Update on lymphogranuloma venereum in the United Kingdom

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Abstract
Objectives: This report updates the UK epidemiology of lymphogranuloma venereum (LGV) to the end of April 2007. Methods: The Health Protection Agency’s Centre for Infections undertakes laboratory testing for LGV and subsequent epidemiological investigation of cases after laboratory confirmation of the LGV serovars (L1–3). Data analysis of enhanced surveillance and laboratory reports was undertaken. Results: From October 2004 to end April 2007, 492 cases of LGV have been diagnosed and enhanced surveillance forms have been returned for 423. Cases peaked in the third quarter of 2005 with an average of 32 cases per month, while in 2006 this fell to 12 cases per month. Nationally, the outbreak is focused in London, Brighton and the North West. All cases are in men, 99% of whom are MSM, with a median age of 40 and predominantly white ethnicity (91%). Co-infection remains considerable: HIV (74%); hepatitis C (14%); syphilis (5%); and other STIs including gonorrhoea, genital herpes and hepatitis B. The number of men reporting greater than 10 sexual contacts in the previous 3 months has reduced from 23% (47) to 13% (15) from 2005–2006. Discussion: The epidemic continues in the mostly white MSM population of the UK. The demographics of LGV remain similar to those previously described and high levels of HIV co-infection continue. Reduced numbers of sexual contacts might be contributing to the reduced numbers of LGV seen in 2006 but could simply mean that LGV is moving out of the highest risk groups.