International Journal of STD & AIDS最新文献

{"title":"BASHH national guideline on the management of balanoposthitis (and related penile skin conditions) 2026.","authors":"Sarah K Edwards, Pareswaran Shashidharan, Imali Fernando, Georgina Morris, Dayan Vijeratnam, Jason Eng Kiat Lim, Deepa Grover","doi":"10.1177/09564624261452757","DOIUrl":"10.1177/09564624261452757","url":null,"abstract":"<p><p><b>Background:</b> Balanoposthitis is a common presentation within sexual health services and encompasses a broad spectrum of infective, inflammatory, premalignant, and systemic conditions affecting the glans penis and foreskin. Accurate diagnosis is essential to ensure appropriate management, avoid unnecessary antimicrobial use, identify sexually transmitted infections (STIs), and recognise conditions requiring specialist referral. The 2025 guideline update was developed to strengthen recommendations on the diagnosis and management of infective balanoposthitis while improving recognition of important non-infective dermatoses and systemic disease presentations.<b>Methods:</b> The guideline update was informed by a review of the current evidence base, emerging clinical data, and expert multidisciplinary consensus. Existing recommendations were reviewed and revised to reflect advances in diagnostic approaches, antimicrobial stewardship, and the management of inflammatory and premalignant penile dermatoses. Particular emphasis was placed on improving diagnostic accuracy, identifying clinical features suggestive of STIs or systemic disease, and clarifying indications for biopsy and specialist referral. <b>Discussion:</b> The updated guideline highlights the importance of a structured clinical assessment supported by targeted investigations where appropriate. Infective causes remain an important consideration, including candidal balanoposthitis, bacterial infection, and STIs; however, the guideline also emphasises the need to recognise common inflammatory dermatoses such as lichen sclerosus, psoriasis, eczema, and Zoon balanitis, as well as premalignant and malignant conditions. The recommendations promote evidence-based treatment strategies, reduce unnecessary empirical antimicrobial prescribing, and encourage earlier identification of patients requiring dermatology, urology, or penile cancer specialist input.<b>Conclusion:</b> This 2025 guideline update aims to support clinicians in the earlier recognition and accurate diagnosis of balanoposthitis and related penile dermatoses. By promoting evidence-based management, antimicrobial stewardship, and timely referral for specialist care where indicated, the guideline seeks to improve patient outcomes and standardise care across sexual health and related clinical services.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"969-983"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-acting injectable cabotegravir/rilpivirine in a pregnant woman living with HIV with hyperemesis gravidarum:a case report and review of literature.","authors":"Emanuela Lattuada, Andrea Delama, Alessandro Castelli, Giovanni Mori, Daniela Piacentini, Massimiliano Lanzafame","doi":"10.1177/09564624261461198","DOIUrl":"10.1177/09564624261461198","url":null,"abstract":"<p><p>IntroductionLong-acting injectable cabotegravir/rilpivirine (CAB/RPV LA) represents a novel antiretroviral strategy that bypasses gastrointestinal absorption, potentially advantageous in pregnant individuals unable to tolerate oral therapy. However, its use in pregnancy remains off-label due to limited pharmacokinetic (PK), safety and clinical outcome data.Case presentationWe report the case of a 26-year-old woman from Ghana living with HIV-1 (subtype CRF02_AG), with a longstanding history of social vulnerability, poor adherence and multiple treatment interruptions. She presented at gestational week (GW) 20 with an ongoing oral regimen of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF), initiated weeks earlier. Despite an initial viral load decline, virological rebound to 57,950 copies/mL was documented at GW 28, attributed to severe hyperemesis gravidarum (HEG) impairing drug intake and absorption. No resistance-associated mutations were detected. Given the inability to tolerate oral therapy, CAB/RPV LA (600/900 mg) was initiated