Venereal lymphogranulomatosis: what is this STI that is exploding in France and Europe?

An alarming increase in sexually transmitted infections has been observed in the European Union, including France.

In addition to cases of gonorrhea, syphilis, and other chlamydiases, the spread of a lesser-known STI is of concern: lymphogranulomatosis venereum (LGV).

This infection, which has increased by 58% in one year, can manifest itself with symptoms that are sometimes very serious.

“As surprising as the increase is, it’s alarming.” It is in these terms that the European Center for Disease Prevention and Control (ECDC) warned about the wave on March 7. “worrying” The prevention of sexually transmitted infections (STIs) observed in the European Union calls for increased action. Although statistics are important, “Probably represents only the tip of the iceberg, as data” Can be underestimated, however, explained ECDC director Andrea Amon during a press conference.

In addition to an increase in already known diseases, including gonorrhea, syphilis and other chlamydiases, especially among young Europeans, the ECDC also warned of an alarming increase in cases of lesser-known STIs, starting with lymphogranulomatosis venereum (LGV). And for good reason, during the study period (2021-2022), this has increased by 58% or 2059 cases. The only four countries that account for 84% of the recorded pollution are France, but also Belgium, Spain and the Netherlands. To prevent this spread, ECDC recommends, as with all STIs, protect yourself by using condoms during sex.

What are we talking about?

Little known, venereal lymphogranulomatosis, also called Nicholas-Faver disease, endemic to certain tropical and subtropical regions, was rare in industrialized countries until the early 2000s. It is a sexually transmitted infection caused by subtypes of bacteria in the Chlamydia trachomatis family. she “Transmitted through anal intercourse and practices such as fist-fucking and use of sex toys or anal irrigation”, The ECDC report clarifies.

It is diagnosed by a blood test that will detect the presence of the bacteria or by sampling if symptoms are present. LGV is diagnosed through a blood test or samples if symptoms are present. Antibiotic treatment may then be prescribed for two weeks to clear the infection completely. Please note that to avoid transmission of infection, it is necessary to protect yourself sexually during the entire period of treatment.

How does the infection manifest itself?

Without treatment, the disease progresses through three stages. It is first characterized by the appearance of lesions at the point of entry of the bacteria into the body (anus, rectum, mouth, etc.), usually between 3 and 30 days after transmission. These first symptoms may appear in the form of rectal ulcers, bleeding, blisters and fissures in the rectum or anus, discharge of blood and pus from the infected area, but also abdominal pain, fever and significant fatigue.

While this usually disappears on its own without the need for treatment, thus going unnoticed, it can be followed by serious complications of the disease, because the bacteria are still present in the body. In the second stage of the disease, usually between two and six weeks after infection, painful swelling of the lymph nodes (adenopathy) in the groin or neck may appear and last for several weeks to several months, as may bloody discharge. Pus from the anus or muscle and/or joint pain, fever and chills.

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In the tertiary stage of the disease, untreated symptoms can lead to narrowing or perforation of the vagina, rectum, or intestine, which is associated with chronic, potentially irreversible inflammation. Blockage of lymphatic vessels can cause swelling of the genitals and, in rare cases, inflammation of the liver or joints. Note that to prevent such complications of LGV, early diagnosis is essential.

More risk to patients?

However, the ECDC regrets that diagnostic capacity for this disease is still very limited in some European Union countries, which “Infection control is difficult and limits the availability of epidemiological data”.

“LGV is more common in men who have sex with men and are living with HIV infection,” However, observe ECDC which anticipates increased vulnerability in these patients. “Between 2018 and 2022, the proportion of HIV-negative LGV cases increased from 47% in 2018 to 69% in 2022,” It is clarified.