Lymphogranuloma venereum

LGV (Lymphogranuloma venereum) in gay and bisexual men

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.

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.

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

Most infections are caught through anal sex – this leads to inflammation in the rectum or ‘proctitis’:
- Anal pain
- Rectal bleeding
- Rectal discharge
- Constipation
- 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

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.

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.

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.

LGV may lead to serious problems in the rectum and lower bowel with acute inflammation, ulceration, fistulae and strictures often mimicking Crohn’s disease.

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.