Sexual Health News
Lymphogranuloma Venereum (LGV)
Since 2003 this sexually transmitted infection (LGV), rare in Great Britain but common in the Caribbean, Africa and South East Asia, has appeared in outbreaks among gay men in a number of European countries neighbouring the UK. Cases of LGV among UK gay men were also diagnosed in 2004.
What is LGV?
Lymphogranuloma Venereum (LGV) is a bacterial infection caused by three sub-types of Chlamydia tracchomatis (types L1, L2 and L3). These sub-types are far more destructive than the variants of the Chlamydia bacterium normally found in the UK. What separates them from the more common Chlamydia bacteria is their ability to infect the lymph nodes, causing them to become inflamed and to drain liquid, and the potentially devastating effects on surrounding tissue caused if the infection goes untreated.
How LGV is passed on?
LGV is almost exclusively transmitted sexually. The following acts (both receptive and insertive), are the most usual transmission methods: fellatio (sucking), anal intercourse; and ‘fisting’. These acts, unless using condoms or latex gloves, are the most common routes of transmission, though LGV can also be passed on by sharing sex toys.
Who is most at risk from LGV?
If infection becomes more widespread the profile of those contracting LGV could alter but, to date, gay men infected with LGV are overwhelmingly from a population who are: likely to be HIV+; have many sexual partners; have unprotected anal intercourse and or fist or get fisted without latex gloves; go to sex parties, sex clubs, leather bars and saunas; have had sex in cities with recent outbreaks or have had sex with men linked to these places.
A small outbreak of around half a dozen cases was reported in Hamburg in 2003, nearly 100 reported in Rotterdam in 2003/2004 (with cases in other Dutch cities including Amsterdam), nearly 40 in Paris and 30 in Belgium (Antwerp). Cases have also been recorded in cities as far apart as Bordeaux and Stockholm. Infected men have reported having sex with men from the UK and UK cases were confirmed in November 2004.
How can the spread of LGV be prevented?
There is no vaccine against the bacteria and having had LGV before does not provide immunity. Condom use for anal sex, and latex gloves for fisting, offer a large degree of protection. When more than two men are having sex a new condom or glove should be used with each man. Sex toys should be covered with a condom and not shared.
LGV should be considered as a possible cause for any case of rectal inflammation. Regular screenings for STIs are advised for men with large numbers of sexual partners.
Links with other STIs.
Among recent cases have been documented cases of men contracting LGV along with Hepatitis C. Also, if two men have sex and one has HIV, then LGV makes HIV transmission more likely. As with other ulcer-causing STIs (syphilis and herpes), damaged mucosal membranes and internal tissue, together with bleeding, give HIV more opportunity to leave one body and enter another.
Source: CHAPS sector summary report