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1 January 2007

Volume 44, Number 1
Clinical Infectious Diseases 2007;44:26–32
© 2006 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2007/4401-0005$15.00
DOI: 10.1086/509922
MAJOR ARTICLE

Lymphogranuloma Venereum in the United Kingdom

Helen Ward,1 3

Iona Martin,2

Neil Macdonald,1

Sarah Alexander,2

Ian Simms,1

Kevin Fenton,1

Patrick French,4

Gillian Dean,5 and

Catherine Ison2

1HIV and STI Section and 2Sexually Transmitted Bacteria Reference Laboratory, Health Protection Agency Centre for Infections, 3Department of Infectious Disease Epidemiology, Imperial College London, and 4Mortimer Market Centre, Camden Primary Care Trust, London, and 5Claude Nicol Centre, Brighton and Sussex University Hospitals, Brighton, United Kingdom

Background.Over the past 2 years, lymphogranuloma venereum (LGV), caused by L serovars of Chlamydia trachomatis, has emerged as a significant problem among men who have sex with men (MSM). We report on, to our knowledge, the largest case series of LGV to date, with detailed epidemiological and clinical characteristics of the epidemic in the United Kingdom.

Methods.A national diagnostic service and surveillance system was established in October 2004. Cases were confirmed by the presence of C. trachomatis and an LGV serovar (L1, L2, or L3) from genotyping. For confirmed cases, an enhanced surveillance questionnaire was sent to the clinician.

Results.Through February 2006, a total of 327 cases of LGV were confirmed. Cases were diagnosed across the United Kingdom, with the majority from London (71%) and Brighton (13%). Case reports were received for 282 MSM. The majority (96%) had proctitis, many with severe local and systemic symptoms. There was a high level of coinfection with human immunodeficiency virus (76%), hepatitis C (19%), and other sexually transmitted infections (39%). Nine cases of human immunodeficiency virus infection were diagnosed around the same time as LGV. Most cases were acquired within the United Kingdom, although patients with early cases were more likely to report contacts in The Netherlands.

Conclusions.We found a significant burden of this once‐rare sexually transmitted infection among MSM in the United Kingdom. LGV may be contributing to the epidemic of human immunodeficiency virus infection by facilitating transmission. Further control efforts are required, including awareness campaigns, continued detailed surveillance, and expanded chlamydia testing among MSM.

Received 15 June 2006; accepted 11 September 2006; electronically published 27 November 2006.

Reprints or correspondence: Dr. Helen Ward, Dept. of Infectious Disease Epidemiology, Imperial College London, Norfolk Place, London W2 1PG, United Kingdom ().

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