intramuscularly at GW 29, with a second injection 4 weeks later. Virological suppression (<20 copies/mL) was achieved within 4 weeks of the first injection. At GW 36, an elective caesarean section was performed with intravenous zidovudine prophylaxis and neonatal zidovudine syrup, resulting in the delivery of a neonate who has tested HIV-negative on all assessments to date. No adverse maternal or neonatal outcomes were observed.DiscussionThis case highlights HEG as an underrecognised cause of antiretroviral treatment failure mediated by impaired absorption rather than virological resistance, and supports CAB/RPV LA as a viable rescue strategy in this setting.ConclusionIt also underscores the urgent need for prospective pharmacokinetic and safety data in pregnancy.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"1055-1058"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Toluidine Red Unheated Serum Test (TRUST) titer and cerebrospinal fluid parameters as predictors of neurosyphilis in HIV-negative people with late latent syphilis.","authors":"Lin Zhu, Xin Gu, Liyan Ni, Wei Zhao, Zhifang Guan, Haikong Lu, Pingyu Zhou","doi":"10.1177/09564624261448329","DOIUrl":"10.1177/09564624261448329","url":null,"abstract":"<p><p>BackgroundThe diagnosis of neurosyphilis is challenging due to the limited sensitivity of cerebrospinal fluid Venereal Disease Research Laboratory (VDRL) test. Late latent syphilis is defined as positive treponemal serology without clinical manifestations and untreated infection for more than 1 year. Symptomatic or asymptomatic neurosyphilis is diagnosed based on cerebrospinal fluid findings and clinical symptoms. This cross-sectional study investigated serum Toluidine Red Unheated Serum Test (TRUST) titer and cerebrospinal fluid inflammatory markers as predictors of neurosyphilis in HIV-negative patients with late latent syphilis.MethodsA total of 196 HIV-negative patients with late latent syphilis who underwent lumbar puncture at the Shanghai Skin Disease Hospital between September 2009 and December 2022 were included. Neurosyphilis was defined as a reactive cerebrospinal fluid (CSF) Venereal Disease Research Laboratory (VDRL). Demographic, clinical, and laboratory variables were analyzed using logistic regression and receiver operating characteristic curves.ResultsOf the 196 patients, 123 (63%) were diagnosed with neurosyphilis. In multivariable analysis, higher serum TRUST titer, elevated CSF white blood cell count, and increased CSF protein levels were independently associated with neurosyphilis. Optimal cutoffs were serum TRUST ≥1:16, CSF protein ≥0.7 g/L, and CSF white blood cell ≥10 cells/μL. The CSF white blood cell count showed the highest diagnostic accuracy (AUC = 0.90). The combination of these three variables improved the sensitivity and specificity by 89% and 90%, respectively.ConclusionAmong HIV-negative patients with late latent syphilis, elevated serum TRUST titer, CSF white blood cell count, and a CSF protein level ≥0.7 g/L are independently associated with neurosyphilis. The composite panel serves as reliable tool for post-lumbar puncture risk stratification and interpretation of CSF findings in routine practice.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"876-883"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician awareness, attitudes and prescribing practices relating to doxycycline post-exposure prophylaxis (DoxyPEP) in Ireland: Cross-sectional survey of sexual health professionals.","authors":"John Gilmore, Enda Barron, Joanna Bergin, Coleen Finlay, Fiona Lyons, Robert Lawlor, Chris Noone, Giovanni Villa, John White, David J Field","doi":"10.1177/09564624261445197","DOIUrl":"10.1177/09564624261445197","url":null,"abstract":"<p><p>BackgroundDoxycycline post-exposure prophylaxis (DoxyPEP) has emerged as a biomedical strategy to reduce bacterial sexually transmitted infections (STIs), yet implementation remains contested due to antimicrobial resistance concerns and limited clinical guidance in many European settings. Evidence on clinician readiness to prescribe DoxyPEP is limited. This study examined awareness, attitudes and prescribing practices among sexual health clinicians in the Republic of Ireland.MethodsA cross-sectional anonymous online survey was conducted among