LGV (Lymphogranuloma Venereum)
What is LGV?
LGV is a sexually transmitted infection caused by a specific type of Chlamydia Trachomatis (serovars L1, L2 and L3).
Symptoms can be complex and severe and may involve multiple sites in the body such as the genitals, the anus, rectum, oral cavity and lymph nodes.
Before 2003, LGV was considered rare in the UK with only a few cases reported every year which were thought to have been acquired abroad.
The number of cases of LGV in UK has risen steadily with most people reporting that they had probably acquired the infection in the UK.
Who gets LGV?
Like all sexually transmitted infections, anyone who has unprotected sex (i.e. doesn't use condoms) can catch LGV.
Recent cases of LGV in the UK have been confined to men who have sex with men.
Particularly high rates of LGV have been seen in men who have sex with men who are also HIV positive.
How do you catch LGV?
LGV is a sexually transmitted infection.
It can be caught by having unprotected vaginal, anal and oral sex, unprotected fisting and sharing of sex toys.
How do you know that you have LGV?
After exposure to infection, a small and painless ulcer appears where the bacteria entered your body (i.e. vagina, rectum, penis, oral cavity). It may heal itself and frequently goes unnoticed.
Disease progresses with painful swelling of the lymph nodes around the groin or other infected area. If the infection was acquired through anal sex symptoms of proctitis often develop (i.e. pain, rectal bleeding and discharge). Systemic symptoms such as fever and malaise are sometimes reported.
In cases which remain untreated a late stage can lead to scarring, swelling and deformity in the genitoanal area.
Some people with LGV may not experience any symptoms but they may still pass the infection on to their sexual partners.
How serious is LGV?
LGV can cause very painful symptoms; however, the infection can be treated with a course of antibiotics.
If left untreated the complications of the infection may require surgery.
Prevention
Sexually active men and women can reduce their risk of all sexually transmitted infections by reducing their numbers of partners, reducing frequency of partner change, and by using condoms correctly and consistently during sexual intercourse.
Latex gloves should be used for fisting and condoms should be used with sex toys.
Diagnosis
To diagnose LGV a doctor will have to take a sample from the urethra, rectum or other sites depending on symptoms and sexual practices. If this sample is found to be positive for Chlamydia, the bacteria will have to be genotyped in a reference laboratory to confirm LGV.
Most testing for sexual infections is done in STI clinics (called genitourinary medicine or GUM clinics) which have specialist facilities for testing and systems for contacting, testing and treating sexual partners. Details of these clinics can be found in the telephone book, from your local hospital or from the STI clinic directory on the web site of the British Association for Sexual Health and HIV (www.bashh.org). Clinics are confidential and will not inform general practitioners (GP) of any results, unless specifically requested to do so. You can attend one of these clinics at any age (even if you are under the age of consent to sex which is 16).
Testing for STIs is now offered by some GPs, contraception clinics and young people's sexual health clinics.
Treatment
LGV infection can be treated.
Most cases require a three week course of antibiotic treatment.
In severe cases, the late complications of LGV infection may need surgical repair, including reconstructive genital surgery.
Sexual partners should also be identified, tested and treated.
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