1887

Abstract

Lymphogranuloma venereum (LGV), the invasive infection of the sexually transmissible infection (STI) , is caused by strains from the LGV biovar, most commonly represented by -genotypes L2b and L2. We investigated the diversity in LGV samples across an international collection over seven years using typing and genome sequencing. LGV-positive samples (=321) from eight countries collected between 2011 and 2017 (Spain =97, Netherlands =67, Switzerland =64, Australia =53, Sweden =37, Hungary =31, Czechia =30, Slovenia =10) were genotyped for and variants. All were found to contain the 9 bp insertion in the gene, previously associated with -genotype L2b. However, analysis of the gene shows -genotype L2b (=83), -genotype L2 (=180) and several variants of these (=52; 12 variant types), as well as other/mixed -genotypes (=6). To elucidate the genomic diversity, whole genome sequencing (WGS) was performed from selected samples using SureSelect target enrichment, resulting in 42 genomes, covering a diversity of -genotypes and representing most of the countries sampled. A phylogeny of these data clearly shows that these -genotypes derive from an -genotype L2b ancestor, carrying up to eight SNPs per isolate. SNPs within are overrepresented among genomic changes in these samples, each of which results in an amino acid change in the variable domains of OmpA (major outer membrane protein, MOMP). A reversion to -genotype L2 with the L2b genomic backbone is commonly seen. The wide diversity of -genotypes found in these recent LGV samples indicates that this gene is under immunological selection. Our results suggest that the -genotype L2b genomic backbone is the dominant strain circulating and evolving particularly in men who have sex with men (MSM) populations.

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2021-06-29
2021-07-29
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