sexual health clinicians in early 2026. Survey items were informed by the Theoretical Framework of Acceptability (TFA). Descriptive statistics summarised responses. Group differences were assessed using χ² tests, independent-samples t-tests, one-way ANOVA and non-parametric tests where appropriate. Pearson correlations explored relationships between implementation constructs.Results101 clinicians participated (60 doctors, 33 nurses, 8 other professionals). Awareness of DoxyPEP was high (95%) and 64% of doctors and nurses reported prior prescribing or recommendation. Current local guidance was variable, with only 28% reporting formal guidance, but willingness to prescribe with national guidance was high (82%) and did not differ between professional groups or specialties.No significant differences were observed between doctors and nurses across knowledge or acceptability domains. Among doctors, implementation perceptions varied by specialty: GU/HIV clinicians reported higher knowledge, perceived effectiveness, intervention coherence and self-efficacy than infectious diseases clinicians and general practitioners.Self-reported knowledge was strongly associated with intervention coherence (r = -0.601, <i>p</i> < .001) and self-efficacy (r = 0.600, <i>p</i> < .001). Ethicality emerged as the only independent predictor of willingness to prescribe (OR = 5.77, 95% CI 2.47-13.47). Concern about antimicrobial resistance was widespread (81%).ConclusionIrish clinicians demonstrate high awareness and substantial readiness to prescribe DoxyPEP. Implementation readiness appears shaped more by ethical acceptability and professional confidence than knowledge alone. National guidance, education and antimicrobial stewardship frameworks will be essential to support safe and equitable integration of DoxyPEP into sexual health services.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"861-869"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penile human papilloma virus (HPV) in high risk populations with and without HIV: Epidemiological insights from Argentina.","authors":"Diego Daniel Salusso, Ana Gun, Agustin Nava, Javier Mariani, Jonathan Garcia, Martin Abba, María Eugenia Salas, Marcelo Golemba, Julián Naipauer, Agustina Grinpelc, Ezequiel Lacunza, Carolina Perez, Carina Cesar, Pedro Cahn, María Ines Figueroa, Valeria Fink","doi":"10.1177/09564624261437168","DOIUrl":"10.1177/09564624261437168","url":null,"abstract":"<p><p>BackgroundHuman papillomavirus (HPV) is a common sexually transmitted infection, with higher prevalence among men who have sex with men (MSM) and people who self-identify as transgender women (PSTGW). High-risk genotypes (hrHPV) carry oncogenic potential. This study assessed hrHPV prevalence in penile samples from MSM and PSTGW in Buenos Aires, Argentina.MethodsA cross-sectional analysis of baseline data from a longitudinal study was conducted. Participants aged ≥18 were recruited from an HIV prevention center. Penile samples, collected via standardized sandpaper exfoliation, were analyzed using the AmpFire HPV Genotyping Assay for 15 genotypes. Logistic regression models identified factors associated with HPV.ResultsAmong 298 samples from 300 participants (256 MSM, 44 PSTGW), HIV prevalence was 27%. Penile hrHPV prevalence was 31%, with no significant difference between MSM and PSTGW (p = 0.465). Frequent genotypes included HPV-33, HPV-53 and HPV-16 (6.3%, 5.3%, and 4.6% respectively). People with HIV (PWH) showed higher hrHPV prevalence than HIV negative individuals (41% vs 27%, p = 0.023), more infections with ≥3 genotypes (15% vs 4%, p < 0.001), and higher nonavalent vaccine genotype detection (30% vs 15%, p = 0.005). Multivariate analysis associated hrHPV infection with being PWH (aOR = 1.99), >5 sexual partners in the past month (aOR = 1.77), and lifetime sex work (aOR = 2.68).ConclusionsPenile hrHPV was highly prevalent among MSM and PSTGW, particularly among PWH and those with a history of sex work. Low vaccination rate and high prevalence of vaccine-preventable genotypes underscore the need to expand HPV vaccination in these populations.