LGV (Lymphogranuloma Venereum)

Lymphogranuloma venereum (LGV) is a sexually transmitted disease caused by a specific type of Chlamydia trachomatis (serovars L1, L2, and L3). LGV is highly prevalent in parts of Africa, Asia, and South America but has been rare in Western Europe for many decades. LGV is a chronic disease that has a variety of acute and late manifestations, starting with a small painless blister or sore where the infection entered the body, that might go unnoticed. Inflamed and swollen lymph glands may then appear in the groin (inguinal syndrome) and/or acute hemorrhagic proctitis (anorectal syndrome) develops. If left untreated, the symptoms can become more severe and cause lasting damage to health.

Since 2003 a series of outbreaks of LGV have been reported in European cities among men who have sex with men (MSM). All current European outbreaks are of the L2 genotype. Most cases present with proctitis, are of white ethnicity, and are HIV-positive.

High levels of concurrent sexually transmitted infections (gonorrhoea, syphilis, Hepatitis B virus, and genital herpes) are also seen. Transmission of Hepatitis C virus has been associated with the LGV outbreak in Rotterdam, Netherlands. Contact tracing has been of limited use as most cases report multiple sexual contacts, mostly anonymous. So far there is no indication that LGV has spread outside this specific sub-group.

In response to the European reports, in October 2004 the HPA launched an initiative to improve LGV case ascertainment and awareness in the UK. By the end of December 2006 over 418 cases had been confirmed.An Enhanced Surveillance UK LGV Incident Team is overseeing the response. The number of cases peaked in June 2005.