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oai:docta.ucm.es:20.500.14352/1036452025-09-02T13:30:11Zcom_20.500.14352_14col_20.500.14352_15

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 Montaña, Ana Carmena, David Köster, Pamela Górgolas, Miguel Fortes Alen, José Cabello-Úbeda, Alfonso Prieto-Pérez, Laura 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. 2024-04-29T17:02:43Z 2024-04-29T17:02:43Z 2023 journal article Pérez-Tanoira, R.; Tamarit, M.d.P.; Montaña, A.M.V.; Carmena, D.; Köster, P.; Górgolas, M.; Fortes Alen, J.R.; Cabello-Úbeda, A.; Prieto-Pérez, L. Increased Prevalence of Symptomatic Human Intestinal Spirochetosis in MSM with High-Risk Sexual Behavior in a Cohort of 165 Individuals. Trop. Med. Infect. Dis. 2023, 8, 250. https://doi.org/10.3390/tropicalmed8050250 10.3390/tropicalmed8050250 https://hdl.handle.net/20.500.14352/103645 https://doi.org/10.3390/tropicalmed8050250 https://www.mdpi.com/2414-6366/8/5/250 eng http://creativecommons.org/licenses/by/4.0/ open access Attribution 4.0 International MDPI