What is it LGV?
Lymphogranuloma venereum (LGV), is a treatable sexually transmitted infection (STI) caused by a bacterium from the chlamydia family. LGV can infect the genitals, anus, rectum (back passage), throat or lymph glands. LGV is mostly commonly found among gay and bisexual men in the UK.
It is acquired from condomless anal, vaginal or oral sex. Engaging in certain sexual practices (eg group sex and fisting (hand is inserted into a partner's rectum) and taking recreational drugs during/around sex increases the risk of LGV transmission. The bacteria can also be carried from one rectum to another from sex toys, fingers, enema equipment, condoms or latex gloves. Infection with LGV could make it easier for you to transmit or acquire HIV.
How does it affect you?
LGV commonly causes symptoms which usually appear within 3-30 days. However some people are asymptomatic.
Most UK LGV infections are found in the male rectum where symptoms include a discharge of mucus and/or blood from the anus/rectum, ulcers or cuts around the anus, pain when they pass a motion or have (receptive) anal sex (proctitis). They may feel constipated or have diarrhoea or a feeling that they have not completely emptied their bowels after passing a motion. LGV in the penis might cause an ulcer, discharge and/or pain on passing urine. Lymph glands in the groin can be swollen. LGV in the mouth or throat is rare but it can cause ulcers, sore throat and swollen glands in the neck. In some cases LGV causes a fever, fatigue and abdominal pain.
LGV Diagnosis
SHL does not test directly for LGV, but if your rectal swab comes back positive for chlamydia and LGV is suspected, you will be referred to a sexual health clinic to have further tests to confirm whether you have LGV or not.
LGV is identified in clinic using a rectal swab, but it can be detected from other genital swabs (vagina, penis), genital ulcers, throat swab, urine and/or pus from swollen lymph nodes. The LGV result can take some time to come back, so your clinic doctor may advise you start treatment for LGV whilst waiting for the result.
Treatment
LGV is usually treated with an antibiotic called doxycycline taken for three weeks. Symptoms should resolve within 1 to 2 weeks but may take up to 3-6 weeks in people with longstanding infection.
Some early LGV infections are initially asymptomatic but symptoms might develop prior to or during the initial days of treatment. Ultimately, these symptoms should also settle promptly.
There are usually no lasting effects, when the infection is treated early enough. Longstanding infection or delayed treatment may lead to scarring and swelling of the skin and blockages in the bowel, permanent swelling of the genitals, arthritis and problems with the liver and lungs.
Contacting partners
If you have test positive for LGV and have symptoms, you will need to inform sexual partners from within the last four weeks. If you don’t have any symptoms, this “look back” period for contacting partners goes further back to three months and sometimes longer.? Your sexual contacts should attend a sexual health clinic for testing and may also be offered treatment on the day they attend. If you feel unable to inform previous sexual partners one of our Health Advisers will be able to notify them on your behalf without revealing your identity if you prefer.
Maintaining good sexual health and preventing re-infection
You should not have oral, anal or vaginal sex during your course of treatment?and?also until your current partner completes their treatment?and?until both you and your partner’s symptoms have abated. This is to avoid reinfection and requiring further treatment.
If you have LGV it is possible you may also have another STI. Therefore it is advisable that you have a full sexual health screen for Gonorrhoea, Chlamydia, Syphilis, HIV, Hepatitis B and Hepatitis C and consider having another STI screen three months after treatment because there is a higher risk of acquiring a further STI (eg HIV) over the next year.
Previous successful treatment for LGV doesn't make you immune so protect yourself by using condoms and lubricant. Cover anything which is moved from one rectum to another with a fresh condom (eg sex toys) or fresh latex glove for each new person it enters (for eg fisting), or clean it with warm water and anti-bacterial soap. Enema equipment should not be shared.
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