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Inicio Medicina Clínica (English Edition) Infecciones de transmisi¢n sexual con afectaci¢n anorrectal: agentes causales,...
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Vol. 152. Issue 3.
Pages 98-101 (February 2019)
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Vol. 152. Issue 3.
Pages 98-101 (February 2019)
Brief report
DOI: 10.1016/j.medcle.2018.02.033
Infecciones de transmisi¢n sexual con afectaci¢n anorrectal: agentes causales, coinfecciones, infecci¢n por el VIH y conductas de riesgo
Infecciones de transmisión sexual con afectación anorrectal: agentes causales, coinfecciones, infección por el VIH y conductas de riesgo
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Daniel Morgado-Carrascoa, Mercè Alsina Giberta, Jordi Bosch Mestresb, Miriam Álvarez Martínezb, José Luís Blanco Arévaloc, Irene Fuertes de Vegaa,
Corresponding author
ifuertes@clinic.cat

Corresponding author.
a Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
b Servicio de Microbiología, Hospital Clínic de Barcelona, Universitat de Barcelona, ISGlobal, Barcelona, Spain
c Servicio de Infectología, Hospital Clínic de Barcelona, Universitat de Barcelona, ISGlobal, Barcelona, Spain
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Tables (2)
Table 1. Sociodemographic characteristics, clinical history and risky sexual behaviours of patients affected by sexually transmitted infections with anorectal involvement.
Table 2. Causal microorganisms of anorectal sexually transmitted infections.
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Abstract
Introduction and objective

Sexually transmitted infections of the rectum and anus (STI-RA) mainly affect men who have sex with men (MSM). The incidence of STI-RA among them has increased in recent years.

Material and methods

Retrospective study in patients with diagnoses of STI-RA in an STI unit during the years 2014 and 2015. Epidemiological, clinical and microbiological data were collected.

Results

We included 95 patients, all of whom were MSM; 88.42% were HIV+; 67.17% did not use a condom during their most recent sexual intercourse; 17.91% had had sex with sex workers and 72.22% had used drugs during sexual intercourse during the previous year. A percentage of 32.92 reported symptoms that had lasted longer than 30 days. Lymphogranuloma venereum (LGV) was diagnosed in 54.73% of the patients. All patients who presented with proctitis and perianal ulcers were diagnosed with LGV infection. All those who presented perianal ulcers without proctitis were diagnosed with syphilis.

Conclusions

All the patients affected by STI-RA were MSM, most of them HIV+, had engaged in high-risk sexual behaviour and had suffered prolonged symptomatology. Clinical and microbiological characteristics of STI-AR could help adjust the empiric therapy.

Keywords:
Proctitis
HIV
Sexually transmitted diseases
Men who have sex with men
Lymphogranuloma venereum
Syphilis
Chlamydia trachomatis
Resumen
Introducción y objetivo

Las infecciones de transmisión sexual con afectación anorrectal (ITS-AR) afectan principalmente a hombres que tienen sexo con hombres (HSH).

Material y métodos

Estudio retrospectivo realizado en pacientes diagnosticados de ITS-AR en una unidad de ITS entre 2014 y 2015. Se recogieron datos epidemiológicos, microbiológicos, clínicos y de conducta sexual.

Resultados

Se analizaron 95 individuos, todos HSH. El 88,42% estaban infectados por el VIH; el 67,17% refirió que la última relación sexual fue desprotegida; el 17,91% tuvo sexo con trabajadores sexuales y, en el año previo, el 72,22% había consumido drogas previamente a las relaciones sexuales. El 32,92% presentaron sintomatología durante más de 30 días. El 54,73% de los diagnósticos fue linfogranuloma venéreo (LGV). Todos los pacientes que consultaron por úlcera asociada a proctitis presentaron infección por LGV. Todos los que consultaron por úlcera perianal sin proctitis asociada fueron diagnosticados de sífilis.

Conclusiones

Todos los pacientes con ITS-AR fueron HSH, la mayoría positivos para el VIH, con conductas sexuales de riesgo y un tiempo de evolución largo. Las características clínicas, epidemiológicas y microbiológicas de las ITS-AR en nuestro entorno podrían ayudar a ajustar mejor el tratamiento empírico.

Palabras clave:
Proctitis
VIH
Enfermedades de transmisión sexual
Hombres que tienen sexo con hombres
Linfogranuloma venéreo
Sífilis
Chlamydia trachomatis

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