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Increased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals

Human intestinal spirochetosis (HIS) can cause gastrointestinal symptoms, although asymptomatic infections have been described. Individuals from low-income countries, people living with HIV, and men who have sex with men (MSM) show increased risk. A retrospective review of all patients diagnosed wit...

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Autores principales: Pérez-Tanoira, Ramón, Tamarit, Marta del Palacio, Montaña, Ana María Vicente, Carmena, David, Köster, Pamela, Górgolas, Miguel, Fortes Alen, José R., Cabello-Úbeda, Alfonso, Prieto-Pérez, Laura
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10224025/
https://www.ncbi.nlm.nih.gov/pubmed/37235298
http://dx.doi.org/10.3390/tropicalmed8050250
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author Pérez-Tanoira, Ramón
Tamarit, Marta del Palacio
Montaña, Ana María Vicente
Carmena, David
Köster, Pamela
Górgolas, Miguel
Fortes Alen, José R.
Cabello-Úbeda, Alfonso
Prieto-Pérez, Laura
author_facet Pérez-Tanoira, Ramón
Tamarit, Marta del Palacio
Montaña, Ana María Vicente
Carmena, David
Köster, Pamela
Górgolas, Miguel
Fortes Alen, José R.
Cabello-Úbeda, Alfonso
Prieto-Pérez, Laura
author_sort Pérez-Tanoira, Ramón
collection PubMed
description Human intestinal spirochetosis (HIS) can cause gastrointestinal symptoms, although asymptomatic infections have been described. Individuals from low-income countries, people living with HIV, and men who have sex with men (MSM) show increased risk. A retrospective review of all patients diagnosed with HIS (n = 165) between January 2013 and October 2020 at a tertiary hospital in Madrid, Spain, was performed to assess risk factors for symptomatic HIS, symptoms, and response to treatment. Most patients were male (n = 156; 94.5%), 86.7% were MSM, and 23.5% practiced chemsex, of whom most were symptomatic (p = 0.039). Most patients (78.4%) reported unprotected oral-anal intercourse. A total of 124 (81.1%) were symptomatic; diarrhea was the most common complaint (68.3%). Multivariable regression showed increased odds of symptoms associated with age under 41 (odds ratio 5.44, 95% CI 1.87–15.88; p = 0.002). Colonoscopy was normal in 153 (92.7%). Furthermore, 66.7% presented previous or concomitant sexually transmitted diseases (STDs). Among the patients, 102 underwent testing for other gastrointestinal pathogens, with positive results in 20 (19.6%). All symptomatic patients without concomitant gastrointestinal infection presenting improvement on follow-up (42 of 53) had received either metronidazole or doxycycline (p = 0.049). HIS should be considered as a cause of chronic diarrhea in MSM with high-risk sexual behavior after other causes have been ruled out; treatment with metronidazole is recommended. Coinfection with other STDs is common.
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spelling pubmed-102240252023-05-28 Increased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals Pérez-Tanoira, Ramón Tamarit, Marta del Palacio Montaña, Ana María Vicente Carmena, David Köster, Pamela Górgolas, Miguel Fortes Alen, José R. Cabello-Úbeda, Alfonso Prieto-Pérez, Laura Trop Med Infect Dis Article Human intestinal spirochetosis (HIS) can cause gastrointestinal symptoms, although asymptomatic infections have been described. Individuals from low-income countries, people living with HIV, and men who have sex with men (MSM) show increased risk. A retrospective review of all patients diagnosed with HIS (n = 165) between January 2013 and October 2020 at a tertiary hospital in Madrid, Spain, was performed to assess risk factors for symptomatic HIS, symptoms, and response to treatment. Most patients were male (n = 156; 94.5%), 86.7% were MSM, and 23.5% practiced chemsex, of whom most were symptomatic (p = 0.039). Most patients (78.4%) reported unprotected oral-anal intercourse. A total of 124 (81.1%) were symptomatic; diarrhea was the most common complaint (68.3%). Multivariable regression showed increased odds of symptoms associated with age under 41 (odds ratio 5.44, 95% CI 1.87–15.88; p = 0.002). Colonoscopy was normal in 153 (92.7%). Furthermore, 66.7% presented previous or concomitant sexually transmitted diseases (STDs). Among the patients, 102 underwent testing for other gastrointestinal pathogens, with positive results in 20 (19.6%). All symptomatic patients without concomitant gastrointestinal infection presenting improvement on follow-up (42 of 53) had received either metronidazole or doxycycline (p = 0.049). HIS should be considered as a cause of chronic diarrhea in MSM with high-risk sexual behavior after other causes have been ruled out; treatment with metronidazole is recommended. Coinfection with other STDs is common. MDPI 2023-04-26 /pmc/articles/PMC10224025/ /pubmed/37235298 http://dx.doi.org/10.3390/tropicalmed8050250 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pérez-Tanoira, Ramón
Tamarit, Marta del Palacio
Montaña, Ana María Vicente
Carmena, David
Köster, Pamela
Górgolas, Miguel
Fortes Alen, José R.
Cabello-Úbeda, Alfonso
Prieto-Pérez, Laura
Increased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals
title Increased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals
title_full Increased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals
title_fullStr Increased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals
title_full_unstemmed Increased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals
title_short Increased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals
title_sort increased prevalence of symptomatic human intestinal spirochetosis in msm with high-risk sexual behavior in a cohort of 165 individuals
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10224025/
https://www.ncbi.nlm.nih.gov/pubmed/37235298
http://dx.doi.org/10.3390/tropicalmed8050250
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