HIV/Sexually Transmitted Infections (STIs) |
Published on: 29 August 2008 |
Lymphogranuloma venereum in the United Kingdom: data to end of June 2008
Recent data on lymphogranuloma venereum (LGV) within the United Kingdom (UK) shows that in the first half of 2008 there was an increase in the number of cases diagnosed. The UK already has the largest cohort of LGV cases in Europe and although the numbers diagnosed each quarter are not particularly great (the average in 2007 was around 47 per quarter) the rise in numbers (to 68 per quarter) in the first half of 2008 is disappointing in terms of prevention of what should be a controllable outbreak.
The basic epidemiology of LGV in the UK is similar to that described previously [1] in that the group at highest risk is men who have sex with men (MSM) who are predominately white, often co-infected with HIV and other STIs, and present to clinical services with proctitis. A few heterosexual cases have, however, been reported, including a single case in a woman.
The HPA developed a case definition and started enhanced surveillance in 2004 [1] and has continued to offer a diagnostic service for LGV in symptomatic cases who are chlamydia positive. To the end of June 2008, 5346 samples had been sent to the Sexually Transmitted Bacterial Reference Laboratory (at the Health Protection Agency's Centre for Infections) for confirmatory testing, of which 775 were confirmed as cases of LGV (figure 1).
Detailed epidemiological data were available for 662 of these cases. Co-infection with HIV was seen in 73% (481/662), 49% of whom (235/481) were on antiretroviral therapy. Co-infection with gonorrhoea, syphilis and hepatitis C were seen in 18% (122/662), 6% (37/662) and 2% (15/662), respectively. Thirty cases were diagnosed with HIV at the same clinic visit.
Most cases (72%; 480/662) were seen in London, 7% (46/662) in Brighton and 4% (28/662) in Manchester. Scotland and Wales reported 22 and three cases, respectively, and the first case from Northern Ireland was reported in 2008.
Seventy nine percent (527/662) of infections are reported to have been acquired in the UK whereas 9% (60/662) were acquired elsewhere in Europe.
Figure 1. Laboratory confirmed cases of lymphogranuloma venereum (LGV), United Kingdom: 2003 to 2008*
Despite attempts to raise awareness among MSM and healthcare professionals, the infection has not been controlled. The UK LGV incident group would like to stress the importance maintaining awareness and prompt identification of potential cases.
References
1. Ward H, Martin I, Macdonald N, Alexander S, Simms I, Fenton KA, et al, for the UK LGV Incident Group. Lymphogranuloma venereum in the United Kingdom. Clin Infect Dis 2007; 44:26-32.
Further information:
http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/1191942171559?p=1191942171559
