in the group with asymptomatic C. trachomatis and/or N. gonorrhoeae infection. Exhaustion and senescence markers were also significant higher in this group. No difference was observed in the soluble CD14 levels.
CONCLUSION
Our findings suggest asymptomatic anorectal C. trachomatis and/or N. gonorrhoeae increase systemic immune activation, potentially increasing the risk of HIV acquisition. Regular screening and treatment of asymptomatic STIs should be explored as adjuvant tools for HIV prevention.
Topics: ADP-ribosyl Cyclase 1; Adult; Asymptomatic Diseases; CD8 Antigens; CD8-Positive T-Lymphocytes; Chlamydia Infections; Chlamydia trachomatis; Cross-Sectional Studies; Flow Cytometry; Gonorrhea; HLA-DR Antigens; Humans; Lymphocyte Activation; Male; Membrane Glycoproteins; Neisseria gonorrhoeae; Rectal Diseases; Young Adult
PubMed: 28692536
DOI: 10.1097/QAD.0000000000001580 -
Annals of Internal Medicine May 2023
Topics: Male; Humans; Homosexuality, Male; Monkeypox virus; Paris; Sexual and Gender Minorities; Sexually Transmitted Diseases; France; HIV Infections
PubMed: 37186931
DOI: 10.7326/L23-0023 -
Annals of Internal Medicine May 2023
Topics: Male; Humans; Homosexuality, Male; Monkeypox virus; Paris; Sexual and Gender Minorities; Sexually Transmitted Diseases; France; HIV Infections
PubMed: 37186932
DOI: 10.7326/L23-0022 -
International Journal of STD & AIDS Jul 2023Gay sex workers (GSWs) within the population of men who have sex with men in China are known as money boys (MBs). Limited research has been conducted to investigate the...
BACKGROUND
Gay sex workers (GSWs) within the population of men who have sex with men in China are known as money boys (MBs). Limited research has been conducted to investigate the infection rate and antimicrobial resistance of () among GSWs in China. This study aimed to evaluate the status of infection among in GSWs.
METHODS
This study was performed among 349 GSWs who were followed up for four years by internet-based sampling collection. The participants were asked to complete an online questionnaire using a mobile app, and trained interviewers took urethral, anorectal, and saliva swab specimens. STIs, including HIV and , were detected. Detection of resistance-associated mutations (RAMs) to macrolides and fluoroquinolones was performed via Sanger sequencing of the 23S rRNA, and genes.
RESULTS
GSWs were enrolled by identifying 10 initial "seeds" from the Blued and WeChat apps. Face-to-face interviews were conducted with 349 GSWs from June 2017 to July 2021. The prevalence of and HIV positivity was 92/349 (26.4%, 95% confidence interval [CI] 21.7-31.0) and 71/349 (20.3%, 95% CI 16.3-24.4), respectively. The proportion of GSWs with infection alone in urethral swabs was 16, and the proportion with symptoms was 2/16 (12.5%). The proportion of GSWs with infection alone in anorectal swabs was 36, and the proportion with symptoms was 3/36 (8.3%). Multivariate regression analysis showed that using new types of drugs in the past 3 months and inconsistent condom usage with clients in the past 30 days were associated with infection. Macrolide resistance within the 23S rRNA gene was detected in 73/88 (83.0%) of the -positive GSWs. Moreover, 79.8% (71/89) of and 21.1% (19/90) of genes had mutations responsible for fluoroquinolone resistance. Three cases had no mutations in any of the three genes, 11 cases had mutations in all three genes, five cases had and gene mutations with no mutation in the 23S rRNA gene, and 42 cases had 23S rRNA and gene mutations with no mutation in the gene.
CONCLUSION
infections in our study displayed a high prevalence and very high levels of macrolide and fluoroquinolone resistance among GSWs in China. Asymptomatic infections are quite common among GSWs. Routine resistance testing of -positive specimens and antimicrobial resistance surveillance are crucial.
Topics: Male; Humans; Anti-Bacterial Agents; Mycoplasma genitalium; Sex Workers; Macrolides; Homosexuality, Male; Mycoplasma Infections; Prevalence; RNA, Ribosomal, 23S; Drug Resistance, Bacterial; Sexual and Gender Minorities; Fluoroquinolones; HIV Infections
PubMed: 36929876
DOI: 10.1177/09564624231160676 -
Sexually Transmitted Diseases Aug 2018We report clinical characteristics of proctitis caused solely by Mycoplasma genitalium (MG) compared with chlamydia and gonococcus. We determined the proportions cured...
BACKGROUND
We report clinical characteristics of proctitis caused solely by Mycoplasma genitalium (MG) compared with chlamydia and gonococcus. We determined the proportions cured with first-line (azithromycin) and second-line antimicrobials (moxifloxacin, pristinamycin).
METHODS
A total of 166 patients attending Melbourne Sexual Health Centre from 2012 to 2016 with symptoms of proctitis were tested for MG, Chlamydia trachomatis, and Neisseria gonorrhoeae. Demographic characteristics, sexual behaviors, clinical symptoms, and signs were recorded. Multinomial multivariable logistic regression was used to test for significant differences in symptoms and signs for the pathogens detected.
RESULTS
Seventeen percent of men had MG (95% confidence interval, 12-24), 21% had chlamydia (15-27), and 40% had gonococcal monoinfection (32-48), whereas 22% had MG coinfection (16-29). Relative to men with MG monoinfection, those with chlamydial monoinfection reported more anal pain (adjusted prevalence odds ratio (aPOR), 4.68 [1.41-14.19]), whereas men with gonococcal monoinfection reported more anal pain (aPOR, 6.75 [2.21-20.55]) and tenesmus (aPOR, 15.44 [1.62-146.90]), but less anal itch (aPOR, 0.32 [0.11-0.93]). The microbiological cure for MG using azithromycin was low at 35% (22-50), whereas moxifloxacin subsequently cured 92% (64-100) and pristinamycin cured 79% (54-94) of infections.
CONCLUSIONS
M. genitalium was almost as common as chlamydia in men presenting to a sexual health center with symptoms of proctitis. Men with anorectal MG monoinfection were less likely to have symptoms and signs compared with those with chlamydia or gonococcus monoinfection. Cure for men with symptomatic anorectal MG by azithromycin was low. We suggest routine testing for MG in cases of proctitis, with test of cure after treatment being essential.
Topics: Adult; Anti-Infective Agents; Azithromycin; Chlamydia trachomatis; Coinfection; Gonorrhea; Homosexuality, Male; Humans; Male; Moxifloxacin; Mycoplasma Infections; Mycoplasma genitalium; Neisseria gonorrhoeae; Pristinamycin; Proctitis; Rectal Diseases; Sexual Behavior; Sexual and Gender Minorities; Victoria; Young Adult
PubMed: 29465653
DOI: 10.1097/OLQ.0000000000000793