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"813-822"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological and clinical characteristics of gestational and congenital syphilis in Hungary: A cross-sectional, single-center case analysis.","authors":"Ugur Cakir, Gábor Karácsony, Eszter Ostorházi, Péter Holló, Béla Tóth","doi":"10.1177/09564624261442270","DOIUrl":"10.1177/09564624261442270","url":null,"abstract":"<p><p>BackgroundIn recent years, gestational and congenital syphilis have re-emerged as significant public health concerns in Hungary. Although national surveillance data are available for syphilis, they do not include gestational cases, and recent studies describing the epidemiological and clinical characteristics of gestational and congenital syphilis remain limited. The aim of the study was to analyze 10 years of data to evaluate the clinical characteristics and outcomes of gestational and congenital syphilis and to identify gaps in prenatal screening and care.MethodsWe conducted a cross-sectional, single-center study at the National STD Centre in Budapest, analyzing data from pregnant women diagnosed with syphilis and their newborns between 2015 and 2025. Maternal epidemiological and clinical data were collected, and neonatal clinical and laboratory data were evaluated where available.ResultsA total of 180 pregnant women with 185 pregnancies were included. Diagnosis was made in the second or third trimester in 139 cases, and 110 cases were classified as early latent syphilis. 173 women were asymptomatic at the time of diagnosis. Penicillin was administered in 176 out of 185 (95%) cases, and an adequate serological response, defined as a ≥4-fold decline in RPR titer, was observed in 176/185 (95%). Neonatal data were available for 106 newborns. 10 (9%, 95% CI: 5-17%) neonates met the diagnostic criteria for congenital syphilis, including nine probable and one confirmed case. Clinical manifestations ranged from asymptomatic infection to severe multisystem involvement. All neonates with congenital syphilis (n = 10), as well as those whose mothers had not received adequate treatment (n = 10), in total 20/106 neonates (19%; 95% CI: 12-27%) were treated with penicillin.ConclusionGestational and congenital syphilis remain significant public health concerns in Hungary. The high proportion of late diagnoses highlights the need for repeated antenatal screening and interdisciplinary collaboration to prevent congenital infection.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"911-915"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13276104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genital herpes and genital warts affect quality of life and emotional well-being.","authors":"Maja Af Klinteberg, Alma Seyer, Nirina Andersson","doi":"10.1177/09564624261438901","DOIUrl":"10.1177/09564624261438901","url":null,"abstract":"<p><p>BackgroundHealth-related quality of life is an important outcome in sexually transmitted infections, but data on genital herpes and genital warts in Sweden are limited. This study aimed to describe health-related quality of life in these patient groups at a Swedish STI clinic and to compare their scores with population norms and between the two diagnoses.MethodsWe conducted a clinic-based cross-sectional survey among adults with clinician-confirmed genital herpes or genital warts at an STI clinic in northern Sweden between November 2023 and September 2025. Health-related quality of life was measured using RAND-36. Global quality of life and sexual life were rated on visual analogue scales, and psychological symptoms were assessed with the DASS-21.ResultsIn total, 91 patients were included, 45 with genital herpes and 46 with genital warts. Current visible lesions were more common in genital warts (98%) than in genital herpes (45%). No significant differences were observed between the groups in global quality of life, sexual life ratings and DASS-21 (all <i>p</i> > 0.12). In contrast, genital herpes patients scored lower than genital warts patients in RAND-36 domains: vitality (46.1 vs 56.7, <i>p</i> = 0.034); and social functioning (68 vs 79, <i>p</i> = 0.048). Compared with Swedish norms, genital herpes patients scored 15-27 points lower in mental and social domains (all <i>p</i> < 0.001), and 9 points lower in general health (<i>p</i> = 0.015). Genital warts patients scored 18 points lower in role emotional (<i>p</i> = 0.008).ConclusionsGenital herpes and genital warts were both associated with impaired health and quality of life in this Swedish clinical sample. Genital herpes patients demonstrated greater mental and social impairment compared to those with genital warts and norms. These findings highlight the need for psychosocial assessment, clear information on transmission and recurrences, and targeted support for patients with pronounced psychological distress.