P490 LGV in patients attending an STI outpatient clinic in berlin: an urban emergence with high proportion of HIV-coinfections

Background Lymphogranuloma venereum (LGV) is the infection of the lymphatic system caused by Chlamydia trachomatis (CT) serovars L1-L3. The first emergence of LGV in networks of men, who have sex with men (MSM) began in Europe (2003), followed by a series of outbreaks worldwide. In the absence of national passive surveillance systems for LGV, we evaluated prevalence and characteristics of LGV in a high-risk population (MSM) attending a STI Outpatient Clinic in Berlin. Methods We performed a retrospective analysis of all tested CT samples (pharyngeal, urethral, rectal) from 2012–2017. All positive rectal samples underwent additional testing for L1-L3 genotype. For this purpose a PCR was performed of a L-specific region (polymorphic H-gene). Results A total of 12,390 samples (5,316 patients) were collected and resulted in 486 L+ swabs (191 patients). The number of tested swabs increased from 1,370 (2012) to 3,634 (2017). The proportion of CT+ swabs fluctuated between 10% and 15%. Among the CT+ patients, the proportion of L+ patients decreased continuously from 37% (2012) to 21% (2017). The majority of patients tested were male, between 26–35 years of age. We observed the highest rate of L-infections in older patients (maximum in the age-group 46–55 years, CT+/L+ 46%). The majority of patients infected with L+ came from central metropolitan districts. The HIV-coinfection rate among CT+ patients decreased continuously from 39% (2012) to 12% (2017). The proportion of HIV+ patients among L+ patients remained high and decreased from 80% (2012) to 50% (2017). Conclusion Our data display the largest epidemiological development of LGV in Germany and demonstrate a high prevalence of genotype L1-L3, which require a prolonged antibiotic treatment compared to other CT serotypes. As the routine screening of anorectal swabs in high-risk population is still not recommended, our results strongly suggest a need for genotyping positive CT rectal specimens. Disclosure No significant relationships.