Abstract
BackgroundIn recent years a few cases of lymphogranuloma venereum (LGV) in heterosexuals in Europe have been reported. It is not known whether LGV transmission among heterosexuals occurs on a wider scale.MethodsHeterosexual male and female STI clinic clients (n = 587) in Amsterdam, the Netherlands, with a positive nucleic acid amplification test (NAAT) result for Chlamydia trachomatis (CT) were screened for IgA anti-MOMP in serum. If the value was above the cut-off index (2.0) the patient’s CT positive urogenital, ocular or rectal sample(s) were selected and tested for LGV by an in-house LGV-specific NAAT.ResultsSera of 126 patients were above 2.0 COI. Some patients had >1 CT positive sample. Samples could not be retrieved from 15 of the 126 persons, and 7 samples that were found positive for CT in the diagnostic amplification process could not be confirmed and hence not typed. We did not find a single case of LGV infection in 123 urogenital, ocular or rectal samples from 104 patients.ConclusionWe found no indications for significant spread of LGV infection in heterosexuals in Amsterdam. Surveillance in females with cervical or anal CT infection is indicated to monitor LGV occurrence in heterosexuals.
Highlights
In recent years a few cases of lymphogranuloma venereum (LGV) in heterosexuals in Europe have been reported
In 2009, rectal LGV was diagnosed in a female patient with proctitis in France [3] and in 2011, inguinal LGV was diagnosed in a female patient in the Netherlands, [4] Both women were infected with strain L2b, indicating
We showed that an IgA anti-MOMP assay had an unexpected high sensitivity and specificity (75.5% and 74.3% respectively) to identify or exclude LGV in Chlamydia trachomatis (CT) infected men who have sex with men (MSM) [7]. This assay had been evaluated in MSM and not in heterosexuals, we considered it quite likely that LGV in heterosexuals might lead in the same manner to a positive IgA anti-MOMP result
Summary
In recent years a few cases of lymphogranuloma venereum (LGV) in heterosexuals in Europe have been reported. In 2009, rectal LGV was diagnosed in a female patient with proctitis in France [3] and in 2011, inguinal LGV was diagnosed in a female patient in the Netherlands, [4] Both women were infected with strain L2b, indicating. In this retrospective study we attempted to estimate if and to what extent LGV is occurring among heterosexual clients of the sexually transmitted infections (STI) clinic with proven CT infections. The gold standard diagnosis for LGV is based on an in-house developed LGV-specific nucleic acid amplification test (NAAT) [5]
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