Abstract
We investigated prevalence of
lymphogranuloma venereum (LGV) among men who have sex with men who were tested
for chlamydia at 12 clinics in the United Kingdom during 10 weeks in 2012. Of
713 men positive for Chlamydia
trachomatis, 66 (9%) had LGV
serovars; 15 (27%) of 55 for whom data were available were asymptomatic.
Lymphogranuloma venereum (LGV)
is a sexually transmitted infection (STI) caused by the L1, L2, and L3 serovars
of Chlamydia
trachomatis (CT). An LGV outbreak among men who have sex with men
(MSM) first reported in the Netherlands in 2003 has since spread across other
industrialized countries (1). Cases are typically seen among white,
HIV-positive MSM who report unprotected anal intercourse, other high-risk
behaviors, and STI co-infection and who commonly have symptoms of proctitis
(i.e., rectal pain, rectal discharge, bloody stools, constipation, and
tenesmus) (2).
The United Kingdom now has the
largest documented outbreak of LGV among MSM worldwide (3,4). Infection control in England has
relied on CT DNA typing and treatment of symptomatic MSM who have CT-positive
rectal infections and their contacts, as well as health promotion. These
measures were supported by a large prospective study in the United Kingdom
during 2006–2007 that reported <6% of LGV CT infections were asymptomatic (5). However, studies in the Netherlands
and Germany, and a smaller UK study, have reported higher proportions (17%–53%)
of asymptomatic infection (6–8). We reinvestigated the prevalence of
asymptomatic LGV CT infection among MSM in the United Kingdom to assess whether
it may be sustaining the current epidemic.
Below: Figure. Data
analysis flowchart for univariable and multivariable analyses of symptomatic
lymphogranuloma venereum (LGV) versus non-LGV Chlamydia trachomatis (CT) infection (Table 1) and asymptomatic LGV versus non-LGV CTinfection (Table 2) in men who have sex with men, United
Kingdom*Patients from Glasgow were excluded from risk factor analyses because
they do not routinely report to the Genitourinary Medicine Clinic Activity
Dataset.
Full article at: http://goo.gl/NJEfPA
By:
Author affiliations: Author affiliation: Public Health
England, London, UK
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