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LGV

lgv

LGV stands for ‘lymphogranuloma venereum’, a type of chlamydia bacteria that attacks the lymph nodes. It is very rarely seen in heterosexual men and women in the UK but cases are being seen among gay and bisexual men.

Symptoms of LGV:

Nearly all LGV infections seen in the UK in recent years have been in the rectum.

Within a few weeks of becoming infected most people get painful inflammation in the rectum (known as ‘proctitis’) with bleeding, pus, constipation or ulcers. They can also get a fever and feel unwell.

A small sore might appear where the bacteria got into the body but most people don’t notice one.

Left untreated LGV can cause lasting damage in the rectum that may require surgery.

LGV in the penis might cause a discharge and pain when urinating, with swollen glands in the groin.

LGV in the mouth or throat is rare but it can cause swollen glands in the neck.


How it's passed on

LGV bacteria usually enter the body through the delicate, moist skin of the rectum and penis.

Women can also get infected through the vagina. Infection through the mouth and throat is possible but rare.

Gay and bisexual men have contracted LGV from having anal sex without condoms and from 'fisting' - when a hand is inserted into a partner's rectum.

The bacteria can also be carried from one rectum to another during group sex, on objects such as sex toys, fingers, enema equipment, condoms or latex gloves.


How to avoid infection:

Cover anything which is moved from one rectum to another with a fresh condom or fresh latex glove for each new person it enters, or clean it with warm water and anti-bacterial soap.

Enema equipment should not be shared.

Having LGV could make it easier for you to get or pass on HIV. But if you have HIV and your treatment has made your viral load undetectable then LGV or other infections don’t appear to make you more likely to pass on HIV.


Testing for LGV

If you’re a gay or bisexual man with possible LGV symptoms, a sexual health clinic will use a swab (a small cotton bud) to take a sample from your rectum and penis.

If a woman is thought to be infected, swabs will be taken from her vagina and cervix.

The samples are initially tested for chlamydia. If it tests ‘positive’ it is then also tested for LGV.

People you’ve had sex with also need to get checked - a clinic can contact them for you if you don’t want to. If you have had LGV once you can get it again.


Treatment

Antibiotics cure LGV with no lasting effects, as long as the infection is treated early enough.

Don’t have sex until treatment has finished or you could pass on the infection.

Most people get tested and treated for infections like LGV at sexual health (or ‘GUM’) clinics. It is free and confidential - no-one else, including your GP, will be told about your visit. However, it is best to go to a sexual health clinic if you have any possible LGV symptoms, because some GPs have misdiagnosed LGV.


Remember:

The more people you have sex with (especially unprotected sex), the more chance you have of contracting infections such as LGV.

You can have them without knowing, so regular check-ups are a good idea, especially if starting a new relationship and/or you want to stop using condoms with your partner.


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The Information Standard: Certified member

This article was last reviewed on 15/9/2015 by Anna Peters

Date due for the next review: 15/9/2018

Content Author: R. Scholey

Current Owner: Health Promotion

More information:

NHS Choices, Open your eyes to STIs, October 2013

NAM aidsmap, LGV (Lymphogranuloma venereum) by Michael Carter, Selina Corkery

STIs make no difference to HIV transmission in those with suppressed viral load. Rodger A et al. HIV transmission risk through condomless sex if HIV+ partner on suppressive ART: PARTNER study. 21st Conference on Retroviruses and Opportunistic Infections, Boston, abstract 153LB, 2014.

STIs make no difference to transmission risk in those with suppressed viral load: Davies O et al. Impact of rectal gonorrhoea and chlamydia on HIV viral load and inflammatory markers in the rectum; potential significance for onward transmission. BHIVA conference, Thursday 23 April 2015, abstract O19

Hunter, H. Color Atlas and Synopsis of Sexually Transmitted Diseases (second edition)  McGraw-Hill, Handsfield, (2001)

McMillan A, Scott GR. Sexually Transmitted Infections (second edition), Churchill, Livingstone, (2000)

BASHH LGV guidelines, BASHH (2013)

British Association for Sexual Health and HIV, Clinical Effectiveness Group, National Guidelines for the Management of Lymphogranuloma Venereum (LGV) (2006)

Edited by Stephen Morse et al, Atlas of Sexually Transmitted Diseases and AIDS, Third Edition, Mosby (2003)


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