Rapid Increase in Lymphogranuloma Venereum among HIV-Negative Men Who Have Sex with Men, England, 2019
Mateo Prochazka, Hannah Charles, Hester Allen, Michelle Cole, Gwenda Hughes, Katy Sinka
Abstract
L ymphogranuloma venereum (LGV) is an inva- sive form of Chlamydia trachomatis infection. In high-income countries, LGV is concentrated among gay, bisexual, and other men who have sex with men (MSM) (1). Although LGM was initially characterized as affecting predominantly MSM living with HIV who have symptomatic proctitis (2,3), recent evidence suggests considerable underestimation of the actual extent of LGV among MSM in Europe because of insuffi cient testing of asymptomatic persons (4). Changes to UK guidelines (5) and testing practices of several large London clinics have led to expanded testing in MSM regardless of HIV status, leading to increased diagnoses among HIV-negative MSM and those without symptoms of proctitis (6-9). Expanded testing may have precipitated a decline in incidence during 2016-2018 (9); however, 2019 saw the highest number of LGV diagnoses reported in England since routine testing began in 2004, and test positivity increased from 8.2% in 2018 to 9.0% in 2019 In this study, we investigated the changing epidemiology of LGV among MSM in England during 2015-2019 and risk factors associated with recent cases.