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Poster Session II: Health Services

(P201) IMPROVING QUALITY OF CARE FOR PATIENTS WITH LYMPHOGRANULOMA VENEREUM

Wednesday, September 18, 2024
4:15 PM - 5:15 PM EST
Background:
Lymphogranuloma venereum (LGV) is caused by Chlamydia trachomatis (CT) serovars L1, L2, or L3, that can cause significant genital ulcer disease, inguinal lymphadenopathy, or proctocolitis. Untreated or chronic LGV proctitis infection may also increase HIV transmission risk. We described factors associated with LGV at the Denver Sexual Health Clinic (DSHC).

Methods:
A retrospective descriptive analysis was performed between 2019-2023 on patients who were assigned male at birth that were tested for LGV due to findings of proctitis with confirmed rectal CT or symptomatic rectal CT. We examined the prevalence and predictive factors of LGV in patients with symptomatic rectal CT and analyzed LGV test turnaround time. Bivariate descriptive analysis and multiple logistic regression analysis were used to evaluate the relationships between presence of LGV and demographics, rectal symptoms, and coinfection.

Results:
LGV was found in 37 (36%) of 104 unduplicated patients. The median age for positive LGV was 33 years (IQR [28-37]) compared to 29 years (IQR [24-35]) with negative LGV. LGV was significantly associated with bleeding (p <.0001) and discharge (p=0.013). In the full logistic regression model, factors that were found to be associated with LGV included bleeding (OR = 5.4, 95% CI: 2.0-14.8, p = 0.001), discharge (OR = 3.1, 95% CI: 1.1-8.8, p=0.030), and positive HIV status (OR = 3.5, 95% CI: 1.2-10.7, p=0.027). The LGV test turnaround time was median of 7 days (IQR [6-9]).

Conclusion:
At the DSHC, LGV is sporadically observed among those with rectal CT with proctitis or other rectal symptoms. LGV is significantly associated with rectal bleeding or discharge and is more frequent among people living with HIV. Patients with these characteristics should be tested for LGV and can be considered for presumptive LGV treatment. If LGV testing is available, LGV test turnaround time allows for more targeted use of extended doxycycline therapy.