Abstract



2019 EUROPEAN GUIDELINE ON THE MANAGEMENT OF LYMPHOGRANULOMA VENEREUM

Henry de Vries

STI Outpatient Clinic, Cluster Infectious Diseases, Health Service Amsterdam, Amsterdam, The Netherlands; Amsterdam UMC, University of Amsterdam, Department of Dermatology, Amsterdam Institute for Infection and Immunity (AI&II), Meibergdreef 9, Amsterdam, The Netherlands

Introduction

Lymphogranuloma venereum (LGV) is endemic among European men who have sex with men (MSM) since 2003. It is a relatively common cause of proctitis, but rarely causes genital or oro-pharyngeal infections. In this presentation new and important issues in the 2019 version will be discussed.

Epidemiology

  • LGV continues to be endemic among European men who have sex with men (MSM) since 2003.
  • LGV infections in heterosexuals are extremely rare in Europe, and there is no evidence of transmission of LGV in the European heterosexual population.

Aetiology and transmission

  • Chlamydia trachomatis serovars/genovars L2b and L2 are the causative strains in the majority of cases in Europe.

Clinical features

  • Among MSM, about 25% of the anorectal LGV infections are asymptomatic. 
  • Genital infections among MSM are rare; the ratio of genital vs. anorectal LGV infections is 1 in 15.

Diagnosis

  • To diagnose LGV, a sample tested C. trachomatis positive with a commercial nucleic acid amplification test (NAAT) platform should be confirmed with an LGV discriminatory NAAT.  

Treatment

  • Doxycycline 100 mg twice a day orally for 21 days is the recommended treatment for LGV.
  • This same treatment is recommended also in asymptomatic patients and contacts of LGV patients. If another regimen is used a test of cure (TOC) must be performed.

46|h.j.devries@amsterdamumc.nl|W1-7
34 IUSTI Congress - European Congres on Sexually transmitted Infections and HIV/AIDS
TAMING THE TIDE of STIs & HIV
Bucharest, September 3-5,