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Lymphoganuloma venereum in the Western world, 15 years after its re-emergence

new perspectives and research priorities

de Vries, Henry J.C.a,b

Current Opinion in Infectious Diseases: February 2019 - Volume 32 - Issue 1 - p 43–50
doi: 10.1097/QCO.0000000000000519
STD II: Edited by Karen E. Rogstad

Purpose of review Lymphogranuloma venereum (LGV) is a serious sexually transmitted infection caused by Chlamydia trachomatis. If left untreated LGV can cause irreversible late sequelae. LGV is endemic among a high-risk population of men who have sex with men (MSM), and largely reported in Western metropoles.

Recent findings Although the majority of LGV patients are HIV positive, in recent years the proportion of HIV-negative MSM with LGV is rising. This could indicate a shift toward lower risk populations. Apart from a few European countries, no proper LGV surveillance efforts have been implemented so far. Moreover, a considerable proportion of the infections are asymptomatic. As a result, the true magnitude of the LGV epidemic is underestimated.

Depending on the stage and location of infection, LGV manifests in a variety of clinical presentations. Among MSM, anorectal infections are overreported as opposed to genital LGV infections in a ratio of 15 to 1, respectively. Therefore, other modes of transmission apart from anal sex are here discussed.

Summary To improve surveillance, cheaper and more practical screening methods are needed. Moreover, randomized clinical trials are needed to evaluate more simple treatment modalities as opposed to the currently recommended 3-week course of doxycycline.

aDepartment of Infectious Diseases, STI Outpatient Clinic, Public Health Service of Amsterdam

bDepartment of Dermatology, Meibergdreef 9, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands

Correspondence to Henry J.C. de Vries, MD, PhD, Department of Dermatology, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands. Tel: +31 205662582; e-mail:

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