Rapid Increase in Lymphogranuloma Venereum in Men Who Have Sex with Men, United Kingdom, 2003 to September 2015

United Kingdom (UK) national data show a sharp increase in diagnoses of lymphogranuloma venereum (LGV) since 2012. Most cases are in men who have sex with men (MSM) living in London, with high rates of co-infection with HIV and other sexually transmitted infections. In light of these data, and the recent finding that one quarter of LGV infections may be asymptomatic, clinicians should be vigilant in testing for LGV, including in asymptomatic HIV-positive MSM.

Laboratory diagnoses of lymphogranuloma venereum (LGV) in the United Kingdom (UK) declined between 2010 and 2012, but the most recent data show near doubling of cases since 2012 to unprecedented levels in 2014 (679 cases). This trend has continued into 2015, with 683 cases diagnosed by 30 September. In 2014, most cases were in men who have sex with men (MSM) and around three quarters were HIV-positive. Here we report national surveillance data showing trends in LGV diagnoses in the UK from 2003 to September 2015

Below:  Number of cases diagnosed with lymphogranuloma venereum, per quarter, United Kingdom, 2003 to end September 2015 (n=4,124)

Characteristics of MSM patients from STBRU laboratory reports matched to GUMCADv2 dataset, United Kingdom, 2014 (n=434)

Characteristics	Number	Percentage
Total number of patientsa	434	100
Ageb
Median (IQR)	37	31–44
16–24	20	5
25–34	146	34
35–44	165	38
45–54	86	20
55–64	12	3
≥65	2	< 1
Other STI or blood borne virus infection diagnosed in 2014c
Gonorrhoea	219	50
Syphilis	76	18
Genital herpes	36	8
Genital warts (Condyloma acuminata)	26	6
Hepatitis C	13	3
HIV status
Positive	321	74
Negative or unknown	113	26
Proximity of HIV diagnosis to LGV diagnosisb
HIV > 3 months before LGV	234	73
HIV 0–3 months before LGV	30	9
Same date	49	15
HIV 0–3 months after LGV	5	2
HIV > 3 months after LGV	3	1
Area of patient residence
London	323	74
Manchester	18	4
Brighton	7	2
Birmingham	7	2
Other	79	18
Country of birthb
United Kingdom	239	57
Outside United Kingdom	177	43
Ethnicityb
White	320	77
Asian	16	4
Black	20	5
Mixed	28	7
Other	29	7

GUMCADv2: Genitourinary Medicine Clinic Activity Dataset; IQR: interquartile range; LGV: lymphogranuloma venereum; MSM: men who have sex with men; STBRU: sexually transmitted bacteria reference unit; STI: sexually transmitted infection.

a Of 677 positive LGV test results in 2014, 440 were successfully matched to GUMCADv2. Six of these were excluded because they were recorded as female or heterosexual in GUMCADv2, leaving 434 matched patients.

b For patients with information available.

c All other STI diagnoses were new except for 14 recurrent cases of genital herpes and 17 recurrent cases of genital warts.

Full article at:  http://goo.gl/4ms65E

By:  T Childs ¹ , I Simms ¹ , S Alexander ² , K Eastick ³ , G Hughes ¹ , N Field ^1 4

1. HIV and STI Department, Public Health England Health Protection Services, Colindale, United Kingdom

2. Sexually Transmitted Bacteria Reference Unit, Public Health England Reference Microbiology Services, Colindale, United Kingdom

3. Scottish Bacterial Sexually Transmitted Infections Reference Laboratory, Edinburgh Royal Infirmary, Edinburgh, United Kingdom

4. Department of Infection and Population Health, University College London, London, United Kingdom

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