LGV (Lymphogranuloma venereum) in gay and bisexual men
What is LGV?
- LGV (Lymphogranuloma venereum) is a sexually transmitted infection caused by three strains of the bacterium Chlamydia trachomatis.
- Until 2004 it was rare in the UK and was mainly seen in travellers returning form abroad.
- From 2004 outbreaks of LGV occurred in gay men across Europe and the UK.
- In the UK outbreaks of LGV occurred amongst gay men in London, Brighton and Manchester
- LGV usually infects the rectum (back passage) leading to ‘proctitis’ – ulceration, anal pain, bleeding, discharge and constipation. The symptoms can sometimes be severe with fevers and feeling generally unwell.
- Testing (rectal swab) needs to be done at a specialised sexual health clinic.
- LGV is easily treated with 3 weeks of antibiotics.
- Co-infection with HIV and hepatitis C is common and a full STI screen is recommended.
How common is LGV?
- LGV is common amongst gay men in London particularly in those visiting clubs and saunas.
- There have been over 1000 infections reported in gay men since the start of the outbreak in 2004 and the infection is continuing to spread.
- 75% of men with LGV are also HIV positive.
How do you catch LGV?
- LGV is passed on through unprotected sex – usually anal sex without a condom – but any of the following ways is possible:
- Anal sex
- Oral sex
- Fisting without gloves
- Using sex toys between partners
What would I notice if I had LGV?
- Most infections are caught through anal sex – this leads to inflammation in the rectum or ‘proctitis’:
- Anal pain
- Rectal bleeding
- Rectal discharge
- Feeling of wanting to defecate
- A small painless ulcer may occur at the site of infection – such as rectum, penis or mouth
- Painful swelling of lymph glands in the groin
- Feeling flu like with fever and tiredness
- Symptoms may appear within a few days or up to 4 weeks after infection
How do I get tested for LGV?
- A chlamydia swab from the rectum (back passage).
- Specialist sexual health clinics such as the Wolverton routinely screen all gay men for rectal chlamydia.
- If you had any of the symptoms above and chlamydia was found, the swab would be sent onto a UK reference laboratory for a special LGV test.
How is LGV treated?
- With a 3 week course of antibiotics:
- Doxycycline 100mg twice daily for 3 weeks.
- All treatments from the Wolverton Centre are free and are given to you in the clinic
- Take doxycycline after food otherwise it make you feel sick.
- Avoid strong sunlight as it may cause a rash.
What about my partner?
- LGV is a sexually transmitted infection so it is important your current and recent partners in the last 4 weeks attend a sexual health clinic for testing and treatment.
What problems can untreated LGV lead to?
- LGV may lead to serious problems in the rectum and lower bowel with acute inflammation, ulceration, fistulae and strictures often mimicking Crohn’s disease.
Will LGV come back again after treatment?
- LGV quickly clears up with antibiotic treatment but you can easily be re-infected again – so protect yourself by using a condom for all anal sex, gloves for fisting and avoid sharing sex toys.