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"901-905"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13276115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ceftriaxone-resistant <i>Neisseria gonorrhoeae</i> in Singapore: Eight years of sentinel surveillance.","authors":"Ren Jie Tsai, Linus Cheng, Ai Ling Tan, Benson Koon Wee Yeo","doi":"10.1177/09564624261440693","DOIUrl":"10.1177/09564624261440693","url":null,"abstract":"<p><p>BackgroundCeftriaxone is currently the most frequently recommended first-line therapy for gonorrhoea globally. The emergence of ceftriaxone-resistant <i>Neisseria gonorrhoeae</i> threatens effective control, yet longitudinal surveillance data remain limited in many settings. Sentinel gonococcal antimicrobial resistance surveillance has been conducted at the Department of STI Control (DSC), Singapore, since 2014. We report findings on the emergence of ceftriaxone-resistant <i>Neisseria gonorrhoeae</i> detected between 2018 and 2025.MethodsWe conducted an analysis of longitudinal sentinel laboratory surveillance data from January 2018 to October 2025. <i>Neisseria gonorrhoeae</i> isolates underwent culture and antimicrobial susceptibility testing using gradient diffusion method (Etest) at the Department of Microbiology, Singapore General Hospital. Isolates with ceftriaxone minimum inhibitory concentrations ≥0.25 mg/L were identified using European Committee on Antimicrobial Susceptibility Testing criteria. Clinical, behavioural and treatment outcome data were extracted from electronic medical records.ResultsAmong 2695 <i>Neisseria gonorrhoeae</i> isolates tested, 23 (0.85%) ceftriaxone-resistant isolates were identified. No ceftriaxone-resistant isolates were detected prior to 2018, and annual detection varied without a consistent upward trend. Median patient age was 35 years (IQR 24-48). The earliest case was a female patient involved in transactional sex work with pharyngeal infection; subsequent cases occurred exclusively among heterosexual individuals, predominantly men with urethral infection. Exposure through encounters involving paid sex as well as the absence of condom use during oral sex, were common. Most infections resolved following treatment with ceftriaxone 500 mg intramuscularly, although persistent pharyngeal infection was observed in one case.ConclusionCeftriaxone-resistant <i>Neisseria gonorrhoeae</i> has been detected in Singapore since 2018 through sentinel surveillance. Continued culture-based antimicrobial resistance surveillance, incorporation of extragenital testing, and prioritisation of test-of-cure for pharyngeal infection are essential to support early detection, guide empirical therapy and inform clinical and public health responses.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"833-838"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polycythemia in males living with HIV post dolutegravir and long term antiretroviral therapy.","authors":"Adwait Bendre, Dhruvi Shah, Darsita Jatakia, Riya Agrawal, Mahvish Shaikh, Theertha Ramesh, Ira Shah","doi":"10.1177/09564624261438983","DOIUrl":"10.1177/09564624261438983","url":null,"abstract":"<p><p>BackgroundDolutegravir based antiretroviral therapy (ART) is widely recommended as first line treatment for people living with HIV because of its potent viral suppression, high genetic barrier to resistance, and a favorable tolerability profile. Haematological adverse effects of ART are well recognized, most commonly anemia, particularly with zidovudine-containing regimens. However, erythrocytosis or polycythaemia is rarely described in association with dolutegravir, and available literature on this possible association remains limited. Case-presentationsWe describe a case series of four male patients living with HIV who developed persistent polycythemia after transition to dolutegravir-based regimens in accordance with National AIDS Control Organization guidelines. All our patients had been on long-term ART since childhood and were virologically suppressed with stable CD4 counts prior to regimen change. Haemoglobin levels progressively increased to >16.5 g/dL within 1 to 3 years of initiating dolutegravir, with peak values ranging from 17.4 to 17.8 g/dL. The patients remained asymptomatic, and leukocyte and platelet counts were largely within normal limits. Evaluation excluded common secondary causes of erythrocytosis including smoking, dehydration, renal dysfunction, and clinical features suggestive of myeloproliferative neoplasms. Liver and renal function parameters were stable, and no evidence of hypoxia or exogenous androgen use was identified. DiscussionThe temporal association between initiation of dolutegravir and rising haemoglobin levels is possibly suggestive of a drug-related effect or a haematological recovery phenomenon following sustained viral suppression. Proposed mechanisms include ART-associated increases in testosterone levels, enhanced erythropoietin production, reduced haemolysis, and improved bone marrow function. Although the patients were clinically stable, persistent polycythaemia may increase long term thrombotic risk and therefore may warrant periodic complete blood count monitoring. ConclusionThis case series highlights the need for awareness of this uncommon but potentially significant haematological observation in patients receiving dolutegravir-based ART and underscores the importance of systematic evaluation to exclude alternative aetiologies.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"923-926"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing epidemiology and clinical presentation of rectal lymphogranuloma venereum in the HIV-PrEP era: A comparative study from Bologna, Italy.","authors":"Valeria Gaspari, Leonardo Calza, Simone Ambretti, Tiziana Lazzarotto, Marielle Ezekielle Djusse, Lorenzo Badia, Claudio Foschi, Antonella Marangoni","doi":"10.1177/09564624261437167","DOIUrl":"10.1177/09564624261437167","url":null,"abstract":"<p><p>IntroductionLymphogranuloma venereum (LGV), caused by <i>Chlamydia trachomatis</i> (CT) serovars L1-L3, has re-emerged in Europe since the early 2000s, predominantly affecting men who have sex with men (MSM), particularly people living with HIV (PLWH). The widespread implementation of HIV pre-exposure prophylaxis (HIV-PrEP) and the associated expansion of sexually transmitted infection (STI) screening programmes may have influenced the epidemiology and clinical presentation of LGV. MethodsWe analysed the clinical and epidemiological characteristics of rectal LGV cases diagnosed in the Bologna metropolitan area during the HIV-PrEP era (2022-2025) and compared them with those of a historical cohort from the pre-HIV-PrEP era (2016-2020). ResultsOverall, 93 rectal LGV cases were identified during 2022-2025, all among MSM, with a median age of 37 years; 66% were symptomatic, 48% were HIV-positive, 31% had concurrent rectal <i>Neisseria gonorrhoeae</i> infection, and 21% were diagnosed with early syphilis. Although the absolute number of LGV cases was higher than in 2016-2020 (93 vs 76), this difference occurred in the context of a substantial increase in anorectal CT testing during the HIV-PrEP era. Accordingly, LGV prevalence among anorectal swabs declined markedly (from 4% to 0.7%). When stratified by population group, HIV-PrEP users with LGV (<i>n</i> = 38) were younger than non-HIV PrEP users (<i>n</i> = 55, including 45 PLWH and 10 non-HIV MSM) and were significantly more likely to be asymptomatic, with lower rates of concurrent bacterial STIs.ConclusionThese findings suggest that rectal LGV remains endemic in our setting but may present with different clinical patterns in the HIV-PrEP era, with a higher proportion of asymptomatic infections among PrEP users, likely reflecting intensified STI screening. Continued epidemiological surveillance is needed to better understand LGV transmission dynamics and to inform tailored prevention and screening strategies among MSM.</p>","PeriodicalId":14408,"journal":{"name":"International Journal of STD & AIDS","volume":" ","pages":"927-930"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}